Dequervein's Tenosynovitis

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“Dr. Julka is stellar to none in his surgical skills and patient management. He not only has the skills and knowledge of a surgeon, but the bedside manner of a friend. He included myself and family in each decision process to ensure all would be aware. I would not hesitate to recommend him to family and friends should their need arise..”

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Dequervein's Tenosynovitis

What is the Dequervein's?

Dequervein’s tenosynovitis is a condition in which a tendon sheath on the thumb side of your wrist becomes inflamed and cases pain.  The inflammation occurs in an area known as the first dorsal compartment. This is a compartment or tunnel created by your wrist bone as well as a tendon sheath. The tunnel holds two very important tendons that are involved with thumb and wrist motion and use.  With activity occasionally these tendons can become inflamed and cause significant pain and limited ability to use the wrist and thumb, 

What are the symptoms of dequervein's tenosynovitis?

The key symptoms of classic dequervein tenosynovitis is pain on the thumb side of your wrist particularly with thumb use. As the sheath becomes tight some patients can have a locking sensation or inability to move their thumb freely.  As the inflammation worsens occasionally a small bump can be noticed on the thumb side of your wrist. 

How is dequervein's tenosynovitis diagnosed?

The good news about dequervein’s is that it is easily diagnosed with a through hand examination and history. No special tests such as Xrays, Ultrasounds or MRIs are required for the diagnosis.

How is dequervein's tenosynovitis treated?

Dequervein’s can be treated with non operative measures as well as surgical treatment.  Mild disease is often treated with braces and/or a cortisone injection which is performed at the time of your visit. More severe disease or symptoms that fail to respond to non operative measures is treated with surgery. 

What is done in dequervein's surgery?

Prior to the surgery Dr. Julka will provide numbing medication to the area so you feel no discomfort during the operation. Dequervein’s surgery entails making a small incision on your wrist over the region of pain. Next, the tendon sheath that is wrapped around the involved/inflamed tendons is cut to open up the sheath and allow the tendons to move freely.  We close all wounds with dissolvable stitches and apply a small bandage to the area after surgery. 

Will my surgery be minimally invasive?

Dr. Julka has been a sought out leader in minimally invasive approach to hand, wrist and elbow surgery.  Dr. Julka performs dequervein’s release surgery in a minimally invasive with a 5mm incision at the wrist which is closed with dissolvable stitches allowing a generally quicker recovery as well no formal hand therapy. 

What kind of anesthesia is required?

The vast majority of our dequervein’s release surgeries are performed with numbing of the hand with a local anesthetic.  Some patients wish to avoid further anesthesia while others prefer to have some mild sedation. Myself and our anesthesiology staff value your preference and allow you to choose between the two options to optimize your experience. 

Do I have to stay overnight in the hospital?

All of our dequervein’s release surgeries are performed in a surgery center on an outpatient basis. 

What can I do after my surgery?

You will be placed in a small soft bandage after your surgery. Unless instructed otherwise you will be allowed to remove your bandage in 48 hours and place a band aid over the incision.  At this time you may use the hand for light activities, shower, and perform exercises gently on your own at home. 

When can I get back to my normal activities?

After dequervein release surgery we will release you back to your regular activities at 4-6 weeks.  Patients who perform activities such as yoga, pushups or other activities that result on significant weight bearing through the hand or wrist may have to alter their activities till 8 weeks or more.  

How do I know if I need to seek treatment?

We recommend you seek treatment as soon as you notice symptoms that are interfering with your quality of life. In our experience we have had better success with non operative treatments such as cortisone injections when patients are seen early in their condition. You do not have to live with hand or wrist pain. Dr. Julka and the rest of the JIS Hand, Wrist and Elbow team are here to help.