Orthopedic Surgery, Sports Medicine
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DeQuervain's surgery
This offer is for an all Inclusive surgical correction of DeQuervain's Syndrome by one of the top orthopedic surgeons in your area. The listed fee includes facility fees, all professional fees, all materials needed, and anesthesia as required.
This surgery is performed in a few hours and you can generally go home the same day.
This procedure is provided in our state of the art surgical center.
Background Information:
What is DeQuervain's Syndrome?
Dequervian's Syndrome is an inflammation of the tendon or tendon sheath at the base of the thumb where it connects to the wrist. This develops when the tendons that pull the thumb away from the fingers become inflamed and irritated as they pass beneath a ligament that holds the tendons to the bone
What are the Symptoms of DeQuervain's Syndrome?
1. Pain at the base of the thumb which may radiate up the forearm or down the thumb
2. Swelling at the base of the thumb
3 Pain increases with wringing motions of the wrist, unscrewing a jar lid, opening a car door, turning a key, or buttoning a shirt
4. Pain increases with pinch, grasping, or other thumb movements
5. Pain increases with pouring type motions when the wrist is pulled down towards the small finger side of the hand
6. Clumsiness and dropping objects when pain causes grip to be insecure
Can I get it from work?
Unfortunately, this is the most common cause of DeQuervain's Sysndrome. Here are a few related activities:
Activities requiring wringing motion
Repetitive activities that move the wrist in the direction of the small finger, especially with grip (for example, pouring from a pitcher using a hammer) or if the thumb is held in the palm of the hand (using a buffing or grinding machine)
When the thumb is held rigidly in the hitch-hiking position (for example, when held tensely off the keyboard while typing)
What can I do to prevent it from getting worse or developing?
Use the power grip (for example, holding an object with all the fingers in a loose grip) versus using a pinch
Use the shoulder to provide movement instead of using isolated wrist movements (for example, while fastening nuts and bolts or when holding the computer mouse)
Use the appropriate tool for the job
Make sure that tools are in good condition and that cutting edges are sharp (reduces the force needed to use the tool)
Use power tools when possible
Use tools that provide leverage; Work in the mid-range of motion; Don't move the wrist through it's motion extremes
Work with the wrist in a neutral position
Use ergonomically designed tools with modified handles that help maintain the wrist in a neutral position if they are available
Avoid holding the thumb in the palm of the hand while bending the wrist towards the palm or towards the small finger side of the hand
Minimize repetition; Periodically rest the arms briefly during repetitive or stressful activity; Stretch often during repetitive activity
Slow down the activity
Use the lightest grip possible (on tools, pens, the mouse, the steering wheel, etc.) that still allows you to maintain good control
Use the least amount of force necessary during the activity
Alternate work activities so the hands are not performing any one task repetitively for any length of time
Use good ergonomic practices at work; Apply these tendon and nerve protection principles to daily and leisure activities as well.
Practice good health habits
What are my Treatment Options?
Splinting (custom fit or pre-fabricated) which holds the wrist neutral and the thumb in a relaxed, functional position (a thumb spica splint)
Avoid the activities which cause pain, especially those requiring pinching and pulling with the thumb; Modify activities which can not be avoided
An ergonomic consultation to modify work environment stressors
Use of ergonomic equipment and tools such as split keyboards and hammers with a specially designed handle that holds the wrist neutral
Education in tendon and nerve protection techniques including modification of sleep and work habits
Hand therapy techniques to improve circulation, decrease swelling and reduce pain
A supervised exercise program to stretch tight muscles, strengthen weak muscles, promote postural balance; the program should include tendon and nerve gliding exercises
The doctor. may prescribe anti-inflammatory medications such as Naprosyn or ibuprofen; if these medications cause stomach irritation, the physician. may also prescribe a stomach calmer such as Zantac
The surgeon. may recommend a cortisone injection near the area of friction at the base of the thumb
...and if that doesn't help, then our practice can perform the surgery, described here:
A DeQuervain's release is a minor operative procedure that releases the sheaths surrounding the two thumb tendons at the base of the thumb
A small incision is made on the thumb side of the wrist
This procedure relieves the pressure and the friction on the tendons
Post Surgical Instructions (we will give you more afterward, this is just a summary)
Keep the incision clean and dry
Change the bandages as needed, especially if saturated with blood
Keep the fingers moving - make a gentle fist and hook fist, spread the fingers apart
Begin gently moving the thumb once the M.D. approves movement
Use your hand for light activity, as normally as possible, but respect pain
Once the stitches are removed, begin gently massaging the scar
Use a silicone based scar bandage if the scar is thick, stuck, red or painful
Gradually increase strength activities at 6 weeks post-surgery
Physical Therapy after the surgery
Cleaning and dressing of the incision until healed
Scar management including massage, the use of scar molds or silicone gel sheeting, ultrasound, hot packs
Swelling reduction techniques including instruction in elevation of the arm, compression wraps, retrograde massage, cold packs
Desensitization techniques if scar is sensitive
Active motion including tendon and nerve gliding exercises as necessary
Strengthening and work conditioning activities beginning at 6 weeks after surgery to tolerance
Will I have full function back?
Most of our patients do return to completely normal function. The pain that travels or radiates up and down the arm is often relieved almost immediately. Pain becomes more centered around the surgical site while the hand is healing.
The surgical area of the wrist will likely be tender for 3-4 months after surgery.
The scar area may be sensitive for about the same length of time.
There will be some amount of swelling over the surgical area for months as well.
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