Journal of Isfahan Medical School

Journal of Isfahan Medical School

Comparing the Therapeutic Results of Methylprednisolone Acetate Injection with or without Thumb Spica Casting in Patients with de Quervain's Disease

Document Type : Original Article (s)

Authors
Abolghasem Zarezadeh 1
Shirvan Rastegar 2
Nazanin Arabzadeh 3
1 Associate Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: There is no consensus in the treatment of de Quervain's disease. This study was performed to compare the methylprednisolone acetate injection with thumb spica cast versus methylprednisolone acetate injection alone for treatment of de Quervain tendinitis.Methods: In this randomized clinical trial, 88 patients with de Quervain's disease were selected from patients who referred to Al-zahra Hospital and the researchers’ private offices in Isfahan, Iran. The patients were randomly assigned into 2 groups. 1 mg methylprednisolone acetate injection in first dorsal compartment of the wrist accompanied with thumb spica cast for 3 weeks was the therapeutic method utilized in the first group; methylprednisolone acetate injection alone was performed in the second group. The patients were evaluated in terms of pain intensity and the relative prevalence of tenderness and Finkelstein's test.Findings: Pain intensity and prevalence of tenderness and Finkelstein's test in both groups were similar and become lower significantly.Conclusion: It seemed that both therapeutic methods are effective equally; but as casting makes trouble for the patients, so corticosteroid injection alone is better than corticosteroid with casting in treatment of de Quervain's disease.
Keywords
de Quervain disease
Methylprednisolon acetate
Thumb spica cast
  1. Wolfe SW, Pederson WC, Hotchkiss RN, Kozin SH. Green's operative hand surgery. 6th ed. Philadelphia, PA: Churchill Livingstone; 2010. p. 2079-83.
  2. Wright PE II, Milford LW. Carpal tunnel and ulnar tunnel syndromes and stenosing tenosynovitis. In: Canale ST, Beaty JH, editors. Campbell's operative orthopaedics. 12th ed. Philadelphia, PA: Mosby; 2012. p. 4299-30.
  3. de Quervain, F. Uber eine Form von chronischer Tendovaginitis. Correspondenz-Blatt f Schweizer Arzte. 1895; 25: 389-394.
  4. Motoura H, Shiozaki K, Kawasaki K. Anatomical variations in the tendon sheath of the first compartment. Anat Sci Int 2010; 85(3): 145-51.
  5. Volpe A, Pavoni M, Marchetta A, Caramaschi P, Biasi D, Zorzi C, et al. Ultrasound differentiation of two types of de Quervain's disease: the role of retinaculum. Ann Rheum Dis 2010; 69(5): 938-9.
  6. Opreanu RC, Wechter J, Tabbaa H, Kepros JP, Baulch M, Xie Y, et al. Anatomic variations of the first extensor compartment and abductor pollicis longus tendon in trapeziometacarpal arthritis. Hand (N Y ) 2010; 5(2): 184-9.
  7. Schned ES. de Quervain tenosynovitis in pregnant and postpartum women. Obstet Gynecol 1986; 68(3): 411-4.
  8. Batteson R, Hammond A, Burke F, Sinha S. The de Quervain's screening tool: validity and reliability of a measure to support clinical diagnosis and management. Musculoskeletal Care 2008; 6(3): 168-80.
  9. Weiss AP, Akelman E, Tabatabai M. Treatment of de Quervain's disease. J Hand Surg Am 1994; 19(4): 595-8.
  10. Clarke MT, Lyall HA, Grant JW, Matthewson MH. The histopathology of de Quervain's disease. J Hand Surg Br 1998; 23(6): 732-4.
  11. Palmer K, Walker-Bone K, Linaker C, Reading I, Kellingray S, Coggon D, et al. The Southampton examination schedule for the diagnosis of musculoskeletal disorders of the upper limb. Ann Rheum Dis 2000; 59(1): 5-11.
  12. Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum 2004; 51(4): 642-51.
  13. Mirzanli C, Ozturk K, Esenyel CZ, Ayanoglu S, Imren Y, Aliustaoglu S. Accuracy of intrasheath injection techniques for de Quervain's disease: a cadaveric study. J Hand Surg Eur Vol 2012; 37(2): 155-60.
  14. Froimson AI. Tenosynovitis and tennis elbow. In: Green DP, editor. Operative hand surgery. 3rd ed. New York, NY: Churchill Livingstone; 1993. p. 1989-2006.
  15. Richie CA, III, Briner WW, Jr. Corticosteroid injection for treatment of de Quervain's tenosynovitis: a pooled quantitative literature evaluation. J Am Board Fam Pract 2003; 16(2): 102-6.
  16. Avci S, Yilmaz C, Sayli U. Comparison of nonsurgical treatment measures for de Quervain's disease of pregnancy and lactation. J Hand Surg Am 2002; 27(2): 322-4.
  17. Peters-Veluthamaningal C, van der Windt DA, Winters JC, Meyboom-de JB. Corticosteroid injection for de Quervain's tenosynovitis. Cochrane Database Syst Rev 2009; (3): CD005616.
  18. Mehdinasab SA, Alemohammad SA. Methylprednisolone acetate injection plus casting versus casting alone for the treatment of de Quervain's tenosynovitis. Arch Iran Med 2010; 13(4): 270-4.
  19. Petit Le MA, Roquelaure Y, Ha C, Bodin J, Meyer G, Bigot F, et al. Risk factors for de Quervain's disease in a French working population. Scand J Work Environ Health 2011; 37(5): 394-401.
  20. Ilyas AM. Nonsurgical treatment for de Quervain's tenosynovitis. J Hand Surg Am 2009; 34(5): 928-9.
  21. Mardani-Kivi M, Karimi MM, Bahrami F, Hashemi-Motlagh K, Saheb-Ekhtiari K, Akhoondzadeh N. Corticosteroid injection with or without thumb spica cast for de Quervain tenosynovitis. J Hand Surg Am 2014; 39(1): 37-41.
Journal of Isfahan Medical School
Volume 33, Issue 331 - Serial Number 331
March and April 2015
Pages 554-562

  • Receive Date 12 April 2015
  • Accept Date 06 April 2022