RESUMO
Is an inflammatory disease affecting the tendon sheasths of the abductor pollicis longus and extensor pollicis brevis passing during the first compartment of the wrist. The inflammatory will cause soft tissue swelling leading to compartment stenosis this clinically leads to acute or chronic pain in the wrist especially in the region and eventually to thumb or hand. First: under general anesthesia,regional,local anesthesia, released the tendons sheaths and retinaculumfor the abductor pollicis longus, extensor pollicis brevis,A thumb splints eventuallyis put post operatively for 7-10 days. Second: skin inscision is performed obliquely or longitudinally. Third: The orthopaedist must see via the inscision site the tendons release from the distal end of LISTER'S hump and there free moveements. Fourth: thumb splint is applied for chronic patients who didn't show any signs of improvement or preserved treatement [more than once injection+splinting] Our study incluted [40] patients diagnosed de quervan's. Patients were selected above the age of twenty years old. Females are affected more than males with a rate F:M=3:1. Patients were classified according to age into 4 groups: [20-30]; [31 -40];[4 1-60]; more than 60 years old. The highest incidence of disease was found in the second age group [3 1-40]. By studying the distribution of males/females in all age groups :we found that the incidence rate of males less than females under 40 years old the incidence rate of females is higher than males in the age -males use of thumb is the most important frequent cause of de quervan's patients in both age groups. -Right hand is slightly more affected than left hand, due to dependence patients an there right hand in performing there works. -Pain, tenderness, swelling in distal lateral forearrm and stifness of the thumb wette seen in all patients. Local anesthesia was used in all cases except for three cases regional anesthesia, and older patients under general anesthesia. Cases of using thumb's supporting splint:- [10] patients needed thumb's supporting spint, in different time, for different times intervals and for different causes: - [4] patients was applied supporting thumb splint directly post operation, due to adhesion the supporting as applied for only 10 days. - [1] patient directly post operation due to excesion of the sub tendinial cyst under the abductor pollicis longuss nd extensor pollicis brevis tendons and thumb's splint was applied for 15 days. - [3] patients the next days post operaion due to adema and they were applied for 7 days. - [2] patients directly post operations to preventive precaution after long operation, thumb's splint was applied for 15 days