Are There Differences in Pain Reduction and Functional Improvement Among Splint Alone, Steroid Alone, and Combination for the Treatment of Adults With Trigger Finger?

Background: Steroid injection and splinting, which are commonly recommended nonsurgical treatments in adults with trigger finger, have been demonstrated to effectively relieve pain and improve function. However, to our knowledge, there have been no direct comparisons of pain relief and function improvement with splinting alone, steroid injection alone, or a combination of splinting and steroid injection in patients with this diagnosis.

Question/purpose: Are there differences in pain reduction and functional improvement in adults with trigger finger treated with splinting alone, steroid injection alone, and a combination of splinting and steroid injection at 6, 12, and 52 weeks after the intervention?

Methods: Between May 2021 and December 2021, we treated 165 adult patients for trigger finger at an academic university hospital.

Unblinding de Quervain: A systematic review of ultrasound-guided injection of corticosteroids for treatment of stenosing tenosynovitis of the 1st extensor compartment.

A systematic review was conducted on studies reporting steroid injections with ultrasound for de Quervain. From 10 studies included and 379 wrists, 73.9% reported complete resolution of symptoms, 18.

Anatomical Variations of the First Dorsal Compartment in de Quervain Tenosynovitis.

Background: De Quervain tenosynovitis of the wrist is a common pathology. The primary aim of this study is to determine the prevalence of extensor pollicis brevis and abductor pollicis longus (APL) anatomical variations in association with de Quervain tenosynovitis. The secondary aim was to compare additional patient-specific factors associated with de Quervain tenosynovitis.

Preferred treatment approach to De Quervain Tenosynovitis in nursing women: conservative management or surgery?

Objective: We aimed to show the effectiveness of different treatment methods in the prevention of clinical symptoms and recurrence of De Quervain Tenosynovitis (DQT), which is often seen in nursing women.

Patients And Methods: Three different treatment methods were used in 124 patients, all of whom were breastfeeding women who visited our clinic between 2017-2022 with a positive Finkelstein test and DQT. Group I comprised 56 patients who underwent surgical treatment under local anesthesia, Group II, 41 patients who received steroid injections as conservative treatment, and Group III, 27 patients who received wrist splints.

Incidence and Risk Factors for Pregnancy-Related de Quervain's Tenosynovitis in South Korea: A Population-Based Epidemiologic Study.

Background: Although pregnant or lactating women have been recognized to be predisposed to de Quervain's tenosynovitis (DQT), there is a lack of epidemiologic evidence. The purpose of this study was to estimate the nationwide incidence of pregnancy-related DQT (PRDQT) and to analyze risk factors using the Korean National Health Insurance (NHI) database.

Methods: A retrospective epidemiologic study of pregnant women in South Korea from 2013 to 2017 was conducted using the NHI claims database.

The anatomy of the tendon of abductor pollicis longus and its morphological variations: An anatomical approach emphasizing the clinical relevance.

Purpose: The anatomical literature describes the abductor pollicis longus as a muscle with a single tendon inserting on the base of the first metacarpal bone, but investigations have shown that it often exhibits morphological variations. However, methodological approaches used to describe these variations have not been useful in a clinical context. Therefore, the purpose of this investigation was to study and relate such anatomical variations in a clinical context.

"Daddy wrist": A high-resolution ultrasound diagnosis of de Quervain tenosynovitis.

De Quervain's tenosynovitis involves the first of the six dorsal compartments of the wrist, which contains the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons. It seems to be associated with female sex (F:M = 10:1), middle age (30-50 years) and activities involving repetitive hand and wrist motions such as typing, piano playing or repetitively lifting children head, such as in postpartum females (hence the term "baby wrist" or "mommy wrist"). Aim of this paper was to illustrate high-resolution ultrasound (US) features of the DQD by describing a well-documented case that occurred in a "new dad" taking care of his babe.

Work-Related De Quervain's Tensosynovitis (DQT): The Diagnosis Dilemma.

A female presented with right wrist pain for nine months. The diagnosis was De Quervain's tenosynovitis; her condition was initially managed conservatively, but later she needed surgery due to the lack of improvement. No workplace intervention had been implemented because her hand surgeons did not consider her occupational exposures.

Risk Factors Associated With de Quervain Tenosynovitis in Postpartum Women.

