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De Quervain’s (Hand surgery)

Overview

De Quervain’s tenosynovitis is a painful inflammation of the tendons on the thumb side of your wrist, causing discomfort when turning, gripping, or making a fist. Although the cause of this condition isn’t known, it can be aggravated by any activity that causes repetitive hand or wrist movement.

It is useful to identify the cause (often, repetitive activity such as hammering or playing tennis) so it can be avoided, ice packs and splints can also help settle acute symptoms of De Quervain’s,  along with painkillers and anti-inflammatory agents.

If these actions prove to be unsuccessful, or the condition reoccurs, surgery is recommended to open the fibrous tunnel to release the tendons and reduce friction. This usually gets rid of the pain quickly.

Best Candidates

  • Anyone with chronic pain the tendon sheath of Abductor pollicis longus

What to Expect

During surgery for De Quervain’s we remove the dense bands of fibrous tissue, so the joints can then be straightened. Firm padded bandaging is applied with a splint, usually for 1 – 4 weeks post-operatively.

Surgery is done on an outpatient basis under local anaesthesia or an arm block. Treating the wound with steroid before closure may help prevent further fibrosis, particularly in severe cases. Following surgery, the hand is put in a high sling to reduce swelling.

After Surgery / Recovery

A wound check and dressing change are done at one week and sutures are removed after two weeks. Your surgeon may recommend a rehabilitation programme under the guidance of a Hand Therapist.

Splints are used for several weeks after surgery for comfort. The procedure, which has a high rate of success, is minor, taking about 40 minutes and resulting in an inconspicuous scar on the thumb side of the wrist.

Procedure Planner

  • Initial Meeting
    First consultation 30 mins
  • Pre-op
    15 minutes for consent & pre med
  • Procedure Time
    30 - 40 mins
  • Recovery Time
    20 mins before leaving theatre complex
  • Post-op Follow Up
    Weeks 1 & 2 with nurses, week 8 with surgeon or more often if needed

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