De Quervain

BACKGROUND: De Quervain's tenosynovitis is a relatively common, painful condition. Although commonly managed nonoperatively, some patients have recalcitrant disease, necessitating surgical release. Traditional surgical release for de Quervain's tenosynovitis with simple retinacular release can leave patients susceptible to first dorsal extensor compartment tendon subluxation. We present a stair-step flap technique that releases the first dorsal compartment while simultaneously preventing postoperative tendon subluxation via fascial lengthening...

BACKGROUND: Though evidence demonstrating benefits of local anesthetic continues to compound, a consensus among surgeons regarding optimal anesthetic modality has not been reached. General and regional anesthetic may still be preferred for patient anxiety, concomitant procedures, increased complexity, or poor patient pain tolerance. Therefore, the primary purpose of this study was to analyze trends in anesthetic utilization using a large-scale state healthcare database for common outpatient hand procedures...

Joint replacement arthroplasty for the treatment of thumb osteoarthritis is gaining popularity as recent studies have demonstrated better pinch and grip strength and faster rehabilitation. Our aim was to identify early complications in modern implant designs using a multicenter study. A total of 381 patients who underwent thumb carpometacarpal replacement surgery in six participating hospitals were enrolled. The complications included were fractures, dislocations, infections, tendon and nerve injuries, and complex regional pain syndrome...

PURPOSE: The internet is a common resource for patients seeking health information. Trends in internet search interests for common hand surgery diagnoses and their seasonal variations have not been previously studied. The objectives of this study were (1) to describe the temporal trends in internet search interest for common hand surgery diagnoses in the recent five-year time period and (2) to assess seasonal variations in search term interest. METHODS: An internet-based study of internet search term interest of 10 common hand surgery diagnoses was performed using Google Trends (Google, Inc...

Common wrist conditions include fractures and other injuries, osteoarthritis, radial epiphysitis, joint instability, de Quervain tenosynovitis, carpal tunnel syndrome, ganglion cyst, and ulnar neuropathy. The initial history and physical examination, with particular focus on the anatomic structures of the wrist, can narrow the differential diagnosis. Magnetic resonance imaging study can be used to identify soft tissue masses and occult osseous processes, particularly with scaphoid fractures. Computed tomography scan is useful in cases of bony abnormalities, high clinical suspicion of occult fracture, and surgical planning...

BACKGROUND: A significant proportion of patients still report pain following a surgical release for de Quervain disease (DQ). This study aimed to investigate the effectiveness of a surgical release for DQ and to identify the preoperative factors associated with pain after a surgical release for DQ. METHODS: This prospective cohort study includes 707 patients who underwent a surgical release and completed the Visual Analog Scale Questionnaire (VAS, range 0-100). We used a paired t-test to analyse the effectiveness of the surgical release on pain at three months post-operatively compared to the pre-operatively measured outcome...

IV.

BACKGROUND: The growing prevalence of smartphone use among college students in China has led to health concerns, including De Quervain's Tenosynovitis (DQT). However, the specific smartphone usage behaviors contributing to DQT remain poorly understood. This study aimed to explore the relationship between smartphone usage behaviors and DQT in college students. METHODS: A cross-sectional study was conducted with 937 students from various majors in Guangxi between September 2021 and April 2022...

PURPOSE: The primary objective of this study was to compare the WALANT (wide awake, local anesthesia, no tourniquet) technique with local anesthesia associated with sedation in relation to pain intensity for minor hand surgical procedures. The secondary objective was to evaluate the need for analgesic complementation. METHODS: A prospective, randomized, comparative, and clinical study was carried out. The sample size in each group was determined after statistical evaluation of the results of a pilot project...

INTRODUCTION: de Quervain's syndrome is a painful condition commonly presented to hand therapists. Exercise is utilised as an intervention, but isometric exercise has not been investigated. We aimed to assess the feasibility and safety of isometric thumb extension exercise for de Quervain's syndrome and to explore differences between high-load and low-load isometric exercise. METHODS: This parallel-group randomised clinical feasibility trial included individuals with de Quervain's syndrome...

Thyroiditis is a common thyroid disorder worldwide. Its commonest variant is Hashimoto's thyroiditis (HT). The usual presenting symptom is hypothyroidism at the time of diagnosis. Most patients are asymptomatic. A few cases may experience more obvious symptoms. The standard treatment is medical, and surgery is rarely indicated. This review aims to shed light on the most relevant articles discussing surgery in thyroiditis and compare them. The author included 16 relevant articles focused on the surgical management of thyroiditis...

