Hand Conditions

de Quervain Syndrome

Definition:

Inflammation of two tendons (abductor pollicis longus and extensor pollicis brevis) and associated synovial membranes on the thumb side of the wrist (tenosynovitis).  

Symptoms:

  • Radial (thumb side) wrist pain that increases with extended activity.
  • Increased pain with grasping and lifting.

Pathology:

  • Shearing (friction) forces create inflammation and thickening of the extensor retinaculum (band shaped ligament that holds the extensor tendons in place on the back of the hand).
  • The inflammation creates stenosing (narrowing) of the synovial membrane tunnel that the tendons glide through (stenosing tenosynovitis).
  • Repetitive thumb adduction and ulnar deviation (hammering motion) creates the shearing forces.

Treatment:

Non-surgical

  • Rest, activity modifications, thumb-spica splint/brace, ice and NSAIDs (ibuprofen)
  • Corticosteroid injection

Surgical

  • de Quervain’s Release
    • Indicated when non-operative treatment fails.
    • The dorsal retinaculum covering the synovial membrane and tendons is incised (released).
    • See Post-op de Quervain’s Release instructions for information on surgical recovery.