DE QUERVAIN TENOSYNOVITIS (COMPRESSION OF THUMB TENDON)

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Our tendons that allows us to lift the thumb and to move away from other fingers pass under a tunnel which is near the thumb base in the wrist. By thickening and hardness in this tunnel, swellings occurred in sheath of the tendon make  This table with pain and sensibility in the wrist is called with the name of the surgeon (Fritz de Quervain) who described the disease first.

It is mostly seen after forcible and recurrent movements which are just started to be done. Especially the position of the hand of which new mothers make during carrying their baby; and effects of hormonal fluctuations in pregnancy and lactation period facilitates this situation to be arisen. De Quervain tendinitis may occur after old wrist fractures, traumas, and exercises after unusual weights.

The most typical symptom is pain in the thumb side of the wrist.  The pain diffuses to the thumb in downwards and to the front arm in upwards. The pain increases in strong clutching and wrist twisting that the thumb is used. (Figure 1) Also swelling may be observed in the pain area of the wrist. The pain which occurs when we twist the wrist in the direction of the little finger by taking the thumb in the fist is typical for diagnosis.

To relax the hand by using a splint which inactivates the painful movements of the thumb in the beginning period is very important. (Figure 2) Besides, swellings of the tunnel and the tendon are tried to be decreased by using non-steroid anti-inflammatory drugs. If symptoms are persistent or getting worse, the tunnel which compresses tendons should be opened surgically. This surgery may be performed by local anesthesia to whole arm or only to the wrist.

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