A prospective study on effectiveness of methylprednisolone acetate injection plus casting versus casting alone for the treatment of de quervain's tenosynovitis.

Abstract

Background: De Quervains Stenosing Tenosynovitis is caused by thickening and accumulation of mucopolysaccharide in the sheath of the abductor pollicis longus and extensor pollicis brevis tendons. Prevalence is estimated at 0.5% among men and 1.3% among women Nonsurgical modalities include rest, ice, non-steroidal anti-inflammatory drugs and splinting. Corticosteroid injection is the mainstay of treatment for those patients who do not respond to the above. Aim: This study was performed to match the result of methylprednisolone acetate injection plus thumb spica cast versus cast alone for the treatment of de Quervain’s tenosynovitis. Materials and Methods: All patients were explained the nature of the disease and plan of treatment. Patients were randomly grouped. Patients were divided into group A and group B.Among 40 patients =, 20 patients of group A treated with injection of Methylprednisolone acetate in the first dorsal compartment of the wrist followed by thumb spica cast and 20 patients of group B treated with thumb spica cast alone. Wrist casting duration in both groups was 1 month and the patients were followed during 6 and 12 weeks. Study Type: Randomized controlled Study. Diagnosis of disease was based on clinical findings. Patients with a previous history of acute trauma, wrist fracture, recent steroid injection and pregnancy were excluded from the study. Result: 65% of study population were female and mean age group was 42.9 years. 35% of them were labourers. By the end of 12 weeks all patients in group A were asymptomatic. Conclusion: Treatment of de Quervain’s tenosynovitis with methylprednisolone acetate injection plus thumb spica cast is found to be more effective and statistically significant.