RESUMO
BACKGROUND: De Quervain's tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist. The diagnosis is made by history and physical examination. Finkelstein's test is positive in typical cases
OBJECTIVE: To assess the clinical effect of local corticosteroid injections for de Quervain's tenosynovitis
MATERIAL and METHODS: Fifty De Querven's Tenosynovitis patients were included in the study
All had a mean of 6 weeks of treatment of the condition with oral and local NSAIDs and had shown no response. The severity of tenderness on first dorsal compartment and pain felt on Finkelstein test was recorded on Visual analogue scale. A mixture of 1 ml [10mg] of triamcinolone acetonide and 1 ml of 1% lidocain hydrochloride was injected in first dorsal compartment of involved wrist. Patients were followed for clinical assessment fortnightly for 24 weeks
Outcome measure was reduction in pain and tenderness on the radial side of wrist and negative Finkelstein test subsequent to local triamcinolone acetonide injection
RESULTS: Out of 50, thirty-five patients [70%] after 1st injection were symptoms free at two weeks, fifteen patients who showed no improvement were given second injection two weeks after the first. 42 [84%] patients at four weeks, and all patients at six weeks were symptoms free and fully satisfied with the therapy. All the 50 patients were followed for 24 weeks and no recurrence was found
The adverse reaction of steroid was seen in 18/50 [36%] of patients, which were subsided in 20 weeks. There was no incidence of nerve injury, tendon rupture, or infection
CONCLUSION: We conclude that one or two local steroid injections in the first dorsal compartment leads to significant improvement in patients with de Quervain's tenosynovitis