In 1895, Swiss surgeon Fritz de Quervain published five studies which opened him the door to immortality as he was the first to describe a rather painful condition that affects the tendons of the thumb. De Quervain syndrome, which is essentially a stenosing tenosynovitis, over a century after the Swiss pioneer, is considered a disease of the modern age: A study published in 2014 in the Muscles, Ligaments and Tendons Journal correlated the disease with the increased number of SMS sent by the volunteer students!

We now know that, in addition to those who routinely use computers, athletes and manual workers are also included in the high-risk groups, namely, those who make repetitive and dynamic movements with their hands. Also, the disease often occurs in patients with rheumatoid arthritis, while even a single tendon injury can cause scarring, preventing their normal functioning. It is also a common finding in pregnancy and seems to also prefer women aged 30-50.

De Quervain syndrome is attributed to repetitive thumb movements which create inflammation conditions in the tendons (the cords which connect the muscle to the bone) and their surrounding envelopes. The result is a local swelling and difficulty in sliding tendons into their canal, which is no more than a bundle of connective tissue. When there is an acute inflammation in the area of ​​the base of the thumb, the patient is unable to make movements such as rotating of the wrist, clenching of the fist or gripping of an object, the thumb seems to be “locked” to every movement. In situations which remain untreated for too long, the pain radiates to the forearm.

Diagnosis is performed through clinical tests from the orthopaedist and through the obtaining of a complete medical history. Radiological examinations shall exclude other diseases which require a different treatment, such as, for example, wrist arthritis. The first goal is to relieve the patient from the pain caused by the severe symptoms. The splint shall stabilize the thumb and the joint, while anti-inflammatory and / or local cortisone infusions in the sheath covering the tendons, are recommended. Above all, however, it is recommended to avoid activities which might irritate the area.
If the symptoms persist after the conservative treatment, or if the improvement is too small resulting in hand dysfunction, the tendons are surgically released from their cover, in order for friction to be eliminated. The duration of the surgery, which is performed under local anaesthesia does not exceed 20 minutes. The skin is sutured applying a special plastic surgery technique so as not to leave an unaesthetic scar, and the sutures do not need to be removed.
Postoperatively, the hand is placed in a suspension sling and the patient has to be on antibiotics and anti-inflammatory drugs. Mild activity is readily acceptable, post-operatively.

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