Background: De Quervain (DQ) disease is caused by stenosis of the first dorsal compartment containing the abductor pollicis longus and extensor pollicis brevis. This condition affects women 6 times more than men and is also commonly reported in pregnant and lactating women. The natural course of the disease and associated risk factors are not well understood.

Percutaneous Release of the First Extensor Tendon Compartment in De Quervain's Disease by Acupotomy with US-Guidance: A Cadaveric Study.

Background: De Quervain's disease is a painful stenosing tenosynovitis of the first dorsal compartment of the hand affecting the tendons of the abductor pollicis longus and extensor pollicis brevis. This study aimed to evaluate the safety and efficacy of percutaneous first extensor compartment releases performed on embalmed cadaveric models by acupotomy operation with or without US guidance.

Methods: Percutaneous release was performed with an acupotomy on 59 wrists of cadavers; 23 wrists were operated with US guidance, and 39 wrists were operated without US guidance.

[DE QUERVAIN'S TENOSYNOVITIS - CLINICAL PRESENTATION AND TREATMENT].

De-Quervain tenosynovitis, named after the Swiss surgeon Fritz De Quervain, is a condition characterized by pain and tenderness over the first extensor compartment of the wrist. This compartment contains the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons in their individual retinacular sheath. Non-inflammatory thickening of the tendinous sheath leads to entrapment of the individual tendons and increased friction.

Are the Pathologic Features of Enthesopathy, Tendinopathy, and Labral and Articular Disc Disease Related to Mucoid Degeneration? A Systematic Review.

Background: Tendinopathy, enthesopathy, labral degeneration, and pathologic conditions of the articular disc (knee meniscus and ulnocarpal) are sometimes described in terms of inflammation or damage, while the histopathologic findings are often consistent with mucoid degeneration. A systematic review of the histopathology of these structures at diverse locations might reconceptualize these diseases as expected aspects of human aging. The potential benefits of this evolution might include healthier patient and clinician mindsets as well as a reduced likelihood of overdiagnosis and overtreatment resulting from greater awareness of base rates of pathology.

Do You Really Need a Hand Surgeon? Common Tendinopathies of the Upper Extremity.

Lateral epicondylitis, de Quervain tenosynovitis, and trigger finger are among the most common tendinopathies of the upper extremity. Lateral epicondylitis is a common condition with a prolonged course that can be frustrating for patients. Nonetheless, most patients improve with a simple wait-and-see approach.

Quantitative Analysis of Ultrasonography for de Quervain's Disease: Comparison of the Affected Side With the Asymptomatic Side.

Objectives: The pathology of de Quervain's disease affects the tenosynovium and rarely the tendons. The ultrasonographic features of de Quervain's disease unresponsive to conservative treatment are unknown. The purpose of this study was to describe and compare the morphological differences between patients with de Quervain's disease that is refractory to conservative treatment and patients who respond to conservative treatment.

Wide-Awake Local Anesthesia, No Tourniquet Surgery in the Philippines.

The use of wide-awake local anesthesia, no tourniquet (WALANT) has been adapted by most hand surgeons in the Philippines. This is especially true for centers with a large volume of patients needing specialized care for the hand. The use of WALANT has enabled surgeons to do procedures on an outpatient basis, thus potentially creating cost-saving measures for patients and health care facilities.

Intraoperative Active Motion Confirmation During Wide-Awake Local Anesthesia No Tourniquet Surgery.

As a recent advance in the field of hand surgery, the wide-awake local anesthesia no tourniquet surgical technique-performed using an epinephrine-containing local anesthetic without a tourniquet while the patient is awake-has attracted attention. The wide-awake local anesthesia no tourniquet technique has been indicated for surgeries such as trigger release, soft tissue tumor excision, surgery for Dupuytren contracture, thumb carpometacarpal arthroplasty, or any other tendon, nerve, or ligament surgeries, requiring intraoperative active motion confirmation. Herein, the surgical procedures performed with the wide-awake local anesthesia no tourniquet technique have been described; moreover, the indications and precautions of this technique have been reconsidered.

Triggering Thumb Is Not Always a Trigger Thumb.

Although rare, the thumb can trigger because of de Quervain disease. An 18-year-old woman presented with painful triggering during thumb movements. Physical examination revealed locking upon thumb extension and painful snapping upon thumb flexion, with tenderness over the first extensor compartment.