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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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De Quervain’s tenosynovitis: Pulling the radius decreases the symptomatology

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  • presenting/speaker Denis Gerlac - PT, Echirolles, France

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSHT19-1259

doi: 10.3205/19ifssh1475, urn:nbn:de:0183-19ifssh14750

Published: February 6, 2020

© 2020 Gerlac.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: This study was carried out to determine whether a traction on the radius, together with the performance of a Finkelstein test, modifies the pain, as part of a De Quervain tenosynovitis (DQT).

Clinical reasoning: The original idea was that abductus pollicicis longus and extensor pollicis brevis, which produce abduction of the thumb and wrist when they contract, also cause an ascension of the radius in relation to the ulna.

The hypothesis was: if this rise of the radius is maintained, it modifies the angle of penetration of the two tendons in the first compartment of the dorsal retinaculum, so that it increases the friction of these two tendons.

Patients and Method: We conducted a single-center prospective study on a group of 36 patients each presenting a DQT.

Proceedings: At the first appointment with the patients, two consecutive Finkelstein tests were performed. The first test was used to highlight the DQT, the second was done with a traction on the radius to see if it modified the pain.

Innovative, analytical or new approach: Thus, if the angle formed by the two tendons at the entrance of the first compartment increases when the radius is ascended, this angle must decrease or even disappear when the radius is pulled down by a traction. In which case, the pains themselves should diminish or disappear.

Results: 100% of the patients undergoing this test saw their pain disappear or decrease.

  • 8 patients saw their pain completely disappear (22.22%).
  • On average, the intensity of pain decreased by 3.97 out of 10 points (Verbal Rating Scale). Knowing that the highest pain measured during the first test was rated 8/10 and the lowest 3/10.

Conclusion: This study shows that a traction on the radius makes decrease even disappear the pain present during a DQT.

Discussion: The series presented here is too small to lead to certainties. It would be interesting to carry out a larger and multicenter study.

It would be interesting also to make a study to follow the evolution of this benefit in the time (the study is in progress).