Invasive vs Non Invasive treatment in stenosing tenosynovitis Kumar Amit1,*, Mittal Piyush2 12nd year Resident, Orthopaedics, Department of Orthopaedics 2Associate Professor, Department of Orthopaedics *Corresponding author: Dr. Amit Kumar Address; B 308 room no. phase 2, New PG Hostel, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat. B.J. Medical College, Civil Hospital, Ahmedabad
Online published on 16 January, 2018. Abstract Background de Quervain's tenosynovitis is an inflammation of abductor pollicis longus (APL) and extensor pollicis brevis (EPB) muscle tendon sheaths at the level of radial styloid process. Its conservative management includes nonsteroidal anti-inflammatorydrugs, wrist and thumb immobilization, ultrasonic therapy (US Th.) and low level laser therapy (LLLT). Invasive methods include local injection of steroid in tendon sheath (inj. LHC) and surgery involving release of tendon sheath. Materials and Method Sixty patients clinically diagnosed de Quervains tenosynovitis were included in the study and randomly assigned to two groups. The average age was 36 years (range: 21–45 years). One group was given LLLT + US Th. And other was injection LHC. The clinical criteria used were Finkelstein's test, tenderness over radial styloid (Ritchie's tenderness scale), grip strength, pain (visual analog scale [VAS]) and radiological criteria was ultrasonographic assessment of change in thickness of APL and EPB tendon sheath. They were measured before commencement and at the end of seven sessions of therapy, as per standard procedure. Results Improvement was seen within both groups in the following outcome measures assessed: Ritchie's tenderness scale, grip strength and VAS. Finkelstein's test was significantly improved in inj. LHC group. Ultrasonographic measurement of tendon sheath diameters, the mediolateral (ML), and anteroposterior (AP) diameters was not found to be significantly different in between the groups after treatment. On comparing both the groups, statistically significant difference was found. However, looking at the mean values, the grip strength and VAS showed better improvement in the inj LHC group as compared to the US+laser therapy group. Top Keywords de Quervains tenosynovitis, low level lasers, ultrasonic therapy, inj LHC. Top |