DeQuervain's Syndrome
synonyms:
DeQuarvain's ICD-9
DeQuarvain's Etiology / Epidemiology / Natural History
- Stenosing tenosynovitis of the 1st dorsal compartment of wrist.
DeQuarvain's Anatomy
- First dorsal compartment: contains the abductor pollicis longus (APL) and extensor pollis brevis (EPB) tendons.
- EPB frequently travels in a separate compartment which must be released during surgery.
DeQuarvain's Clinical Evaluation
-
- Pain/tenderness over the 1st dorsal compartment/radial aspect of wrist. Worsened with thumb movement.
- Finkelstein test=pain in 1st compartment when wrist is ulnarly deviated with thumb flexed in palm. (Finkelstein H, JBJS 1930;12:509)
- Most common in women 30-50. New mothers, housekeepers, athletes requiring forceful grasping coupled with ulnar deviation or repetitive thumb use (golf, fly fishing, racquet sports, javelin).
- Note
DeQuarvain's Xray / Diagnositc Tests
- P/A, lateral and Roberts (hyperpronated) wrist films indicated to rule out thumb CMC arthritis.
DeQuarvain's Classification / Treatment
- Acute: thumb spica splint, nsaids, acitivity modification.
- Subacute (patients who have failed acute management): Corticosteriod injection into first dorsal compartment.
- Chronic (patients who have 2 or more injections): Surgical release of first dorsal compartment. The EPB frequently has separate compartment which must be released.
DeQuarvain's Associated Injuries / Differential Diagnosis
DeQuarvain's Complications
- Continued pain
- Superficial radial nerve palsy
- Tendinous adhesions
- Hypertrophic scarring
- Volar tendon subluxation
DeQuarvain's Follow-up Care
- Thumb spica splint for 6 weeks.
- Sutures removed at 10 day follow-up visit.
DeQuarvain's Review References
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