FREQUENTLY ASKED QUESTIONS
Q. Fasting before Operation?
A. Nothing to eat or drink at least 6 hours before the operation.
Q. Anaesthetic?
A. General, arm block or local anaesthetic can be used.
Q. Duration of Operation?
A. About 30 minutes.
Q. Pain?
A. Local anaesthetic is instilled at the time of surgery, so there should be very little pain initially. Pain is usually very mild and easily settled with simple analgesia such as paracetamol.
Q. Will I be in a plaster after the operation?
A. No.
Q. Will I need physiotherapy after the surgery?
A. Usually just your own movements will be enough to regain normal movement. If recovery is slow, hand therapy treatment may be recommended.
WHAT IS DE QUERVAIN'S DISEASE?
De Quervain's disease is a painful inflammation of specific tendons of the thumb. The swollen tendons and their coverings cause friction within the narrow tunnel or sheath through which they pass. The result is pain at the base of the thumb. It is one of the most common types of tendon lining inflammation.
WHAT ARE THE SYMPTOMS OF DE QUERVAIN'S?
Pain along the thumb aspect of the wrist, directly over two thumb tendons is common in cases of de Quervain's. The condition can occur gradually or suddenly. In either case, the pain may travel into the thumb or up the forearm. Thumb motion may be difficult and painful, particularly when pinching or grasping objects.
Some people also experience swelling and pain on the side of the wrist at the base of the thumb. The pain may increase with thumb and wrist motion. Some people feel pain if direct pressure is applied to the area.
WHAT CAUSES DE QUERVAIN'S?
Overuse, a direct blow to the thumb, repetitive grasping and certain inflammatory conditions, such as rheumatoid arthritis, can all trigger the disease. New mothers who repetitively lift their babies, is a common cause of problems. Often, its cause is unknown. De Quervain's affects women eight to 10 times more often than men.
HOW IS DE QUERVAIN'S TREATED?
Treatment usually involves wearing a splint 24 hours a day for four to six weeks to immobilize the affected area and refraining from any activities that aggravate the condition. Ice may be applied to reduce inflammation. If symptoms continue, your doctor may give you anti-inflammatory medication such as naproxen or ibuprofen, to decrease swelling. Cortisone injection into the sheath around the tendons may be necessary to reduce the inflammation. If de Quervain's disease does not respond to conservative medical treatment, surgery may also be recommended.
SURGERY
Surgery for de Quervain's disease is an outpatient procedure done under general or local anesthesia. Surgical release of the tight sheath eliminates the friction that worsens the inflammation, restoring the tendons' smooth gliding capability. Upon recovery, your surgeon will recommend an exercise program to strengthen your thumb and wrist. Recovery times vary, depending on your age, general health and how long the symptoms have been present.
