Quervain's tenosynovitis is a pathology that affects the synovial sheath of the tendons in the thumb (thumb of the hand), namely the tendons of the long abductor muscles of the thumb and the short extensor of the thumb. The disease occurs more frequently among women.

The role of the synovial sheath is to protect and nourish the tendons, and its inflammation is called tenosynovitis.

activities or certain trades that involve intense, excessive use of the hand leading to an inflammation of the area (pianists, typists, tailors)

repeated minor injuries to the area

practicing certain sports that overload the joint (tennis, volleyball, bowling)

pregnancy due to hormonal changes

Signs and symptoms of Quervain's tenosynovitis include:

swelling (swelling) of the wrist

pain when mobilizing the thumb and ulnar deviation of the radiocarpal joint

sensitivity / pain to palpation and percussion of the anatomical tobacco

thumb stiffness

hypoaesthesia or dysesthesia on the back of the thumb - in some cases where the radial nerve is affected

The diagnosis of Quervain's tenosynovitis is established after consultation based on the anamnesis and clinical examination of the patient. Also at the time of the consultation, all aspects related to surgery will be discussed. Suggestions for Quervain's tenosynovitis are in addition to the local symptoms mentioned above and the following specific tests:

Finkelstein test - the thumb goes to the thumb, being held with the other fingers and the hand is deflected towards the ulnar. The test is positive if there is pain in the radial stylus.

Brunelli test - is more specific than the Finkelstein test, consists of the radial deviation of the fist with the thumbs in active abduction and is positive when pain occurs when performing it.

In some cases, when there are other associated pathologies, additional investigations such as ultrasound or radiography may be necessary.

It is forbidden to take anticoagulant or antiplatelet drugs about 10 days before surgery. At the time of the consultation, the patient will inform his doctor about any treatments or chronic diseases he has.

Non-surgical treatment: it is recommended in the early stages of the disease or in cases with mild symptoms and consists of resting the hand with immobilization in a special orthosis to limit the movement of the thumb to which is added anti-inflammatory medication or local infiltrations with corticosteroids.

Surgical treatment: recommended in more advanced cases of the disease or when there are no results after drug treatment. The surgery is performed under local anesthesia and involves making an incision to identify the tendons and release them from the synovial sheath and suture the wound.

Complications that may occur following surgical treatment of Quervain's tenosynovitis are:

lesions of the branches of the radial nerve

persistence of symptoms in case of incomplete sectioning

bleeding

infection

tendon subluxation

postoperative stiffness

Postoperatively it is recommended:

keeping the hand elevated (in the raised position) to decrease postoperative edema

the removal of the sutures will be done in about 10-14 days

force activities are prohibited for about 2 months postoperatively

the patient can resume normal activities after about 3-4 weeks

it is recommended to wear an orthosis about 3 weeks after surgery

the patient will follow a recovery program to regain mobility and strength

In the absence of treatment, Quervain's tenosynovitis worsens and invalidates the patient, making it increasingly difficult for him to use his hand properly, to grab objects, etc.

To prevent this condition, we recommend the following to patients:

avoiding repetitive hand movements

avoid lifting heavy objects

break from certain activities that overload the wrist