Corticosteroid Injection with or without Thumb Spica Cast for de Quervain Tenosynovitis
Abstract
Introduction: de Quervain tenosynovitis is a common
condition presenting to Orthopedics Out Patient
Department, treatment for which varies widely. The aim
of this study was to compare the outcome of treatment
with Corticosteroid Injection and Corticosteroid
Injection plus Thumb Spica Cast in de Quervain
tenosynovitis.
Materials and Methods: Seventy-five randomly
assigned patients received 40 mg of methylprednisolone
acetate with 1 ml of 2% lidocaine and the patients in
Corticosteroid Injection and Corticosteroid Injection
plus Thumb Spica Cast group received thumb spica
cast as well. The primary outcome was assessed using
treatment success rate, and the secondary outcome
was assessed using Visual Analog Scale and Quick
Disabilities of Arm, Shoulder and Hand scores.
Results: The treatment success rate was 89.7%
in the Corticosteroid Injection and Corticosteroid
Injection plus Thumb Spica Cast group and 50% in the
Corticosteroid Injection group. Although both methods
improved the patients’ conditions significantly in terms
of relieving pain and functional ability at the final visit,
Corticosteroid Injection plus Thumb Spica Cast group
showed significant improvement (p value <0.001).
Conclusion: The combined technique of corticosteroid
injection and thumb spica casting was better than injection
alone in the treatment of de Quervain tenosynovitis in
terms of treatment success and functional outcomes.