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deQuervain Release 25000

 
CPT Coding Technique
Indications Complications
Contraindications Follow-up Care / Rehab Protocol
Alternatives Outcomes
Pre-op Planning / Case Card Review References

synonyms:deQuervain's release, 1st extensor compartment release, incision 1st extensor compartment

deQuervain Release CPT

deQuervain Release Indications

  • deQuervain's disease which has failed to improve with conservative care. 

deQuervain Release Contraindications

  • Active infection
  • Medically unstable patient

deQuervain Release Alternatives

  • Conservative care:thumb Spica Splint, nsaids, acitivity modification, Corticosteriod injection into first dorsal compartment. 

deQuervain Release Pre-op Planning

  • Basic hand set

deQuervain Release Technique

  • Pre-op antibiotics
  • Sign operative site
  • Anesthesia: local anesthesia, with or without intravenous sedation
  • Consdier tourniquet
  • Prep and drap
  • Incision: can be transverse, longitudinal, oblique or chevron over the first dorsal compartment.   Chevron-style incision may aid in visualization of the radial sensory nerve
  • Blunt dissection under loop magnification
  • Identify and protect the radial sensory nerve.
  • Expose the first dorsal compartment incise the retinaculum along its dorsal margin in line with the APL and
    EPB tendons.
  • APL tendon is larger, generally has two or more distinct tendons
  • EPB tendon is smaller, dorsal,  often lies in a separate compartment
  • Any intra-compartmental septae are released and excised.
  • Debride any loose tenosynovial tissue on the tendon
  • Close skin incision
  • Dressing

deQuervain Release Complications

  •  Infection
  • Incomplete relief of pain
  • Stiffness

deQuervain Release Follow-up care

  • Post-op: bulky dressing.  Consider thumb spica splnt
  • 7-10 Days: Remove dressing, may gradually resume activities as tolerated. 
  • 3 Weeks:  ensure full ROM.  May consider OT if stiffness or continued pain.  
  • 6 Weeks: ensure patient has returned to full activities.  

deQuervain Release Outcomes

deQuervain Release Review References