De Quervain Injection: Difference between revisions

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==Background==
Injection for [[De Quervain Tendinopathy]].
==Anatomy==
The APL and EPB usually run together in the first dorsal compartment. The tendons can often be seen with the thumb held in resisted extension. They can also be palpated at the base of the 1st metacarpal.
==Technique==
*The aim is to inject between the two tendons within the sheath
*Position: Ulnar side of hand resting on surface with thumbheld in slight flexion
*Identify the gap between the two tendons
*Insert needle perpendicularly into the gap then slide proximally between the tendons (needle going distal to proximal)
*Inject solution as a bolus
==Complications==
Subcutaneous fat atrophy, particularly noticeable in dark skinned thin women. This may be permanent. The risk can be reduced by using hydrocortisone.
==Aftercare==
Rest hand for one week with taping. Avoid provoking activities and start a graded load programme.
==Videos==
<youtube>Y8BSLvsyRTg</youtube>
<youtube>Y8BSLvsyRTg</youtube>


[[Category:Hand & Wrist Procedures]]
[[Category:Hand & Wrist Procedures]]
[[Category:Hand & Wrist]]
[[Category:Hand & Wrist]]

Revision as of 09:20, 29 June 2020

This article is a stub.
De Quervain Injection
Indication De Quervain Injection
Syringe 1mL
Needle 25G 16mm
Steroid 10-20mg triamcinolone
Local 0.75mL 2% lidocaine
Volume 1mL


Background

Injection for De Quervain Tendinopathy.

Anatomy

The APL and EPB usually run together in the first dorsal compartment. The tendons can often be seen with the thumb held in resisted extension. They can also be palpated at the base of the 1st metacarpal.

Technique

  • The aim is to inject between the two tendons within the sheath
  • Position: Ulnar side of hand resting on surface with thumbheld in slight flexion
  • Identify the gap between the two tendons
  • Insert needle perpendicularly into the gap then slide proximally between the tendons (needle going distal to proximal)
  • Inject solution as a bolus

Complications

Subcutaneous fat atrophy, particularly noticeable in dark skinned thin women. This may be permanent. The risk can be reduced by using hydrocortisone.

Aftercare

Rest hand for one week with taping. Avoid provoking activities and start a graded load programme.

Videos