Abstract:Background: de Quervain’s disease (DQ) is painful tenosynovitis of first dorsal compartment of hand. It is usually caused by overuse or repetitive activity. There are various modalities of treatment of DQ. Different studies have shown effectiveness of local corticosteroid injection, splinting or both in western population but to our knowledge, there is no effectiveness data available for Indian population. This study was performed to compare the outcome of corticosteroid injection versus splinting for the treatment of de Quervain’s tenosynovitis. Methods: This randomized prospective study was conducted from July 2015 to December 2016 in Orthopaedics OPD of RKMSP.A total of 100 patients with de-Quervain’s tenosynovitis were treated with either of these methods1) corticosteroid injection in first dorsal compartment of wrist, 2) splinting, local ice or hot compression and topical Non-Steroidal Anti-Inflammatory (NSAIDs) gel. Treatment effectiveness was measured by Wong-Baker FACES Pain Rating Scale, 0-10 Numeric Pain Rating Scale, size of nodule over radial styloid and grading of tenderness over 1st dorsal compartment. Results: In the first group, a total of 50 patients were included (corticosteroid injection), and 50 patients in the second group (splinting, local ice or hot compression and topical Non-Steroidal Anti-Inflammatory (NSAIDs) gel). The mean age was 32.6 years (21 – 61 years) in all patients. There were 90 women and 10 men. Overall success rate was 90% in the first and 60% in the second groups, with a significant difference for both groups with respect to pain score and cure rate (P<0.05). Temporary pain was the most common adverse reaction at the site of injection and was noted in 40% of patients. Conclusion: Though steroid injection has excellent outcome, splinting can be an alternative viable treatment option for dQ especially in patients with low grade disease or reluctant to injection because of fear of probable adverse reactions.
Sunny Kumar Mallick, Dipak Kumar Jha, Arindam Majumdar, Siddhartha Mahapatra. A comparative study between splinting versus corticosteroid injection in de-quervain’s disease. Int J Orthop Sci 2018;4(3):22-26. DOI: 10.22271/ortho.2018.v4.i3a.05