creators_name: Kamath, BJ creators_name: Vardhan, H creators_name: Jayasheelan, N creators_name: Mahale, A creators_name: Kumar, A creators_id: bjkamath@satyam.net.in editors_name: Kakkilaya, Srinivas editors_id: Kakkilaya BS type: journale datestamp: 2015-02-21 14:35:53 lastmod: 2015-04-20 11:43:46 metadata_visibility: show title: Optimisation of Surgical Results in de-Quervain’s Disease ispublished: pub subjects: OJHAS full_text_status: public keywords: De Quervain’s tenosynovitis; Ultrasonography; Loupe; Finkelstien’s test. abstract: Background: De Quervain’s disease poses more problems with respect to management than the diagnosis. Surgery is resorted to when the conservative methods fail. There are known complications of the surgical intervention. Surgeon contemplating the surgery should be aware of these and make every attempt to optimize the results and avoid the above mentioned complication. Methods: Sixty symptomatic wrists in 57 individuals suffering from de Quervain’s disease who needed surgery were studied preoperatively with ultrasound. Number of tendons and the sub septae identified in the ultrasound examination preoperatively were confirmed on the table during the surgery. The release was brought about under local anesthesia, with magnification taking care to avoid injury to the cephalic vein and superficial branch of radial nerve, not to violate the anterior margin of the sheath, thus preventing complications. A negative post release finkelstein test was ensured before the wound closure. Results: All 60 patients who underwent release for de Quervain’s disease were symptom free, satisfied and fully functional. Conclusions: De-Quervain's disease not relieved by conservative methods needs surgical release under local anesthesia with a transverse incision with Preoperative ultrasound examination for the number of tendons and subseptae. Avoiding the violation of the volar aspect of the sheath, loupe magnification, tourniquet and post release Finkelstein’s test before wound closure, will ensure optimal results. date: 2014-02-20 date_type: published publication: Online Journal of Health and Allied Sciences volume: 4(6) publisher: Kakkilaya BS refereed: TRUE referencetext: 1. Rhodes CE et al. Stenosing Tenosynovitis of fingers and thumb. CORR 1984;190:236-238. 2. Harvey FJ et al. de –Quervain’s disease: Surgical or Nonsurgical treatment. J Hand Surg A. 1990;15:83-87. 3. Abrislam SJ et al. De-Quervain’s tenosynovitis: Clinical outcomes of the surgical treatment with longitudinal and transverse incisions. Oman Medical Journal; 2011 March;26(2):91-93. 4. Gundes H et al. Longitudnal incision in surgical release of de- Quervain’s disease. Techniques in Hand and Upper Extremities. 2005;9(3):149-152. 5. Ilias AM et al. De- quervain’s tenosynovitis of the wrist. J Am AcadOrthop Surgery. 2007 Dec;15:757- 764. 6. Li Viet D, Lantieri L. De-Quervain’stenosynovitis transversal scar & fixation of the capsular flap. Rev ChirOrthopReparatriceAppar Mot.1992;78(2):101-106. 7. SchellerA. Long Term results of surgical release of de-Quervain’sStenosing Tenosynovitis. IntOrthop. 2009 Oct;33(5):1301-1303. 8. Santarlasci et al. First Extensor Compartment Release and Retinacular Sheath Reconstruction for de-Quervain’s Disease. Atlas of Hand Clinics1999;4:39-54. 9. Slade JF. Endoscopic De-quervain’s Release. In Capo JP, Tan V. Atlas of Minimally Invasive Hand & Wrist Surgery. Informa Health Care; Newyork. 2008. pp 317-319. 10. Giles KW. Anatomic Variations affectingthe surgery of de-Quervain’s disease. JBJS. 1960;42B(2):352-355. Available at http://www.bjj.boneandjoint.org.uk/content/42-B/2/352.full.pdf 11. Jackson WT et al. Anatomical variations in first extensor compartment of wrist.JBJS. 1986;68(6):923-926. 12. Belsole RJ. De Quervain’s tenosynovitis: diagnostic and operative complications.Orthopedics. 1981;4:899–903. 13. Keon- Cohen B. de-Quervains disease. JBJS. 1951;33B:96-99. 14. Bahm AJ et al. The anatomy of de –Quervain’s.IntOrthop. 1995;19:209-211. 15. Chhem et al. Ultrasonography of the musculoskeletal system.RadiolClini North Am.1994;32(2):275-289. 16. Giovagnorio F et al. Ultrasonographicevaluation of de-Quervain’s disease. J Ultrasound Med. 1997;16:685-689. citation: Kamath, BJ and Vardhan, H and Jayasheelan, N and Mahale, A and Kumar, A (2014) Optimisation of Surgical Results in de-Quervain’s Disease. [Journal (On-line/Unpaginated)] document_url: http://cogprints.org/9713/1/2013-4-6.pdf