De Quervain’s Tenosynovitis

This condition results in the sheath covering the tendons at the thumb side of the wrist becoming thickened and painful. The sheath normally acts as a tunnel that holds the tendons in place and enables them to slide up and down freely when the wrist or thumb moves. When the sheath thickens, the tunnel becomes narrower and it is more difficult for the tendons to slide through. This can result in the tendons becoming inflamed and often results in pain when using the hand.

If conservative treatments have been ineffective in dealing with this disease, surgical treatment may be recommended. The surgeon will make a small incision along the side of the wrist into the sheath to allow the tendons to glide freely. Do not drive to the hospital yourself. You will need a responsible adult to pick you up after your surgery.

After the operation, the hand will be wrapped in a bulky bandage. You will not be able to use your thumb for gripping for two weeks. Remove the heavy bandage after four days to allow better movement but keep the wound covered and dry, with the dressings provided.The wound will be checked in about 10 days following the surgery and you will be asked to start massaging the scar with a moisturiser. You may get back to driving after 4 days and if you feel safe to do so. You can consider going back to work after 5 days, although, people with heavy manual jobs may need up to four weeks off.

Generally, this procedure is considered to be very effective and low risk. However some people may have problems. The commonest problem is a little swelling and inflammation of the scar. This is usually temporary and is helped by scar massage. Sometimes, nerves surrounding the scar may become irritable and tender which will settle down after some time. Occasionally there may be more widespread swelling and stiffness of the hand, which if severe is called reflex sympathetic dystrophy and is rare. Infection is also rare.