What is de quervain's tendon surgery?

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De Quervain's tendon release: Overview

De Quervain's tendon release is surgery to decrease pressure on a tendon that runs along the side of the wrist near the thumb. Tendons are flexible, ropelike fibers that connect muscle to bone. In de Quervain's (say "duh-kair-VANZ") tendinitis, the tendon becomes swollen. This causes the tendon to rub painfully against the tissue that covers it.

This surgery will probably be done while you are awake. The doctor will give you a shot (injection) to numb your hand and prevent pain. You also may get medicine to help you relax.

The doctor will make a cut (incision) in the skin on the side of your wrist near the base of your thumb. The doctor will make a cut to open the tight band over the swollen part of the tendon. This will allow the tendon to move freely without pain. The doctor will close the skin incision with stitches. You will have a scar on the side of your wrist that will fade with time.

You will go home on the same day as the surgery. How soon you can return to work depends on your job. If you can do your job without using your hand, you may be able to go back to work in a few days. But if your job requires you to do repeated hand or wrist movements, put pressure on your hand, or lift things, you will need more time. Ask your doctor when you can go back to work.

How can you care for yourself after de Quervain's tendon release?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk.
  • For a few weeks after surgery, avoid using your hand. This includes lifting things heavier than a couple of pounds or doing repeated arm or hand movements, such as typing, using a computer mouse, washing windows, vacuuming, or chopping food. Do not use power tools, and avoid other activities that make your hand vibrate.
  • Ask your doctor when you can drive again.
  • You may be able to go back to work a few days after surgery. It depends on the type of work you do and how you feel. Ask your doctor when you can go back to work.
  • You may shower, but do not get your hand wet until your doctor says it is okay. Keep the bandage dry by covering it with plastic. Do not take a bath, swim, use a hot tub, or soak your hand until your doctor says it is okay.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. Your doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • Leave the bandage on your hand until your doctor says it is okay to remove it.
  • After your doctor says you can take off your bandage, wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

Exercise

  • Gently bend and straighten your fingers throughout the day to keep them flexible and help reduce swelling.
  • You may need wrist and hand therapy. This can help you regain movement, strength, and grip in your wrist and hand. To get the best results, you need to do the exercises correctly and as often and as long as your doctor or your physical or occupational therapist tells you to.

Ice and elevation

  • Put ice or a cold pack on your hand and wrist for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
  • Prop up your wrist on a pillow anytime you sit or lie down for the first 2 or 3 days. Try to keep your wrist above the level of your heart. This will help reduce swelling.
  • Wear a sling to support your hand, if directed by your doctor. Make sure to move your arm and shoulder often if you wear a sling. This will help prevent your elbow and shoulder from getting stiff.

How do you prepare for de Quervain's tendon release surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • You may need to shower or bathe with a special soap the night before and the morning of your surgery. The soap contains chlorhexidine. It reduces the amount of bacteria on your skin that could cause an infection after surgery.
  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After De Quervain's tendon release: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • Bright red blood has soaked through the bandage over your incision.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • Your hand or fingers are cool or pale or change color.
  • You have tingling or numbness in your hand or fingers.
  • You cannot move your fingers.
  • Your cast or splint feels too tight.

Watch closely for any changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

After de Quervain's tendon release: Overview

De Quervain's (say "duh-kair-VAZ") tendon release is surgery to reduce pressure on a tendon that runs along the side of the wrist near the thumb. The doctor made a cut, called an incision, in the skin on the side of your wrist near the base of your thumb. The surgery opens the tissue over the swollen part of the tendon. This allows the tendon to move freely without pain.

Your wrist and thumb will be sore and swollen at first. You may feel numbness or tingling near the incision. This feeling will probably start to get better in a few days, but it may take several months to go away. Your doctor will take out your stitches 1 to 2 weeks after surgery. Your doctor or your physical or occupational therapist may recommend that you wear a splint on your hand for 1 to 4 weeks after surgery.

It may take 6 to 12 weeks for your hand to heal completely. After you heal, you may be able to move your wrist and thumb without pain.

How soon you can return to work depends on your job. If you can do your job without using your hand, you may be able to go back after a few days. But if your job requires you to do repeated hand or wrist movements, put pressure on your hand or wrist, or lift things, you will need more time. Your doctor can help you decide how much time you will need to take off work.

What happens on the day of de Quervain's tendon release surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You may get medicine that relaxes you or puts you in a light sleep. The area being worked on will be numb.
  • The surgery will take about 30 minutes.
  • After surgery, you will have a thick bandage on your hand and wrist. You may not be able to bend your wrist.
  • You will probably go home after 1 hour in the recovery room.

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