De Quervain’s Tenosynovitis is a hand condition affecting a patients’ ability to move their thumb. It used to be referred to as washerwoman’s sprain or mother’s wrist but with the advent of technology, is now commonly referred to as “Blackberry thumb” from typing and texting on small handheld devices.
De Quervain’s Tenosynovitis is named after the Swiss surgeon who first identified the condition, Dr. Fritz de Quervain. Patients with this condition have difficulty gripping objects and performing their daily activities.
De Quervain’s Tenosynovitis is a hand condition affecting a patient’s ability to control movement of their thumb. There are two tendons which control thumb movements. These tendons are housed in a small tunnel or sheath which is lined with a soft, smooth tissue layer called synovium. Synovium enables the smooth gliding movements of the tendons within the sheath. Inflammation of the synovium lining affects the ability to move the thumb freely and is the cause of De Quervain’s tenosynovitis.
Signs and symptoms
Commonly reported symptoms associated with De Quervain’s tenosynovitis include the following:
Causes and risk Factors
The cause of De Quervain’s tenosynovitis is idiopathic or unknown. However, there are certain risk factors that may increase your chance of developing the condition. These can include the following:
Hand and wrist conditions should be evaluated by an orthopedic hand surgeon for proper diagnosis and treatment. Your surgeon will perform the following:
De Quervain’s tenosynovitis is diagnosed based on a simple test called the Finkelstein Test. Your doctor will ask you to make a fist with your fingers closed over the thumb and the wrist angled towards the pinky finger. This maneuver is usually painful over the tendons in the thumb side of the wrist in patients with this condition.
Conservative treatment options
Your surgeon will recommend conservative treatment options to treat your condition if you are experiencing pain and are having difficulty using your hands for everyday activities. Treatment options will vary depending on the severity of the condition. Conservative treatment options may include the following:
If conservative treatment options fail to resolve the condition and symptoms persist for 6 months or more and your quality of life is adversely affected, your surgeon may recommend you undergo a surgical procedure to open the tendon sheath and allow more room for tendon movement.
This surgery is usually performed in an operating room under local or regional anesthesia on an outpatient basis as day surgery. Your surgeon makes a small incision over the affected tendons in the wrist area. The surgeon then cuts the sheath or tunnel that holds the tendons giving them more room to move. The incision is then closed with sutures and covered with a sterile dressing.
After surgery your surgeon will give you guidelines to follow. Common post-operative guidelines include:
Your surgeon may recommend occupational therapy for strengthening exercises and measures to prevent recurrence.
Eating a healthy diet and not smoking will promote healing.
Risks and Complications
As with any major surgery there are potential risks involved. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery takes place.
Complications can be medical (general) or specific to hand surgery. Medical complications include those of the anesthetic and your general wellbeing. Almost any medical condition can occur so this list is not complete.
Risks and complications of surgery
The majority of patients suffer no complications following tendon release surgery; however, complications can occur and include:
Risk factors that can negatively affect adequate healing after surgery include:
A good knowledge of this procedure will make the stress of undertaking the procedure easier for you to bear. The decision to proceed with the surgery is made because the advantages of surgery outweigh the potential disadvantages. It is important that you are informed of these risks before the surgery.