Johanne J Garçon1, Bertille Charruau1, Emilie Marteau1, Jacky Laulan2, Guillaume Bacle1. 1. Unité de chirurgie de la main, hôpital Trousseau, CRHU de Tours, route de Loches, 37044 Tours, France. 2. Unité de chirurgie de la main, hôpital Trousseau, CRHU de Tours, route de Loches, 37044 Tours, France. Electronic address: jacky.laulan@orange.fr.
Abstract
INTRODUCTION: Surgery is indicated in De Quervain's tenosynovitis only after failure of medical treatment, often due to individual anatomical variants. We use Le Viet's technique, to avoid tendon instability. The aim of the present study was to evaluate long-term results, with the hypothesis that this surgical technique is reliable, providing lasting results. PATIENTS AND METHODS: All patients operated on between 1993 and 2015 were included, and results were assessed by telephone questionnaire at a minimum 1-year's follow-up. Surgical technique was systematically as described by Le Viet, with subcutaneous fixation of the retinaculum flap. Any anatomical variants were specified. In 26 cases, a concomitant pathology was treated in the same step. In addition to demographic data, the study looked for: pain on VAS, functional impairment, tendon dislocation, and satisfaction. RESULTS: There were no intra- or immediate postoperative complications. Of the 89 patients, 74 (80 wrists) were successfully recontacted: 68 women and 6 men, with a mean age of 48.5 years (range, 19-71 years). The 15 patients lost to follow-up showed initial progression comparable to the rest of the population. A supernumerary septum was found in 50 cases, and an abductor pollicis longus tendon with multiple slips in 35 cases. There were no recurrences. Functional impairment was absent in 68 wrists, moderate in 8 and significant in 4, including 3 with associated diseases. Mean VAS was 0.76 (range, 0-10). No patients reported tendon dislocation or neuroma. Patients were very satisfied in 72 cases, satisfied in 6 and dissatisfied in 2 cases with associated diseases. DISCUSSION: Results in the present series, with a mean follow-up of 9.5 years, were favorable, with total regression of functional impairment in 85% of cases and a satisfaction rate of 97.5%. There were no cases of tendon dislocation, neuroma, or recurrence. Residual problems were all related to associated diseases, whether pre-existing or with subsequent onset. CONCLUSION: Le Viet's technique gives reliable, lasting results without complications or recurrence. LEVEL OF EVIDENCE: IV, retrospective study.
INTRODUCTION: Surgery is indicated in De Quervain's tenosynovitis only after failure of medical treatment, often due to individual anatomical variants. We use Le Viet's technique, to avoid tendon instability. The aim of the present study was to evaluate long-term results, with the hypothesis that this surgical technique is reliable, providing lasting results. PATIENTS AND METHODS: All patients operated on between 1993 and 2015 were included, and results were assessed by telephone questionnaire at a minimum 1-year's follow-up. Surgical technique was systematically as described by Le Viet, with subcutaneous fixation of the retinaculum flap. Any anatomical variants were specified. In 26 cases, a concomitant pathology was treated in the same step. In addition to demographic data, the study looked for: pain on VAS, functional impairment, tendon dislocation, and satisfaction. RESULTS: There were no intra- or immediate postoperative complications. Of the 89 patients, 74 (80 wrists) were successfully recontacted: 68 women and 6 men, with a mean age of 48.5 years (range, 19-71 years). The 15 patients lost to follow-up showed initial progression comparable to the rest of the population. A supernumerary septum was found in 50 cases, and an abductor pollicis longus tendon with multiple slips in 35 cases. There were no recurrences. Functional impairment was absent in 68 wrists, moderate in 8 and significant in 4, including 3 with associated diseases. Mean VAS was 0.76 (range, 0-10). No patients reported tendon dislocation or neuroma. Patients were very satisfied in 72 cases, satisfied in 6 and dissatisfied in 2 cases with associated diseases. DISCUSSION: Results in the present series, with a mean follow-up of 9.5 years, were favorable, with total regression of functional impairment in 85% of cases and a satisfaction rate of 97.5%. There were no cases of tendon dislocation, neuroma, or recurrence. Residual problems were all related to associated diseases, whether pre-existing or with subsequent onset. CONCLUSION: Le Viet's technique gives reliable, lasting results without complications or recurrence. LEVEL OF EVIDENCE: IV, retrospective study.
Authors: Julia Blackburn; Mark J W van der Oest; Ruud W Selles; Neal C Chen; Reinier Feitz; Ana-Maria Vranceanu; Jarry T Porsius Journal: Clin Orthop Relat Res Date: 2019-12 Impact factor: 4.176
Authors: Julia Blackburn; Mark J W van der Oest; Neal C Chen; Reinier Feitz; Liron S Duraku; J Michiel Zuidam; Ana-Maria Vranceanu; Ruud W Selles Journal: Clin Orthop Relat Res Date: 2021-05-01 Impact factor: 4.176
Authors: Romy Bosman; Liron S Duraku; Mark J W van der Oest; C A Hundepool; Vaikunthan Rajaratnam; D M Power; Ruud W Selles; J Michiel Zuidam Journal: Plast Reconstr Surg Glob Open Date: 2022-05-06