Outcome of longitudinal versus transverse incision in de Quervain's disease and its implications in Indian population.

Abstract

de Quervain's disease is an inadequacy into the first extensor compartment of wrist between the osteofibrous tunnel and the tendons. This mechanical conflict generates a tenosynovitis of the extensor pollicis brevis and the abductor pollicis longus tendons in first dorsal extensor compartment of the wrist. (1) To compare the clinical results obtained by longitudinal and transverse incisions and (2) the implication of clinical results in Indian population. This study was conducted at Kalpana Chawla Government Medical College, Karnal, Haryana. The inclusion criteria were positive Finkelstein's test and no response to non-surgical treatment for 6 weeks. Forty-eight patients with de Quervain's disease who did not respond to conservative treatment were operated with two different incisions. The patients were followed at 6 weeks, 3 and 6 months to compare the surgical outcomes. During a three-month follow-up, a significant difference was shown between the two methods (p = 0.0001). Results of surgical treatment with longitudinal incision were better (only one hypertrophic scar), but there were 12 postoperative complications with transverse incision. Visual analog scale (VAS) was used to evaluate the hypertrophic scar. In transverse incision group, out of five patients, four patients who developed hypertrophic scar have poor score according to VAS. Overall, longitudinal incision should be used for surgical treatment for de Quervain's disease due to lower risk of complications.