synonyms:deQuervain's release, 1st extensor compartment release, incision 1st extensor compartment
deQuervain Release CPT
deQuervain Release Indications
- deQuervain's disease which has failed to improve with conservative care.
deQuervain Release Contraindications
- Active infection
- Medically unstable patient
deQuervain Release Alternatives
- Conservative care:thumb Spica Splint, nsaids, acitivity modification, Corticosteriod injection into first dorsal compartment.
deQuervain Release Pre-op Planning
deQuervain Release Technique
- Pre-op antibiotics
- Sign operative site
- Anesthesia: local anesthesia, with or without intravenous sedation
- Consdier tourniquet
- Prep and drap
- Incision: can be transverse, longitudinal, oblique or chevron over the first dorsal compartment. Chevron-style incision may aid in visualization of the radial sensory nerve
- Blunt dissection under loop magnification
- Identify and protect the radial sensory nerve.
- Expose the first dorsal compartment incise the retinaculum along its dorsal margin in line with the APL and
- APL tendon is larger, generally has two or more distinct tendons
- EPB tendon is smaller, dorsal, often lies in a separate compartment
- Any intra-compartmental septae are released and excised.
- Debride any loose tenosynovial tissue on the tendon
- Close skin incision
deQuervain Release Complications
- Incomplete relief of pain
deQuervain Release Follow-up care
- Post-op: bulky dressing. Consider thumb spica splnt
- 7-10 Days: Remove dressing, may gradually resume activities as tolerated.
- 3 Weeks: ensure full ROM. May consider OT if stiffness or continued pain.
- 6 Weeks: ensure patient has returned to full activities.
deQuervain Release Outcomes
deQuervain Release Review References