Outcomes of Single Corticosteroid Injection in De Quervain's Tenosynovitis.

OBJECTIVES

The aim is to demonstrate the effectiveness of steroid injection in treating De Quervain disease. This study took place in the Orthopedic and Spine unit of Hayatabad Medical Complex. This study started in June 2022 and ended in February 2023.

MATERIALS AND METHODS

Seventy-five patients and 76 hands with De Quervain's Tenosynovitis were recruited for the study. Of these 75 patients, 54 (72%) were female and 21 (28%) were male. The diagnosis of De Quervain's Tenosynovitis was established from the patients' histories, physical examinations, and special tests. One ml of local anesthetic (2% of xylocaine) mixed with 1 ml of Corticosteroid (Depo-Medrol®, containing methylprednisolone acetate 40 mg/ml) were injected between abductor pollicis longus (APL) and extensor pollicis brevis (EPB), 3-4 cm proximal to radial styloid on the effected side. Patients were reviewed at two- and three-weeks period after injection.  Results: Sixty-three (84%) patients were completely pain-free, 9 (12%) patients had mild pain, while 2 (2.2%) patients had no improvement in pain status at all. 1 (1.3%) patient didn't show up on the second follow-up.

CONCLUSION

Injecting corticosteroids into the first compartment of the dorsal extensor tendon is a good treatment for De Quervain's tenosynovitis. The incidence of De Quervain's disease is higher in females and in the right hand. Only a limited subset of individuals who have not responded to non-invasive and minimally invasive treatments can be considered for surgical intervention. The study's limitations include a small sample size and fewer follow-ups. Further studies, especially randomized controlled trials with large sample sizes and long follow-ups, are needed to determine the long-term efficacy of steroid injection in De Quervain's tenosynovitis and whether the documented effect is likely to have occurred due to the treatment.