De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is a debilitating condition characterised by pain on the thumb-side of the wrist. It is named after the Swiss surgeon Fritz de Quervain who first described the disease in 1895.
The underlying cause is inflammation of the tunnel that surrounds two tendons that help control movement of the thumb. Frequently it occurs after a period of repetitive ‘overuse’ – one of the most common presentations is in the mother of a newborn baby. The sudden requirement to continually pick up an infant can lead to rubbing of the tendons against the tunnel wall creating inflammation and discomfort.
The pain can be spectacularly exacerbated by tucking your thumb into your fingers and tilting your wrist to the side.
The treatment of de Quervain’s depends on the severity of the symptoms and can include splinting, hand therapy, corticosteroid injections, and hand surgery. A review with a Hand Surgeon is a good starting point.
For further information please contact Dr Yuen or read more about De Quervain’s Tenosynovitis.
Dupuytren’s contracture is a disease which causes the formation of rope-like cords in the palms and fingers of your hand. As these cords tighten, your fingers will bend towards your palm, until eventually you cannot straighten them.
Unfortunately there is no cure for Dupuytren’s contracture, but there are a number of effective treatment options. Previously the mainstay of treatment had always been hand surgery, from which it often could take several months to fully recover from the operation.
Recently a minimally invasive option, the injection of collagenase (Xiaflex), has become available. While it still does not fully cure Dupuytren’s disease, it does have a number of benefits over surgical options. These include a faster recovery, a more rapid return to activities, decreased(or absent) scarring, and of course it removes the risks and inconvenience of surgery and anaesthesia.
Collagenase is given by a needle injected directly into the Dupuytren’s cord. This can be done in a hand surgeon‘s rooms rather than an operating theatre. Your hand will be wrapped in a bulky bandage to temporarily restrict your activities, and you will be required to stay for 30 minutes following the injection to ensure there is no evidence of an allergic reaction.
A review appointment with your hand surgeon will be booked for you the next day or a few days later. If the cord has not already ruptured spontaneously from the collagenase, then under local anaesthesia your finger will be stretched until the cord is broken. A visit to the hand therapist the same day will be required for the application of a night time splint and the commencement of an exercise program.
For further information please contact Dr Yuen or read more about Xiaflex here