Abstract

Outcome of surgical resection of de quervain’s stenosing tenosynovitis

Author(s): Taufiq Morshed, Md Zahid Ferdous, Md Atiquzzaman, Dibakar Sarkar and Ananta Kumar Sen

Introduction: It is thought that repetitive and forceful manual work with wrist deviated to ulnar wards and thumb abducted and extended may lead to de Quervain’s tenosynovitis. There is a lot of treatment option both operative and non-operative for this condition. However, surgical decompression is considered when conservatives measures failed after tried for 3-6 months. But there are some complications such as neural adhesion or neuroma formation, subluxation of the volar tendon, scar hypertrophy, radial sensory nerve injury, reflex sympathetic dystrophy, infection, etc. Materials and Methods: The study was an interventional type of prospective study done at Kurmitola General Hospital from September 2017 to July 2019. A total of 31 patients of de Quervain’s tenosynovitis were included in the study precisely following inclusion and exclusion criteria. Among them, 2 patients could not be followed-up. Results: Two (6.9%) patients had not improved after 1 year of follow-up. Rest 27 (93.1%) cases were cured as there were insignificant pain or tenderness, below 4 VAS score and negative Finkelstein test. Preoperative VAS score was reduced from 8.1 ± 1.29 to 1.41 ± 2.23 at 1 month, 1.24 ± 2.15 at 6 months, and 1.10 ± 2.26 at 12-month follow-up. Functional outcomes measured using Quick DASH were also reduced significantly. Preoperative Quick DASH score was 75.39 ± 14.27 which was reduced to 16.85 ± 18.26 at 1 month, 13.56 ± 20.42 at 6 months and 15.05 ± 22.24 at 12-month follow-up. One patient developed an infection and cured with an antibiotic. Two patients had tendon subluxation after the operation where 1 cured and others had some problems. No other complication noted. Conclusion: The findings in our study showed that most of the patients were completely relieved from de Quervain’s tenosynovitis with very few complications. However, there was a limited follow-up. The surgical procedure was also time-consuming as done at OT with proper aseptic precaution. Despite those limitations, simple surgical resection in de Quervain’s tenosynovitis showed a very good treatment option.s.