US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases
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To evaluate the efficacy of ultrasonography-guided percutaneous treatment of de Quervain tenosynovitis with the combination of a corticosteroid injection and release of the retinaculum of the first extensor compartment tendons with a 21-gauge needle.
Materials and methods
The first part of our study consisted of ten procedures on cadaver wrists followed by dissection to analyse the effectiveness of the retinaculum release and detect any collateral damage. The second part was a prospective clinical study of 35 procedures. Outcomes were evaluated through a 6-month clinical follow-up and telephone interview at the end of the study. The following parameters were monitored over time: pain level on a visual analogue scale, the QuickDASH and the PRWE. Patient satisfaction questionnaires were also administered.
No complications were found during the cadaver study. However, the release was confirmed as ‘partial’ in all wrists. In the clinical portion of this study, significant improvement was observed in 91.4 % of cases (32/35) within 1 month and the results were stable until the end of the study; all of these patients avoided surgery. The release procedure failed in three patients who eventually required surgical treatment.
US-guided partial release and simultaneous corticosteroid injection for treatment of de Quervain’s disease using a 21-gauge needle is feasible in current practice, with minimal complications.
• Ultrasound-guided treatment of de Quervain's disease is feasible with a 21G needle.
• There was notable regression of clinical signs in 91.4 % of cases.
• The procedure is very safe, no iatrogenic neurovascular or tendinous injuries occurred.
• Our procedure requires only one session and 3 days away from work.
KeywordsDe Quervain disease Tendon entrapment Ultrasonography, interventional Injections, intralesional Tenotomy
Abductor Pollicis Longus
Extensor Pollicis Brevis
Patient Rated Wrist Evaluation
- Quick DASH
Quick Disabilities of the Arm, Shoulder and Hand outcome measure
Radial nerve’s sensory branch
- VAS pain
Visual analogue scale for pain
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Dr Franck Lapègue.
Conflict of interest
The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.
Statistics and biometry
One of the authors has significant statistical expertise.
Written informed consent was obtained from all subjects (patients) in this study.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
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