IMPORTANCE: There is a plethora of treatment options for patients with de Quervain tenosynovitis (DQT), but there are limited data on their effectiveness and no definitive management guidelines. OBJECTIVE: To assess and compare the effectiveness associated with available treatment options for DQT to guide musculoskeletal practitioners and inform guidelines. DATA SOURCES: Medline, Embase, PubMed, Cochrane Central, Scopus, OpenGrey.eu, and WorldCat...

Subacute granulomatous thyroiditis (SGT)/De Quervain's thyroiditis is a rare self-limiting inflammatory disease, accounting for 3% of all thyroid disorders. Most commonly seen in middle aged women, it shows a characteristic triad of pain in the anterior cervical region, increased ESR and recent history of viral upper respiratory tract infection. The cytomorphological features are not pathognomonic and can also be seen in Hashimoto's thyroiditis, granulomatous infections, sarcoidosis, and papillary thyroid carcinoma...

The purpose of this study is to determine the additional effect of high-intensity laser therapy (HILT) when combined with therapeutic exercise and splinting in the treatment of patients diagnosed with de Quervain's tenosynovitis. Nineteen patients diagnosed with de Quervain's tenosynovitis were randomly divided into two groups: the HILT group and the sham HILT group. A total of 9 HILT or sham HILT sessions were administered, with 3 sessions per week for 3 consecutive weeks. Both groups received the thumb spica splint and therapeutic exercise...

Episodic memory, the ability to consciously recollect information and its context, varies substantially among individuals. While prior fMRI studies have identified certain brain regions linked to successful memory encoding at a group level, their role in explaining individual memory differences remains largely unexplored. Here, we analyze fMRI data of 1,498 adults participating in a picture encoding task in a single MRI scanner. We find that individual differences in responsivity of the hippocampus, orbitofrontal cortex, and posterior cingulate cortex account for individual variability in episodic memory performance...

Objective  To evaluate the open surgical treatment for carpal tunnel syndrome as a risk factor for the development of stenosing tenosynovitis that results in trigger finger and De Quervain disease. Materials and Methods  A retrospective study analyzing the medical records of patients submitted to open surgical release of carpal tunnel syndrome between 2010 and 2021 in a secondary- and tertiary-level hospital. The following data were collected: pathological history, duration of the follow-up after the surgical treatment for carpal tunnel syndrome, development of trigger finger or De Quervain tenosynovitis, affected fingers, and the interval between the end of surgery and symptom onset...

Previous studies have shown that females typically outperform males on episodic memory tasks. In this study, we investigated if (1) there are differences between males and females in their connectome characteristics, (2) if these connectivity patterns are associated with memory performance, and (3) if these brain connectome characteristics contribute to the differences in episodic memory performance between sexes. In a sample of 655 healthy young subjects (n = 391 females; n = 264 males), we derived brain network characteristics from diffusion-weighted imaging (DWI) data using models of crossing fibers within each voxel of the brain and probabilistic tractography (graph strength, shortest path length, global efficiency, and weighted transitivity)...

The first extensor wrist compartment (FEWC) displays significant variants. This review highlights all possible variants that may be associated with the occurrence and pathophysiology of de Quervain's tenosynovitis. A thorough search of PubMed and MEDLINE databases, following the PRISMA guidelines, was conducted from 2002 to 2022 to evaluate all FEWC variants, including the following: 1) the presence of an inter-tendinous septum, 2) the number of tendinous slips of the abductor pollicis longus (APL) and the extensor pollicis brevis (EPB) muscles, 3) their distal insertions and 4) the presence of a bony ridge within the FEWC...

PURPOSE: Treatment of de Quervain tenosynovitis is largely empiric. Patient-Reported Outcomes Management Information System (PROMIS) scores at the time of diagnosis might provide insights into the probability of success of nonsurgical management and predict the necessity for surgical treatment. We aimed to identify which, if any, of the PROMIS metrics may be used to identify patients who will opt for surgery or be managed with injection alone. METHODS: Patients presenting to a tertiary academic medical center from 2014 to 2019, with a sole diagnosis of de Quervain tenosynovitis, were identified and separated by initial and most invasive treatment of either injection or surgery...

Diagnostic and interventional US of the wrist and hand can be challenging due to the small size and superficial location of structures and various disorders that need to be considered. A quadrant-based approach (volar, ulnar, dorsal, and radial) provides a rational method for performing a focused examination and joint positioning during both diagnostic imaging and intervention. Volar wrist disorders primarily involve the median nerve and the digital flexor system comprised of the flexor tendons and pulleys...