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Mr Paul Jarrett MB ChB FRCSed (Orth) FRACS FA OrthA

CONSULTING & OPERATING
St John of God Murdoch

Direct Line 1300 527 738 Fax 1300 527 329 Email admin@pauljarrett.info

DeQuervain’s Tenosynovitis / Tenovaginitis

On the thumb side of your wrist and the back of your hand the tendons which run from your hand pass through small tendon sheaths. These tendons can become inflamed and swollen where they run in the tendon sheaths, and this is relatively common for the two tendons running to your thumb which pass through a sheath called the first dorsal compartment. When these two tendons become inflamed the tendon sheath also thickens and we call this condition DeQuervain’s tenovaginitis or tenosynovitis.

 

DeQuervain’s causes pain on the thumb side of your wrist which is worse when you deviate your wrist towards your little finger. It can cause marked pain and reduced function of your wrist. It is relatively common in women in the months following giving birth.

DeQuervain’s Treatment

Non Operative Treatment

If your condition is mild, it may be reasonable to leave it alone to get better by itself, but if it is reasonably troublesome or severe, then it is worth seeing our hand therapists to get a splint and special exercises. Often it will be worth having a steroid (cortisone) injection which resolves the problem in about half of people with DeQuervain’s.

Operative Treatment

In severe cases, we have a small surgical procedure called a DeQuervain’s release which is usually highly successful. There is a small risk of infection with steroid injections, and a rare chance of the tendon rupturing, or your skin near the injection site becoming discoloured or indented.

DeQuervain’s Release Postoperative Care

After DeQuervain’s surgery, usually within a fortnight, you will have reasonably good everyday hand use, but it is wise to avoid any heavy activities until at least six weeks after surgery as it will take several months to improve maximally. The usual risks of hand surgery are present. In particular, there is a sensitive nerve called the superficial radial nerve right beside the procedure area, and although Mr Jarrett will take every care to protect this nerve, a small risk of the nerve becoming injured or causing pain and numbness after surgery remains.