De Quervain Tendinosinovitis Summary

Reference:Mardani-Kivi M et al Corticosteroid injection with or without thumb spica cast for de Quervain tenosynovitis. J Hand Surg Am. 2014 Jan;39(1):37-41.

In case you ever wondered where the name for this painful thumb condition came from, it is named after Dr. Fritz de Quervain, the Swiss surgeon who first identified the condition in 1895.

De Quervain Tenosynovitis also known as ?mommy thumb? and ?Blackberry thumb? can be a challenging condition to treat. Pain management is especially difficult when individuals are involved in activities that require the repetitive use of their extensor and abductor pollicis muscles such as typists, carpenters or mothers carrying their new born.

For diagnosis, the Finkelstein’s test usually immediately reproduces their pain. In case you are again wondering, the name comes from Dr. Harry Finkelstein, an American surgeon who described the test in 1930.

Although I am generally anti-corticosteroid injections into tendons, I actually support its use in de Quervain as I have not yet found another magic cure for it.

This recent study compared the efficacy of a corticosteroid injection with or without thumb spica cast for de Quervain tendinitis.

Patients with de Quervain tenosynovitis were randomly assigned into two groups:

Group 1: Corticosteroid injection (40 mg of methylprednisolone acetate with 1 cc lidocaine 2%)

Group 2: Corticosteroid injection + thumb spica fiberglass cast for 3 weeks

Result: The treatment success rate was 69% for group 1 and 93% for group 2.

Personal Comment: It appears that if a patient is unresponsive to 4-6 weeks of conservative PT treatments, then suggest to the patient to consult an MD for an injection followed by 3-4 weeks of thumb splitting.

Posted on: June 12, 2014

Categories: Wrist & Hand

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