De Quervain's disease - causes, symptoms, diagnosis and treatment

De Quervain's disease - narrowing (stenosis) of the channel, which houses the tendon I brush of a finger. The cause of the disease - permanent channel trauma when moving it tendons. As the disease progresses due to the narrowing of the tendon duct are becoming harder to rub on his wall in the tendon sheath develops inflammation (tendonitis), and they swell, leading to further damage to the channel during movement and promoting the further development of stenosis.

The disease develops gradually and proceeds chronically. Women are affected more often than men, the elderly - often young. Usually the disease is detected the connection with the nature of work or the increased load on the brush when performing household duties.

traumatology and orthopedics dominates the view that the de Quervain's disease is predominantly professional in nature.

I finger - the most active. It is involved in almost all the small movements of the hand and plays a significant role in the performance of a number of larger operations, such as locking objects or tools. With a constant performance of movements associated with prolonged stress thumb and wrist deviation in the direction of the little finger, and without considerable load on the tendons and channel increases even more. It creates favorable conditions for the development of stenosis and associated inflammation.

The disease usually occurs in pianists, housekeepers, milkmaids, laundresses, seamstresses, mechanics, furriers, masons, field workers, painters, namotchits, utyuzhilschits and so on. D. However, this pathology can be detected and unemployed women. In the latter case, the disease associated with the development of domestic responsibilities and carrying small children in their arms.

orthopaedist or traumatologist. Conservative therapy on an outpatient basis. The patient applied a plaster or plastic bus for a period of 1-1.5 months, providing peace of the affected limb, and subsequently recommended to wear special bandage for I finger.

Furthermore, the patient is prescribed NSAIDs (ibuprofen, naproxen, etc.). When expressed pain syndrome perform injections of corticosteroids.

With the ineffectiveness of conservative therapy surgical treatment. The operation is performed in a hospital in a planned manner. Typically, local anesthesia is used. Prior to anesthesia doctor says the most painful point, and after the introduction of novocaine performs oblique or cross-sectional area of ​​the styloid process, passes through this point.

Then he gently removes dull hook towards the subcutaneous tissue with veins and superficial branch of the radial nerve, exposing the back of a bundle. Bunch dissected and partially excised.

With long-term course of the disease in the affected area may occur tendon adhesions to the tendon sheath and the vagina with the periosteum. If you find all the adhesions carefully excised.

The wound was sutured in layers, making sure to completely free movement of the tendon. Hand placed on a triangular bandage. Sutures are removed on day 8-10. Recovering disabled usually 14-15 days after surgery.

Postoperatively, possibly numbness and pins and needles in the area of ​​I, II and III finger half due to anesthesia or compression of superficial branch of the radial nerve. These symptoms disappear within 2-3 weeks.

It should be noted that the disease is caused by a chronic pathological process in the annular ligament. If the patient after the surgery still overloads hand, the disease may recur. Therefore, patients are usually recommended to change the nature of professional activity and reduce the load on the hand when performing household duties.