De Quervain's Tenosynovitis Surgical Release

Surgery for de Quervain's tenosynovitis is done to relieve swelling and pain in the wrist and thumb. The swelling and pain was caused by inflammation (the body's way of reacting to injury or infection). The inflammation occurred at the covering (sheath) around the tendons (tough cords of tissue). The sheath was opened during surgery. This opening gives the tendons more space to move. Once you recover from the surgery, the pain you used to feel should be improved. Normal movement of your wrist and thumb should return. Most of the time, surgery for de Quervain's tenosynovitis is an outpatient procedure. That means you will go home the same day.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies.

  • Medicines taken including herbs, eyedrops, prescription medicines (especially blood thinners [anticoagulants]), aspirin and other over-the-counter medicines and steroids (by mouth or cream).

  • Previous problems with anesthetics or medicines used to numb the skin.

  • Possibility of pregnancy, if this applies.

  • Any history of blood clots in your legs or lungs.

  • Any history of bleeding or other blood problems.

  • Previous surgery.

  • Other important health problems.

RISKS AND COMPLICATIONS

  • Pain at the incision site.

  • Blood that pools under the incision (hematoma).

  • Infection at the incision site.

  • Swelling.

  • Allergic reaction to the anesthesia.

  • A return of pain or stiffness in the thumb.

  • Rarely, nerve injury.

BEFORE SURGERY

  • Two weeks before your surgery, stop using aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief. This includes prescription drugs and over-the-counter anti-inflammatory drugs. Also stop taking vitamin E.

  • If you take anticoagulants, ask your caregiver when you should stop taking them.

  • Stop smoking.

  • Do not eat or drink for about 8 hours before your surgery.

  • Arrive at least an hour before the surgery, or whenever your surgeon recommends. This will give you time to check in and fill out any paperwork.

  • Your surgery will probably be an outpatient procedure. That means you will go home the same day. Make arrangements in advance for someone to drive you home.

THE PROCEDURE

  • You will be given a local anesthetic or regional anesthetic so you do not feel pain. Your thumb and wrist area will be numbed, but you will still be awake.

  • The surgeon will make a cut (incision) in the wrist. Then, the sheath that wraps around the tendons will be opened. This gives the tendons inside the sheath more room. There will be less pressure on them, and that helps relieve the pain.

  • If there are small sacs filled with fluid (cysts) or other inflamed tissues, they can be removed during the surgery.

  • The incision will be closed with small stitches. This will be covered with a dressing (a piece of gauze).

  • A splint or brace will be put on your wrist and thumb area to keep it from moving.

AFTER SURGERY

  • You will stay in a recovery area until the anesthesia has worn off. Your blood pressure and pulse will be checked often. Once your body functions are back to normal, you will be able to go home.

  • You will have a splint or brace on your wrist and thumb area.

  • The surgeon will give you a prescription for pain medication to keep you comfortable.

  • Before you are sent home, you will be shown how to care for the area around the cut (incision) that was made during surgery. Make sure you know how often the bandage (dressing) should be changed. You also need to know when the splint and dressing can be taken off for good.

  • Ask whether you will need physical or occupational therapy. If so, ask about referrals.

  • Be patient. It will take a few weeks before you can use your wrist and thumb normally again.