Several operative methods have been described for de Quervain’s disease, but no definite consensus has emerged in the literature. Sometimes simple release of the extensor retinaculum can cause incomplete relief, whereas re-adhesion and excessive excision of the extensor retinaculum can cause volar subluxation of the abductor pollicis longus and extensor pollicis brevis tendons. Partial removal of the extensor retinaculum may be used as an alternative to solve problems such as incomplete release or re-adhesion and volar subluxation of the tendons. In this prospective study, we evaluated the early results of operative treatment with one-quarter partial resection of the extensor retinaculum when conservative methods have failed.
Aims and Objectives
. The study was designed to asses functional evaluation in term of patient based scoring system and and pain improvement using visual analogue score.
. To record any complications during intra operative and post operative period.
Materials and Methods: Thirty patients (30 hands; 25 females and five males; mean age: 48.2 years; range: 20 to 60 years) with de Quervain’s disease were surgically treated. The surgical procedure was performed under local infiltration anesthesia. One-quarter partial resection of the extensor retinaculum on the dorsal side of the wrist was performed. During the clinical follow-up period treatment results, a patient-based scoring system and visual analogue scale were used. The mean follow-up duration was 5.83 months (range: 4 to 9 months).
Results: In early follow ups there was significant improvement in pain and function, but at final follow up functional score was 1.33+/- 0.60(p value <.001) and mean visual analogue score was 0.33+/-0.60 (range: 0—10). Two patients with wound infections were treated with adapted antibiotics. All patients were relieved of their symptoms; no triggering, recurrence or volar subluxation of the tendons of abductor pollicis longus or extensor pollicis brevis occurred. With this partial resection technique and according to a treatment scoring system described by Sawaizumi et al. 22 hands had excellent results, 6 hands had good results, and 2 hands had fair results; no hand exhibited a poor result.