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De Quervain’s Release Surgery: A Comprehensive Guide

De Quervain’s tenosynovitis is a condition that affects the tendons on the thumb side of your wrist, causing pain and limiting hand movement. This hand disorder is prevalent among individuals who perform repetitive tasks with their hands. 

When conservative treatments like rest, splinting, and medications fall short, De Quervain’s release surgery becomes a viable option. Read on below to learn more about this procedure.

What is De Quervain’s tenosynovitis?

De Quervain’s tenosynovitis is a painful condition characterized by the inflammation of the tendons (on the thumb side of the wrist) and the synovial sheath surrounding them. 

Specifically, the two tendons affected are the abductor pollicis longus and the extensor pollicis brevis, which control the movement of the thumb. These tendons travel through a narrow tunnel-like structure called the tendon sheath, located on the side of the wrist near the base of the thumb.

The inflammation of these tendons and the surrounding sheath increases friction during thumb and wrist movement. This can then result in the following symptoms:

  • Pain and swelling
  • Difficulty with thumb and wrist movement
  • Tenderness
  • Catching or snapping sensation
  • Warmth and redness

If these symptoms persist or significantly impact daily activities, it’s advisable to seek medical attention for an accurate diagnosis and appropriate management.

When is De Quervain’s release surgery recommended?

Treatment options for De Quervain’s tenosynovitis range from conservative measures, such as rest, splinting, and anti-inflammatory medications, to more interventional approaches like corticosteroid injections.

However, orthopedic specialists will recommend De Quervain’s release surgery for the following reasons:

  • When conservative approaches fail to provide significant and lasting improvement.
  • When there is severe and persistent pain.
  • When there is a notable restriction in thumb and wrist movement.
  • When symptoms persist, and the condition becomes chronic. 

The decision to undergo De Quervain’s release surgery should be made collaboratively between the patient and their healthcare team, considering the individual’s overall health, lifestyle, and preferences.

How is it performed?

De Quervain’s release surgery, also known as De Quervain’s tenosynovectomy, is a procedure that involves releasing the constricted sheath that surrounds the affected tendons, allowing them to move more freely without causing pain or discomfort. 

Here is an overview of how it is typically performed:

  • The surgery is commonly performed under local anesthesia, which numbs the affected hand and wrist. This allows the patient to remain awake during the procedure while ensuring they do not feel pain in the surgical area.
  • The surgeon makes a small incision at the base of the thumb, on the side of the wrist, where the affected tendons are located. The incision is usually about 1 to 2 inches long.
  • The surgeon identifies the constricted tendon sheath and then proceeds to open or release it. This step is crucial in creating more space for the tendons to move freely without being impinged or irritated.
  • Once the release is completed, the surgeon closes the incision with sutures. In some cases, dissolvable stitches may be used, eliminating the need for suture removal in the postoperative period.
  • The surgical site is typically covered with a sterile dressing to protect the incision and provide support during the initial stages of healing.

After the surgery, patients are usually monitored in a recovery area for a short period. Instructions for postoperative care, including pain management, hand elevation, and activity restrictions, are provided.

What to expect immediately after the surgery?

Immediately after the surgery, patients can expect some discomfort, swelling, and restricted movement. The surgical site will be covered with a dressing or bandage to protect the incision. This dressing helps minimize the risk of infection and provides support to the healing area.

Patients will receive specific postoperative instructions from their healthcare team. These instructions may include guidance on wound care, medication management, ice application, and rehabilitative exercises.

What is the rehabilitation process like after De Quervain’s release surgery?

The recovery process after De Quervain’s release surgery involves several stages, each with its own set of considerations and milestones.

7-14 days

After a week or two of rest and elevation, your doctor may instruct you to undergo physical therapy sessions to gradually restore flexibility and strength. However, patients are usually advised to avoid heavy lifting or strenuous activities during this phase.

2-6 weeks

A physical therapist will work with you during this rehabilitation period. They will guide you on specific exercises and decide when it’s time to increase your level of activity as directed by your healthcare provider. 

8-12 weeks

After 8 to 12 weeks, you should be able to achieve full range of motion in the thumb and wrist. Your doctor may also allow you to resume normal daily activities by this time, such as work and light recreational activities. 

Three months and beyond

After three months, long-term follow-up appointments are still necessary so your physician can assess the overall healing and hand functionality. Continued guidance on hand care and any ongoing restrictions or precautions may be provided.

Patients should recognize that the timeline and specific instructions for recovery can vary based on individual factors, such as overall health, the extent of the surgery, and any complications. 

It’s important to maintain open communication with the healthcare team and actively participate in the recommended rehabilitation to achieve the best possible outcome after De Quervain’s release surgery.

Where to find the best outpatient orthopedic clinic?

At Raleigh Orthopaedic Surgery Center, we pride ourselves on being your dedicated partners in orthopedic care, providing a premium experience that prioritizes your well-being. 

Our primary focus is not just on delivering exceptional surgical interventions but also on ensuring you feel confident, informed, and reassured every step of the way.

Choosing our facility means choosing excellence in orthopedic care. Our team of Raleigh orthopedic surgeons are leaders in their field, committed to delivering the highest standard of surgical expertise. Rest assured, you are in capable hands, and your well-being is our top priority.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.