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Abstract
COMPARATIVE STUDY BETWEEN SURGICAL RELEASE AND LOCAL INJECTION IN TREATMENT OF DE QUERVAIN DISEASE
Dr. Rabah Abdulla AL- Ebadi, F.I.C.M.S (Ortho)*, Dr. Omar Farooq Khaleel, C.A.B.M.S, Dr. Mamoon Abdulmunem AL-Dabbagh, F.I.C.M.S
ABSTRACT
Background: De Quervain disease is a condition that is known to be the reason of lateral side wrist pain. it is more frequently happens with people that do heavy manual jobs like housewives, butchers. Despite there is a controversy in the management of De Quervain's tenosynovitis, but conservative management, including corticosteroid injections combined with a lidocaine into the first dorsal compartment. and surgical release of the first dorsal compartment. through an oblique incision are considered as beneficial treatment. Objective: The aim of this study is to compare between the effectiveness of local corticosteroid injection and open surgical release in treatment of De Quervain disease in terms of symptomatic relief, patient’s satisfaction and complications, Patients and Methods: The study is prospective Clinical trial study carried out in orthopedic unit in Al-Jumhoori Teaching Hospital in Mosul from April 2020 to October 2021.The total number of patients were Forty four patients with De Quervain disease, were grouped randomly into two groups; the first group consisting of twenty three patients who were treated with local corticosteroid injection and the second group consisting of twenty one patients were treated by surgical decompression. Results: in this study, there were Thirty nine(88.63)females and five(11.36) males with a female to male ratio(7.8). Group 1 consisted of Twenty three patients treated with local injection of the first dorsal compartment, Eighteen (78.26 %) treated with this method obtained complete relief without recurrence of symptoms. Five (23.529 %) patients did not respond to treatment and this non response was defined by failure of resolution of symptoms and at least two out of the three diagnostic criteria, Group 2 consisted of twenty one patients treated by surgical Release . nineteen (90.47 %) patients achieved complete resolution. two (9.52 %) patients failed to respond to surgical decompression, The failure of response was defined by development of a painful scar in one and persistence of symptoms in the other. Conclusion: Surgical release comes with better outcome with cases having De Quervain tenosynovitis that fail to respond to local injection.
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