De Quervain’s Tenosynovitis – Needs injection Plus Splinting

Having a Dequervain’s wrist tenosynovitis fail injection means surgery is a distinct possiblity; thumb spica increased success rates. Injection alone was successful in  69% without and 93% with splinting.

J Hand Surg Am. 2013 Dec 3.in  press
Corticosteroid Injection With or Without Thumb Spica Cast for de Quervain Tenosynovitis.|
Mardani-Kivi M, Karimi Mobarakeh M, Bahrami F, Hashemi-Motlagh K, Saheb-Ekhtiari  K, Akhoondzadeh N.
http://www.ncbi.nlm.nih.gov/pubmed/24315492

  •  Injected “40 mg of methylprednisolone acetate (1 cc) with 1 cc lidocaine 2%  using an insulin needle (25 or 27 gauge) in the first dorsal compartment at the point of maximal tenderness.”
  • combo group – 3 weeks fiberglass cast and injection
  • results –  injection alone waws successful in 69% cases; injection and casting was successful in 93% of cases.

An earlier study compared casting to injection and casting:
Mehdinasab SA, Alemohammad SA.
Methylprednisolone acetate injection plus casting versus casting alone for the treatment of de Quervain’s tenosynovitis.
Arch Iran Med. 2010;13(4):270-274.
http://www.ams.ac.ir/AIM/010134/004.pdf

  • well padded wrist thumb spica cast for 4 weeks
  • same injection as above except they specify “about 2 cm above the styloid process of the radius into the first dorsal compartment of the wrist.”
  • Results –  casting alone successful in 36.1% of cases; injection and casting effective in 86.5% of cases

Comment – looks like if you are serious about treating de quervain’s tenosynovitis, you need to at least splint thumb/wrist  for 3-4 weeks after injection. air max 90 pas cher air max 90 pas cher

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