Muhammad Saaiq1. 1. Department of Plastic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad, Pakistan.
Abstract
BACKGROUND: This randomized clinical trial was undertaken to document the clinical presentation of de Quervain's disease and evaluate the outcome of management with triamcinolone acetonide (TAC) injection versus surgical decompression. METHODS: Half of the patients were assigned to the corticosteroid injection group (group A) and half to the surgery group (group B). In group A, 40 mg of TAC was injected into the affected first extensor compartment. In group B, surgical decompression of first extensor compartment was performed. RESULTS: There were 56 patients with 38 (67.85 %) females and 18(32.14%) males. The age range was 23-66 years. In group A, one injection was employed among 7(25%) patients whereas two injections among 21(75%) patients. Local complications with injections were observed among 7 patients. Symptomatic relief with injection at 6-weeks was observed among 25% patients whereas recurrence at one year was observed among 9(32.14%) patients. In group B, no critical complications were encountered following surgery; all the patients had symptomatic relief at 6-weeks and there was no case with recurrence at one year. CONCLUSION: Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.
BACKGROUND: This randomized clinical trial was undertaken to document the clinical presentation of de Quervain's disease and evaluate the outcome of management with triamcinolone acetonide (TAC) injection versus surgical decompression. METHODS: Half of the patients were assigned to the corticosteroid injection group (group A) and half to the surgery group (group B). In group A, 40 mg of TAC was injected into the affected first extensor compartment. In group B, surgical decompression of first extensor compartment was performed. RESULTS: There were 56 patients with 38 (67.85 %) females and 18(32.14%) males. The age range was 23-66 years. In group A, one injection was employed among 7(25%) patients whereas two injections among 21(75%) patients. Local complications with injections were observed among 7 patients. Symptomatic relief with injection at 6-weeks was observed among 25% patients whereas recurrence at one year was observed among 9(32.14%) patients. In group B, no critical complications were encountered following surgery; all the patients had symptomatic relief at 6-weeks and there was no case with recurrence at one year. CONCLUSION: Surgical decompression provided superior results in terms of providing symptomatic relief at 6-weeks among all patients, absence of complications and no recurrence. The corticosteroid injections (CSI) were associated with the need for repeat injections among 75% cases and a recurrence rate of 32.14% at one year, rendering it to be comparatively a poorer choice.
Entities:
Keywords:
Corticosteroid injections; Surgical decompression; Triamcinolone acetonide; e Quervain’s disease; e Quervain’s syndrome; e Quervain’s tenosynovitis
Authors: Audrey Petit Le Manac'h; Yves Roquelaure; Catherine Ha; Julie Bodin; Geraldine Meyer; Frederic Bigot; Martin Veaudor; Alexis Descatha; Marcel Goldberg; Ellen Imbernon Journal: Scand J Work Environ Health Date: 2011-03-21 Impact factor: 5.024