Movements involving grasping or pinching are particularly painful and difficult.Ĭonservative management of De Quervain’s tenosynovitis involves lifestyle advice (avoiding repetitive actions) and a wrist splint. Steroid injections will reduce swelling and relieve pain in most cases, and can be repeated several times if a good response is observed.įor those failing to respond to conservative management, surgical decompression of the extensor compartment can be performed under local or general anaesthetic. Patients with De Quervain’s tenosynovitis will often complain of pain near the base of the thumb with an associated swelling (secondary to thickening of the tendon sheath). It is most common in women between the ages of 30-50, especially in those with occupations or hobbies involving repetitive movements of the wrist. The fingers were flexed, and tactile sensation of the hand was intact.De Quervain’s tenosynovitisis inflammation of the tendons within the first extensor compartment of the wrist, resulting in wrist pain and swelling. The radial and ulnar pulses were palpable. On examination, the hand was swollen with extensive bruising over the palm (fig 1). However, as the pain increased and did not respond to analgesics, he went to his local emergency room five hours after the injury. He was diagnosed with a soft tissue injury and treated with analgesics. Compartment syndrome is defined by high pressures in a closed myofascial compartment, which affects initially the muscles and later the nerves and vessels. It is consistently found on the base of the fourth compartment.
The Posterior Interosseous Nerve is the only nerve found in the dorsal wrist compartments. He had no history of coagulopathy and did not use anticoagulants. The Extensor compartments of the wrist contain the extensor tendons of the hand. His right hand was swollen with a bruise on the palm. DORSAL WRIST: compartments of extensor tendons first compartment. Careful wound care, edema management, splinting, and hand therapy are critical. He consulted his family doctor two hours later with diffuse pain of his right hand that was exacerbated by movement of his fingers. extensor tendons can be performed by placing the hand on a gel tube with the fingers. Definitive management is emergent fasciotomies with incisions designed to decompress the involved hand compartments, which could include the thenar, hypothenar, and interosseous compartments, and the carpal tunnel. Herein, we describe two cases reported at a. Correspondence to: T H Lui .ukĪ construction worker in his 50s was hit on his right hand by a metal pipe. However, necrosis may be associated with compartment syndrome especially when the bite is on the hands or feet.5Guangdong Provincial Engineering Research Center of Wound Repair and Regenerative Medicine, Guangdong Provincial Academician Workstation of Wound Repair and Regenerative Medicine, China.4Department of Trauma and Orthopedics, Second Affiliated Hospital of Shenzhen University & Affiliated Baoan Hospital of Shenzhen, Southern Medical University, The 8th People’s Hospital of Shenzhen, Shenzhen, Guangdong 518101, China Installation and use of alcohol-based hand rub (ABHR) dispensers that are 95 or less alcohol content by volume are allowed in each smoke compartment as per.3St Teresa’s Hospital, Hong Kong SAR, China.1Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, NT, Hong Kong SAR, China.Wah Bong Wong, private orthopaedic surgeon 3, Compartments are defined as enclosed myofascial spaces bound by thicker connective tissues or bones.
Tun Hing Lui, consultant, honorary clinical professor 1 2,.
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