Kocaeli Med J. 2021; 10(1): 166-170 | DOI: 10.5505/ktd.2021.64872

Comparative Clinical Results of one-year Follow-up of Surgical Decompression and Steroid Ýnjection in Patients Diagnosed With De Quervain Tenosynovitis in The Postpartum Period

Sibel Mutlu¹, Tansel Mutlu^2
1Department of Gynecology and Obstetric, Medical Faculty, Karabuk University, Karabuk, Turkey
²Department of Orthopedics and Traumatology, Medical Faculty, Karabuk University, Karabuk, Turkey

INTRODUCTION: De Quervain tenosynovitis most often affects patients in pregnancy and postpartum period. Nonsteroidal anti-inflammatory drug therapy and splinting treatment is sufficient, but steroid injection or surgical decompression is preferred around the tendon in patients who do not respond to treatment.In our study, it was aimed to determine the difference in efficacy between surgical decompression and steroid injection treatments
METHODS: 31 patients were included in the retrospective study conducted in Karabük University Education and Research Hospital between 2014-2020. Patient selection was made from pregnant patients who did not benefit from naproxen sodium treatment and splinting due to De Quervein tendinitis between these dates. Sixteen of them had been given steroid injection (group I), and 15 had surgical decompression (group II). Clinical evaluation of the patients was made according to patient-based satisfaction scoring and visual analog scale (VAS), and the time to relaxation after treatment was examined and a comparison was made between the two groups.
RESULTS: The treatments applied in both groups provided satisfactory benefits. Patient satisfaction was similar between the two groups (p> 0.227). There was a significant decrease in VAS in both groups.There was no significant difference in terms of decrease between the two groups (p> 0.43).
DISCUSSION AND CONCLUSION: In patients who do not benefit from the use of splinting with nonsteroidal anti-inflammatory drug therapy in the postpartum period, steroid injection between the tendon and the sheath can be used as an alternative to the more invasive surgical treatment.Surgical treatment should be applied firstly in patients who want their symptoms to decrease rapidly.

Keywords: De quervain, splint, tenosynovitis, decompression, steroid, pregnancy

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Doðum sonrasý De Quervein Tenosinovit Tanýsý Konulan Hastalarda Ýki Farklý Tedavi Biçimi Olan Steroid Enjeksiyonu ile Cerrahi Dekompresyonun Bir Yýllýk Takiplerin Karþýlaþtýrmalý Klinik Sonuçlarý

Sibel Mutlu¹, Tansel Mutlu^2
1Karabük Üniversitesi Týp Fakültesi, Kadýn Hastalýklarý ve Doðum Anabilim Dalý, Karabük, Türkiye
²Karabük Üniversitesi Týp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalý, Karabük, Türkiye

GÝRÝÞ ve AMAÇ: De Quervain tenosinoviti en sýk gebelik ve doðum sonrasý dönemdeki hastalarý etkilemektedir. Genellikle nonsteroidal antienflamatuar ilaç tedavisi ve splint uygulama tedavisi yeterli olmakla birlikte tedaviye yanýt alýnamayan hastalarda öncelikle tendon etrafýna steroid enjeksiyonu veya cerrahi dekompresyon tercih edilmektedir. Çalýþmamýzda cerrahi dekompresyon ile steroid enjeksiyonu tedavileri arasýndaki etkinlik farkýnýn belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 2014-2020 yýllarý arasýnda Karabük Üniveristesi Eðitim Araþtýrma Hastanesinde retrospektif olarak yapýlan araþtýrmaya göre 31 hasta çalýþmaya dahil edildi. Hasta seçimi; belirlenen tarihler arasýnda De Quervain tendiniti nedeniyle öncelikle naproksen sodyum ilaç tedavisi ve splint uygulanýp fayda görmeyen gebe hastalardan oluþturuldu. Bunlardan 16 hastaya steroid enjeksiyonu(grup I), 15 hastaya cerrahi dekompresyon yapýlmýþtý(grup II). Hastalarýn klinik deðerlendirilmesi hasta bazlý memnuniyet skorlamasý ve visüel analog skalaya (VAS) göre yapýldý ve tedavi sonrasý rahatlama olana kadar geçen süre incelenerek iki grup arasýnda karþýlaþtýrma yapýldý.
BULGULAR: Her iki grupta uygulanan tedaviler hasta memnuniyeti açýsýndan tatmin edici fayda saðlamýþtý. Ýki grup arasýnda memnuniyet göstergesi benzer bulundu (p>0,276). VAS yönünden her iki grupta anlamlý azalma görüldü. Ýki grup arasýnda azalma yönünden anlamlý fark yoktu (p>0,43).
TARTIÞMA ve SONUÇ: Doðum sonrasý dönemde nonsteroidal antienflamatuar ilaç tedavisi ile birlikte splint kullanýmýndan fayda görmeyen hastalarda tendon ile kýlýfý arasýnda uygulanan steroid enjeksiyonu, daha invazif olan cerrahi tedavinin alternatifi olarak uygulanabilir. Hýzlý bir þekilde þikayetlerinin azalmasýný isteyen hastalarda cerrahi tedavinin ön planda uygulanmasý gerektiði görülmektedir.

Anahtar Kelimeler: De quervain, splint, tenosinovit, dekompresyon, steroid, gebelik

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