Transcript DE QUERVAIN’S TENDONITIS

DE QUERVAIN’S TENDONITIS
What is De Quervain’s?
 Also known as first compartment tendinitis, De Quervain’s
is characterized by irritation and constriction around the
tendons located at the base of the thumb.
 Thickening around the tendons cause pain and swelling
along the thumb side of the wrist and is often increased
with wrist and thumb motion.
De Quervain’s anatomy
Thickened, inflamed
tendons and sheath
Treatment options
 Splints
 May be used to rest the thumb and wrist
 Anti-inflammatory medications
 Can be taken orally to reduce swelling and relieve pain
 Try to modify or avoid activity that causes pain
Cortisone injections
 Cortisone injections are often given to
help reduce inflammation in and
around tendons and joints.
 This medication is injected with a local
anesthetic. This will provide pain relief
from the injection for a few hours
following. It is common to have
increased soreness for a few days after
the injection.
 Onset of the medication may take up
to a week before you begin noticing
improvement. Symptom relief is
variable, but averages from 1-3 months.
 Diabetics should use cortisone with
caution, as it can increase blood sugar
levels.
Surgical treatment
 FIRST DORSAL COMPARTMENT RELEASE
 Surgical treatment for this involves releasing the inflamed
tendon sheath and making room for the irritated tendons.
 This is an outpatient procedure performed under local
anesthesia. We are able to give you some sedative
medication through an IV to keep you comfortable.
 The procedure takes about 15-20 minutes to perform.
Risks
 Anesthetic
 Infection
 Numbness
 Recurrence
Post-operative care
 A soft dressing is applied after
surgery. You will be able to use
your hands for light activity later
that day.
 Keep the surgical dressing and
incision clean and dry. After 48
hours you may remove the soft
dressing and your incision may
get wet in the shower, but no
soaking. Apply a band-aid to
keep the incision clean if
necessary.
 Approximately 10-14 days postoperatively you will return to Dr.
Foad’s office for a follow-up visit
and suture removal.
DEQUERVAIN’S TENDONITIS
POST-SURGICAL FAQ’S
When do I see Dr. Foad after surgery?
You will return to see Dr. Foad for your post-op visit about
10-14 days after surgery.
When can I use my hand?
You will be able to begin using your hands for light
activities usually the night of surgery. You will have a soft
bandage on the hand that leaves your fingers and wrist free
to move. You can perform simple functions such as
feeding yourself, brushing your teeth, carrying a cup of
coffee, etc. and continue to increase those as tolerated.
How do I care for my dressings?
You will have a soft bandage (not containing any hard cast
material) after surgery. This should not get wet. You will
be able to remove this on your own 48 hours after surgery.
At that time you can cover the incision site with a band aid
to keep it clean.
When may I shower or bathe?
You may begin to shower or bathe as soon as you like. If
the original surgical dressing is still on, take care not to get
it wet. After 48 hours, please remove your soft dressing.
You may wash your incision in the shower, however, do
not submerge the incision underwater for an extended
period of time, such as in a pool or hot tub.
When do the stitches come out?
Typically, Dr. Foad uses dissolvable stitches that are under
the skin and do not require to be removed. In some cases
that external stitches are necessary, they will be removed at
your post-op visit 10-14 days after surgery.
What if my pain medication causes itching
or nausea?
It is not uncommon for pain medications to cause these two
side effects. If you experience itching you may take
Claritin or Benadryl to help with this. If you are
experiencing nausea, a prescription for Phenergan (aka
promethazine) was given for this purpose on the day of
your procedure. Remember to take your pain medication
with food to diminish the potential for nausea.
What about swelling?
Swelling is quite common following these procedures. Do
your best to keep the hand elevated above the level of your
heart. Moving the fingers to open and close into a tight fist
is also encouraged. Taking ibuprofen (Advil, Motrin) in
addition to your pain medication will help with swelling
(note: do NOT take more acetaminophen/Tylenol as it is
already a component in the prescriptions you were given)
When may I drive?
You may begin driving again when you feel comfortable
behind the wheel AND you are no longer taking any of the
narcotic pain medications. If you would feel comfortable
driving next to yourself on the road, it is probably safe for
you return to this activity.
When can I go back to work?
It depends on the type of work you do. Those with jobs
that are more sedentary and do not require heavy loads on
the hands are often able to start returning to their duties
within 1-2 weeks. Jobs that involve extensive heavy lifting
and strain on the hands may take 3-4 weeks before they are
able to return to work functions more normally. This is
something quite unique to every patient’s situation and can
be discussed more specifically with Dr. Foad at your office
visit.