deQuervain[ management and tretament .ppt

inflamation

1. Management of
DeQuervain’s Syndrome

2. 2
Introduction
=DeQuervain's syndrome
=Washerwoman's sprain
=Radial styloid tenosynovitis
=De Quervain's disease
Named after Swiss surgeon Fritz de
Quervain (1885)

3. 3
Definition
a painful inflammation
of the tendons in the first
dorsal compartment of
the wrist
The lubricating synovial
sheath lining this
compartment thickens
and swells
involves : the abductor
pollicis longus (APL)
and the extensor pollicis
brevis (EPB).
 

4. 4
Incidence
omost often in individuals between the ages
of 30 and 50.
oWomen : 8 to 10 times more often than
men.

5. 5
Etiology
 
Anything that:
changes the shape of the compartment or
causes swelling or thickening of the
tendons:
–Repetitive trauma
–Overuse
–Inflammatory process
–Unknown (frequently)

6. 6
Sign and Symptoms
Pain over the thumb side of the
wrist (primary symptom)
Swelling over the thumb side
"snapping" when the thumb is
moved
 decreased thumb motion
 skin raising
prominence of the radial
styloid.

7. 7
How to Diagnose
Finkelstein Test
1.bending thumb into
the palm of hand
2.make a fist
3.bend the wrist away
from the thumb
towards the small
finger

8. 8
Treatment
Medical therapy
–Rest of the thumb and wrist (with or without
splinting)
–anti-inflammatory drug
–Steroid injection
Surgical Therapy

9. 9
Surgical Treatment

10. 10
Imaging
not necessary for routine diagnosis
Radiographs are negative
helpful to differentiate between the patient who
has deQuervain tendinitis and one who has
osteoarthritis at the thumb CMC joint or who has
both conditions.

11. 11
Complications of Surgery
Superficial radial nerve injury
Subluxation of released tendons
Neuritis
Persistent entrapment symptoms

12. Thank you