Results of surgical treatment of De Quervain's tenosynovitis: 80 cases with a mean follow-up of 9.5 years - 24/08/18

Doi : 10.1016/j.otsr.2018.04.022

Johanne J. Garçon, Bertille Charruau, Emilie Marteau, Jacky Laulan ^⁎ , Guillaume Bacle
Unité de chirurgie de la main, hôpital Trousseau, CRHU de Tours, route de Loches, 37044 Tours, France

^⁎Corresponding author.

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Abstract

Introduction

Surgery is indicated in De Quervain's tenosynovitis only after failure of medical treatment, often due to individual anatomical variants. We use Le Viet's technique, to avoid tendon instability. The aim of the present study was to evaluate long-term results, with the hypothesis that this surgical technique is reliable, providing lasting results.

Patients and methods

All patients operated on between 1993 and 2015 were included, and results were assessed by telephone questionnaire at a minimum 1-year's follow-up. Surgical technique was systematically as described by Le Viet, with subcutaneous fixation of the retinaculum flap. Any anatomical variants were specified. In 26 cases, a concomitant pathology was treated in the same step. In addition to demographic data, the study looked for: pain on VAS, functional impairment, tendon dislocation, and satisfaction.

Results

There were no intra- or immediate postoperative complications. Of the 89 patients, 74 (80 wrists) were successfully recontacted: 68 women and 6 men, with a mean age of 48.5 years (range, 19–71 years). The 15 patients lost to follow-up showed initial progression comparable to the rest of the population. A supernumerary septum was found in 50 cases, and an abductor pollicis longus tendon with multiple slips in 35 cases. There were no recurrences. Functional impairment was absent in 68 wrists, moderate in 8 and significant in 4, including 3 with associated diseases. Mean VAS was 0.76 (range, 0–10). No patients reported tendon dislocation or neuroma. Patients were very satisfied in 72 cases, satisfied in 6 and dissatisfied in 2 cases with associated diseases.

Discussion

Results in the present series, with a mean follow-up of 9.5 years, were favorable, with total regression of functional impairment in 85% of cases and a satisfaction rate of 97.5%. There were no cases of tendon dislocation, neuroma, or recurrence. Residual problems were all related to associated diseases, whether pre-existing or with subsequent onset.