De Quervain's release is a surgical procedure that aims to reduce pressure on the tendon that runs along the side of the wrist near the thumb.
This procedure is normally performed to treat De Quervain’s syndrome or De Quervain's tenosynovitis, which is the swelling of the tendons along the thumb side of the wrist. Those with this condition experience pain and tenderness, along with limited flexibility and mobility in this area when carrying out certain activities such as moving the thumb or wrist, gripping or grasping, forming a fist, or lifting something with their arms.
Tendons are structures that attach muscles to bones, covered by a thin layer of soft tissue called synovium that allows them to slide easily through the sheath that surrounds them. When swelling and inflammation happens, the tendons can no longer move or fit well inside this sheath, resulting in friction and pain during certain thumb and wrist movement.
De Quervain's tenosynovitis is normally caused by overuse, strain, repetitive movement, or traumatic injury to the thumb. It may also be caused by inflammatory medical conditions such as rheumatoid arthritis. Some pregnant women also experience this condition due to fluid retention caused by hormonal changes.
When this condition does not improve with other forms of treatment or becomes severe, De Quervain’s release surgery is typically recommended to alleviate pain and discomfort.
How does De Quervain’s release work?
During a De Quervain’s release procedure, the orthopaedic surgeon makes a cut (incision) in the skin along the side of your wrist, near the base of the thumb. Then, the tendon sheath over the inflamed tendons is opened up, and excess tissue around the tendon may also be removed. This procedure aims to release the tendon sheath to allow more space for the irritated and inflamed tendons to move.
DeQuervain’s release is a minimally invasive procedure that can be done under local anaesthesia to numb the area and prevent you from feeling pain. It usually takes around 30 minutes, depending on the individual and the severity of the condition.
Benefits of De Quervain’s release
Treats De Quervain's tenosynovitis
Alleviates pain, stiffness, and discomfort
Improves mobility and flexibility in the wrist and thumb
What conditions does De Quervain’s release treat?
De Quervain’s release can be used to treat the following conditions:
De Quervain's tenosynovitis
What results can I expect?
You can expect to go home the same day after the surgery as it is generally performed as an outpatient procedure. Your wrist and thumb may feel sore and swollen initially, and you may experience numbness or tingling. However, this is normal and will usually last only a few weeks.
Your stitches will be removed 1 or 2 weeks after the surgery, and you may be recommended physiotherapy to regain flexibility and strength in your wrist and thumb. You may also need to wear a splint on your hand for up to 4 weeks after surgery.
It may take 3-4 months for your hand to heal completely. When you reach full recovery, you should be able to move your wrist and thumb without any pain or discomfort.
Results will vary from person to person, depending on the treatment area, severity of the issue, and your overall health. Your orthopaedist can give you a better idea of what to expect based on your individual needs and circumstances.
How many treatment sessions are needed?
Only 1 surgical procedure at a time is typically required for De Quervain’s release.
However, if you have problems in both hands, the procedure may be carried out twice in 2 separate sessions. You may also need to attend physiotherapy sessions and follow-up appointments with your orthopaedist to monitor your progress and recovery.
Your orthopaedic surgeon will be able to provide you with a bespoke treatment plan, tailored to your needs and requirements.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.