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International Surgery and Ortho Conference
October 25-26, 2017 | Toronto, Canada
Case Rep Surg Invasive Proced 2017 | Volume 1 Issue 3
Surgical decompression in de Quervain Tenosynovitis: A case from Nepal
Shiva Prasad Parajuli
1
, Bhogendra Bahadur KC
2
, Norman Lamichhane
2
and
Sabita Dhakal
3
1
Kaski Model Hospital, Pokhara, Nepal
2
Academy of Health Sciences, Pokhara, Nepal
3
Nepali Technical Assistance Group, Nepal
D
e Quervain tenosynovitis is a common cause of functional
impairment. Steroid injection has good result but
significant numbers of cases develop resistance requiring
surgical decompression. This study assesses the outcome
of surgery. Symptomatic de Quervaint tenosynovitis cases
resistant to conservative treatment that underwent surgical
decompression and postoperative thumb immobilization
using thumb spica splint cast during four and half years
were analyzed. They were followed for at least three months
for clinical and functional outcome. Patient demography,
visual analogue score (VAS) and complications were
analyzed descriptively. There were 34 cases of de Quervaint
tenosynovitis, mean age 42±16 years, and female 88.2%.
Treatment was successful in all cases. The mean VAS score
reduced to 0.5 from 6.82, p-value <0.01. Complication
occurred in one case. Reduction in VAS score was significantly
better than other techniques of treatment like SCI or SCI with
TSC application. We found septation in 47% and multiple APL
slips in 11.8% of our 34 cases. In contrast, the cadaveric study
reports anatomical variation of multiple septation of APL in
57.6% and septation of first dorsal compartment in 47% in
66 cases. 22 This indicates that the failure of treatment with
corticosteroid injection may contribute to this anatomical
variation and ultrasound guided injection may result in
less number of resistant cases. Surgical decompression of
de Quervain tenosynovitis was safe and effective in cases
resistant to conservative treatment.
Speaker Biography
Shiva Prasad Parajuli is an Orthopedic surgeon practicing orthopedics and traumatology
since 2007 in government and private hospitals of Nepal. He has strong knowledge
and skills on managing the trauma patients in emergency for primary management
and after for final management like surgeries. He has done many surgeries on trauma
and orthopedics such as nailing, plating, hemiarthroplasty, soft tissue injuries,
corrective osteotomies. Further, he has been actively involved in research on trauma
management and Orthopedics in Nepal.
e:
parajulishiva12@gmail.com