DeQuervains Tenosynovitis

Dr. Steven Rueda is one of the most sought after doctors for DeQuervains tenosynovitis in Palm Beach. The condition arises from inflammation of the lining that covers the wrist tendons. These tendons help move the thumb out of the palm. It is very common on woman during and shortly after pregnancy. It is also common in patients with poorly controlled diabetes.

DeQuervains Tenosynovitis Symptoms and Diagnosis

The symptoms arising from DeQuervains are related to inability of the tendon to glide easily through the pulley system. Some of the most common symptoms include:

 

  • Pain after bending the thumb down
  • Pain moving the wrist from side to side
  • Locking and crepitus in the wrist when moving the thumb

In some cases patients present with all of the symptoms, and in some cases only with some of them. In some cases patient’s present only with pain on the wrist with no locking or crepitus.

The diagnosis of DeQuervains is usually performed by clinical examination and history.

WHAT CAUSES DeQuervains Tenosynovitis?

The tendons affected by DeQuervains head towards the thumb through a tunnel that passes by a structure called the “extensor retinaculum”. This tunnel is very tight, and any inflammation in the tendon limits the ability of the tendon to glide smoothly. Patients with DeQuervains have increased inflammation in the tendon lining which leads to increased friction in the tunnel. These changes translate into symptoms of locking, catching, pain, and limited motion of the thumb.

DeQuervains Tenosynovitis Treatment Options

There are three main ways to treat DeQuervains: activity modification and splints, steroid injections, and surgery. Splints are effective for some patients, particularly those with recent onset and those with pain only during movement. Steroid injections are an excellent alternative for most patient’s who present for the first time for evaluation. An injection containing steroid and local anesthesia is placed around the tendons to reduce the inflammation in the area. Dr. Rueda likes to perform these with ultrasound guidance for precise placement. Injections may cure the symptoms in 50-70% of the patients. Dr. Rueda uses ultrasound to ensure the injection is optimally placed in the location needed. Surgery is indicated for patients who have failed conservative treatment and steroid injections. The advantage of surgery is it has the highest success rate of all the options previously mentioned.
Dr. Rueda performs DeQuervains using a traditional open surgery. The procedure removes inflammation from the tendon lining and opens up the tight tunnel or “pulley”, leading to increased room for the thumb tendons.

DeQuervains Tenosynovitis Procedure

Dr. Rueda performs DeQuervains using a traditional open surgery. The procedure removes inflammation from the tendon lining and opens up the tight tunnel or “pulley”, leading to increased room for the thumb tendons.

Incisions

Made along a vertical direction in line with the forearm.

RECOVERY AND DOWNTIME

Outpatient procedure. Most patients are actually surprised at having less pain that they expected. There is tightness, swelling for the first few days after surgery. An elastic bandage is applied and removed in a day. The patient then begins therapy to gradually increase the movement in thumb and wrist.

Most patients generally return to work in 1-2 days. Weight lifting and manual exercise is not allowed until 3 weeks after the surgery.

Why Choose Precision Hand Center for your DeQuervains Tenosynovitis Procedure?

Dr. Rueda, a Hand Fellowship trained surgeon who has 7 years and 2,000 procedures of experience will be your safe and best choice for DeQuervains. Successful results in this procedure requires a surgeon that is experienced and knowledgeable in hand surgery and hand anatomy. Dr. Rueda has published articles in peer reviewed journals and his work has been presented in several national conferences. Dr. Rueda’s passion for patient education and custom centered approach will guarantee you feel comfortable every step of the way. Dr. Rueda also believes in treating his patients as if he was treating his own family; you can trust you will enter a trusting and long-term relationship and have some of the best DeQuervains treatment Palm Beach can offer.

FREQUENTLY ASKED QUESTIONS (FAQ)

Patients with classic history, symptoms, and exam who have failed conservative treatment are good candidates for the procedure.

It is uncommon but its possible. The recurrence rate of DeQuervains is very small. If it happens surgery focuses on releasing the tendon from scar and freeing up more of the tunnel if needed. Activity modification may also be recommended.

Complications are very rare in DeQuervains surgery; it is a very safe procedure. Some of the uncommon risks include infection and bleeding of the surgical site. There are also other major complications that are very unlikely including damage to the radial nerve or thumb tendons.