De Quervain's Disease: Comparison between Two Methods of Intra-sheath Methylprednisolone Acetate Injection
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 3
Abstract
Introduction: De Quervain's disease is a tenosynovitis of first dorsal compartment tendons around radial styloid process. It is very common condition seen and treated during routine orthopaedic OPD practice. Study was done to compare between two methods of intra-sheath Methylprednisolone acetate Injection in de Quervain's disease. Material and Methods: 30 De Quervain's disease patients were treated with an intra-sheath injection of Methylprednisolone acetate (MA) from May 2014 to Dec 2015. A mixture of 1 ml (40 mg) of MA and 1 ml of 1% lidocaine hydrochloride was used for injection. The first 15 patients (Group-1), received injection by 26 gauge needle inserted vertically at the site just above the indurated tendon sheath into the first dorsal compartment of wrist. Remaining 15 patients (Group-2) were injected by a 1100 bent needle (26G), introduced into the tendon sheath longitudinally between the EPB and APL tendon. All were followed up for about 6 months. A questionnaire was given to them regarding their treatment outcome, satisfaction rate and any recurrence. Complications and total number of injections for full relief were also noted. The results were categorised into four categories: excellent, Good, Fair and Poor. All these variables has been compared between two injecting methods. Results: The efficacy rate was 93%. The treatment results of longitudinal injection method was better than those of vertical injection method. Recurrence was observed in seven hands (23%), and complications in 11 hands (37%); however, over 93% of patients were satisfied with the injection. Conclusion: Longitudinally injecting method of injecting steroid increases the precision to be intra-sheath and also minimises the chances of leakage of drug into surrounding tissue. By s howing upto 100% of efficacy rate, the longitudinal injection method is an effective option to treat De Quervain's disease.
Authors and Affiliations
Gopal Tiwari, Shalini Sharma
Keywords
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