de Quervain Syndrome
Definition
Inflammation of two tendons (abductor pollicis longus and extensor pollicis brevis) and associated synovial membranes on the thumb side of the wrist (tenosynovitis).
Symptoms
- Radial (thumb side) wrist pain that increases with extended activity.
- Increased pain with grasping and lifting.
Pathology
- Shearing (friction) forces create inflammation and thickening of the extensor retinaculum (band shaped ligament that holds the extensor tendons in place on the back of the hand).
- The inflammation creates stenosing (narrowing) of the synovial membrane tunnel that the tendons glide through (stenosing tenosynovitis).
- Repetitive thumb adduction and ulnar deviation (hammering motion) creates the shearing forces.
Treatment
Non-surgical
- Rest, activity modifications, thumb-spica splint/brace, ice and NSAIDs (ibuprofen)
- Corticosteroid injection
Surgical
- de Quervain’s Release
- Indicated when non-operative treatment fails.
- The dorsal retinaculum covering the synovial membrane and tendons is incised (released).
- See Post-op de Quervain’s Release instructions for information on surgical recovery.