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Morbus Quervain - Handen Team Zeeland

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Direct na een injectie is enige dagen rust<br />

voorgeschreven en het voorzichtig opbouwen<br />

van de belasting, mogelijk met een spalk die<br />

de duim belemmerd.<br />

Er zijn enkele gevallen bekend van rupturen<br />

na injecties, maar dit is zeer zeldzaam.<br />

• chirurgie<br />

De chirurgische behandeling is in de regel ook<br />

erg effectief.(Huang and Strauch, 2000)<br />

Er zijn verschillende chirurgische technieken<br />

om de pulley te doorsnijden of te<br />

verlengen.(Gundes and Tosun, 2005;<br />

Kapandji, 1990)<br />

De bedoeling van de ingreep is om deze pezen<br />

meer ruimte te geven:de tunnel wordt<br />

opengemaakt zodat de pezen niet meer<br />

kunnen wrijven tegen de wand van de tunnel.<br />

Het is een kleine ingreep die meestal onder<br />

een plaatselijke verdoving gebeurt.<br />

Nabehandeling is gericht op rustig opbouwen<br />

van belasting en glijden van de pezen dmv<br />

actief bewegen van de duim.<br />

Een bijzonder nare complicatie van een<br />

operatie bij De <strong>Quervain</strong> is een iatrogene<br />

zenuw laesie van de nervus radialis<br />

superficialis. Neuroom vorming is een<br />

bijzonder pijnlijke en lastig te behandelen<br />

aandoening.<br />

Referenties<br />

Alberton GM, High WA, Shin AY, Bishop AT. 1999. Extensor triggering<br />

in de De <strong>Quervain</strong>'s stenosing tenosynovitis. J Hand Surg<br />

[Am] 24(6):1311-1314.<br />

Alexander RD, Catalano LW, Barron OA, Glickel SZ. 2002. The<br />

extensor pollicis brevis entrapment test in the treatment of<br />

de De <strong>Quervain</strong>'s disease. J Hand Surg [Am] 27(5):813-<br />

816.<br />

Brunelli G. 2003 De <strong>Quervain</strong>. [Finkelstein's versus Brunelli's test in De<br />

De <strong>Quervain</strong> tenosynovitis]. Chir Main 22(1):43-45.<br />

Chien AJ, Jacobson JA, Martel W, Kabeto MU, Marcantonio DR. 2001.<br />

Focal radial styloid abnormality as a manifestation of de De<br />

<strong>Quervain</strong> tenosynovitis. AJR Am J Roentgenol<br />

177(6):1383-1386.<br />

de De <strong>Quervain</strong> F. 2005. On the nature and treatment of stenosing<br />

tendovaginitis on the styloid process of the radius.<br />

(Translated article: Muenchener Medizinische<br />

Wochenschrift 1912, 59, 5-6). J Hand Surg [Br] 30(4):392-<br />

394.<br />

Giovagnorio F, Andreoli C, De Cicco ML. 1997. Ultrasonographic<br />

evaluation of de De <strong>Quervain</strong> disease. J Ultrasound Med<br />

16(10):685-689.<br />

Gundes H, Tosun B. 2005. Longitudinal incision in surgical release of<br />

De De <strong>Quervain</strong> disease. Tech Hand Up Extrem Surg<br />

9(3):149-152.<br />

Harvey FJ, Harvey PM, Horsley MW. 1990. De De <strong>Quervain</strong>'s disease:<br />

surgical or nonsurgical treatment. J Hand Surg [Am]<br />

15(1):83-87.<br />

Huang HW, Strauch RJ. 2000. Extensor pollicis longus tenosynovitis: a<br />

case report and review of the literature. J Hand Surg [Am]<br />

25(3):577-579.<br />

Jirarattanaphochai K, Saengnipanthkul S, Vipulakorn K, Jianmongkol S,<br />

Chatuparisute P, Jung S. 2004. Treatment of de De<br />

<strong>Quervain</strong> disease with triamcinolone injection with or<br />

without nimesulide. A randomized, double-blind, placebocontrolled<br />

trial. J Bone Joint Surg Am 86-A(12):2700-2706.<br />

Kapandji AI. 1990. [Enlargement plasty of the radio-styloid tunnel in the<br />

treatment of De De <strong>Quervain</strong> tenosynovitis]. Ann Chir Main<br />

Memb Super 9(1):42-46.<br />

Kurppa K, Viikari-Juntura E, Kuosma E, Huuskonen M, Kivi P. 1991.<br />

Incidence of tenosynovitis or peritendinitis and<br />

epicondylitis in a meat-processing factory. Scand J Work<br />

Environ Health 17(1):32-37.<br />

Kurppa K, Waris P, Rokkanen P. 1979. Peritendinitis and tenosynovitis.<br />

A review. Scand J Work Environ Health 5 suppl 3:19-24.<br />

Kutsumi K, Amadio PC, Zhao C, Zobitz ME, An KN. 2004.<br />

Measurement of gliding resistance of the extensor pollicis<br />

longus and extensor digitorum communis II tendons within<br />

the extensor retinaculum. J Hand Surg [Am] 29(2):220-224.<br />

Kutsumi K, Amadio PC, Zhao C, Zobitz ME, An KN. 2005 -a. Gliding<br />

resistance of the extensor pollicis brevis tendon and<br />

abductor pollicis longus tendon within the first dorsal<br />

compartment in fixed wrist positions. J Orthop Res<br />

23(2):243-248.<br />

Kutsumi K, Amadio PC, Zhao C, Zobitz ME, Tanaka T, An KN. 2005 -b.<br />

Finkelstein's test: a biomechanical analysis. J Hand Surg<br />

[Am] 30(1):130-135.<br />

Rossi C, Cellocco P, Margaritondo E, Bizzarri F, Costanzo G. 2005. De<br />

De <strong>Quervain</strong> disease in volleyball players. Am J Sports<br />

Med 33(3):424-427.<br />

Skoff HD. 2001. "Postpartum/newborn" de De <strong>Quervain</strong>'s tenosynovitis<br />

of the wrist. Am J Orthop 30(5):428-430.<br />

Tanaka S, Petersen M, Cameron L. 2001. Prevalence and risk factors<br />

of tendinitis and related disorders of the distal upper<br />

extremity among U.S. workers: comparison to carpal tunnel<br />

syndrome. Am J Ind Med 39(3):328-335.<br />

Witczak JW, Masear VR, Meyer RD. 1990. Triggering of the thumb with<br />

de De <strong>Quervain</strong>'s stenosing tendovaginitis. J Hand Surg<br />

[Am] 15(2):265-268.<br />

Witt J, Pess G, Gelberman RH. 1991. Treatment of de De <strong>Quervain</strong><br />

tenosynovitis. A prospective study of the results of injection<br />

of steroids and immobilization in a splint. J Bone Joint Surg<br />

Am 73(2):219-222.<br />

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