deQuervain's tenosynovitis involves the inflammation of the tendons to the first extensor compartment. These tendons include the abductor pollicis longus tendon and extensor pollicis brevis tendon. It is often seen in post-partum females because they are lifting their young children which causes an inflammatory response above the respective tendons. It can also been seen in post traumatic instances as well as patients that have an underlying systemic disease such as diabetes. Initial course of treatment is an injection of cortisone into the area about the inflamed tendons as well as splinting involving the wrist and thumb and forearm. The vast majority of patients will improve with this. Approximately 15% of patients will not receive relief from the above outlined treatment. In these cases, surgical intervention is warranted.
This is a procedure which is done under local anesthesia and involves the division of the tendon sheath at the level of the first extensor compartment on the dorsal radial aspect of the wrist. In addition to dividing the sheath, often inflammatory tissue is found and/or cystic material and this is also removed during the surgical procedure. Postoperatively, a subcuticular or a dissolvable stitch is placed for cosmetic purposes and a bandage is placed for approximately 10 days. The patient can utilize the hand immediately for light duties and/or typing and writing. After the 10 day course, the bandages are removed and a brief period of therapy may or may not be indicated.