Selected Characteristics of Seven Studies that Examined the Treatment of de Quervain’s Tenosynovitis.
| Study Characteristics | Weiss et al1 1994 | Harvey et al2 1990 | Anderson et al3 1991 | Witt et al4 1991 | McKenzie5 1972 | Zingas et al6 1998 | Christie7 1955 |
|---|---|---|---|---|---|---|---|
| Women’s wrists | 80 | 70 | 50 | 64 | 25 | 12 | 16 |
| Men’s wrists | 13 | 12 | 5 | 19 | 5 | 7 | 4 |
| Bilateral | 0 | 0 | 1 | 4 | 0 | 0 | 0 |
| Mean age, years (range) | 38 (17–72) | 45 (16–83) | 47 (21–80) | 44 (16–75) | 49.5 (25–74) | 39 (24–63) | 46 (18–74) |
| Demographics | No difference in treatment success when comparing sex, hand dominance, age, or duration of symptoms | Women with infants and small children, hand dominance, secretary, nursing occupation | Housework, clerical | No association found between sex, hand dominance, age, or duration | Not noted | Homemaker, barber, salesperson | Tailor, cutter, seamstress, poster artist |
| Criteria for diagnosis | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test | Pain at radial wrist, tender over 1st dorsal compartment, Finkelstein’s test |
| Exclusion criteria | Not noted | Previous treatment | No previous steroid injection within past 6 months | Rheumatoid arthritis | Not performed | Previous wrist surgery, previous 1st extensor compartment injection, rheumatoid arthritis in pregnancy | No obvious preceding trauma |
| Duration of symptoms, mo (range) | 7 (0.25–36) | 3.2 (0.75–14) | 4.4 (1–24) | 5.35 (0.5–18) | 1.25–9 | 3.9 (1–11) | 8 (1–36) |
| Injection medicine used | 1 cc betamethasone, 1 cc 1% lidocaine | Hydrocortisone acetate or methyl prednisolone acetate, “local” anesthetic | Methyl-prednisolone, 80 mg, 1% Xylocaine 1.5 cc | 40 mg methyl-prednisolone, 1% lidocaine 1 cc | 25 mg hydrocortisone, 2% lidocaine 1 cc | 6 mg Celestone, 1% lidocaine 3 cc | 25 mg hydrocortisone acetate, 2% procaine 1 cc |
| One injection | 42 | 45 | 33 | 0 | 24 | 19 | 16 |
| Repeated injection | 0 | 7 | 14 | 0 | 5 | 0 | 4 |
| Injection and splint | 14 | 0 | 0 | 87 | 0 | 0 | 0 |
| Thumb spica splint | 37 | 0 | 39 | 0 | 0 | 0 | 0 |
| NSAID | 0 | 0 | 39 | 0 | 0 | 0 | 0 |
| Rest | 0 | 0 | 17 | 0 | 0 | 0 | 0 |
| Definition of success | Absence of diagnostic criteria | Absence of diagnostic criteria | Absence of diagnostic criteria | Absence of diagnostic criteria | Absence of diagnostic criteria | Absence of diagnostic criteria | Absence of diagnostic criteria |
| Side effects | Not noted | 2 nontender nodules, 2 skin color changes | Skin color changes and fat atrophy = 16, flare = 5 | None | None | None | Superficial thrombo-phlebitis (1) |
| Failure | 45 (underwent surgery) | 11 (6 had 2 injections, 5 had 1 injection) | 5 | 30 (within 3 months) | 1 | 8 (3 had surgery, 5 had return of criteria) | 1 |
| Follow-up, mo (range) | 4, 13 (6–14) | 0.5, 20 (0.25–84) | 1.5, 48 (6–71) | 18 (12–30) | 0.5, 1, 3, 18 | 1, 3 | 3.5 |
NSAID - nonsteroidal antiinflammatory drug.