Tendovaginits de Quervain
Tendovaginitis de Quervain is a tenosynovitis that occurs mainly in women over the age of 40, which is why it is also called “housewife’s thumb”. Overuse or injury to the tendons causes swelling and painful compression of the tendons. A long bending of the hand can also push and compress the tendons.In tendovaginitis de Quervain, the tendons of the short thumb extensor muscle (Musculus extensor pollicis brevis) and the long thumb abductor muscle (Musculus abductor pollicis longus) are particularly affected.
Both tendons run in the first tendon compartment on the back of the hand. The compression of the tendons leads to an inflammatory reaction of the tendon sheaths, which causes severe pain below the thumb. This pain occurs mainly when holding or grasping the hand firmly.
Often affected persons can hardly move the thumb in pain and there is a visible swelling below the thumb. Tendovaginitis de Quervain is initially treated conservatively by immobilizing the tendons and avoiding painful movements. Special splints or bandages can be worn for immobilization.
The use of anti-inflammatory painkillers such as ibuprofen or diclofenac can also provide relief. If the conservative treatment methods do not lead to an improvement, cortisone injections can be helpful, but improper injections can also damage the tendons. If the pain returns and the cortisone injections do not help, an operation can be performed in which the first tendon compartment is split.
This prevents compression of the tendons and reduces the pain. The operation can be performed on an outpatient basis. The hand should be immobilized for about a week after the operation and then slowly and gradually regained weight bearing. After about three weeks, full weight-bearing of the hand is usually possible.
