Tenosynovectomy Wrist Surgery

Orange County's Experts Wrist Surgeons

Wrist tendonitis, also known as tenosynovitis or de Quervain’s tendinosis, involves irritation and inflammation of the tendons in the wrist. It occurs when two tendons around the base of your thumb become irritated or swollen. Swelling of the tendon and the tendon sheath can cause pain, numbness and tenderness along the thumb side of the wrist. You may notice opening and closing your hand or bending and rotating the wrist causes pain. You should seek medical attention if you have numbness or tingling in the fingers, the inability to move the wrist, or severe wrist swelling.

Wrist Tendonitis Symptoms

The main symptom of wrist tendonitis or de Quervain’s tenosynovitis is pain or tenderness at the base of your thumb.

Other Wrist Tendonitis symptoms include the following:

• Swelling on the thumb side of the wrist.
• Numbness along the back of your thumb and index finger.
• A “catching” or “snapping” sensation when moving the thumb.
• A squeaking sound as the tendons move within the swollen sheaths.
• Difficulty moving the thumb and wrist due to pain and swelling.

Diagnosing Wrist Tendonitis / de Quervain’s Tendinosis

Your wrist surgeon will perform a physical examination involving the Finkelstein test whereby you will rest your thumb across your palm. Then, make a fist with your fingers closed over your thumb. Then bend your wrist towards your little finger. This test will be quite painful on the thumb side of your wrist if you have de Quervain’s tendinosis.

Treatment for Wrist Tendonitis

Relieving inflammation and swelling is the goal in treating wrist tendonitis / de Quervain’s tendinosis.

Nonsurgical Treatment

In most cases, wrist tendonitis does not involve surgery. Many people can benefit from nonsurgical treatment and lifestyle changes including:

• Activity Modification: Avoid activities and sports that worsen symptoms
• Medications: Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help relieve pain and inflammation.
• Splints: Splints may be used to immobilize the thumb in order to rest the affected area.
• Steroid injections: A cortisone injection is a common treatment that reduces inflammation and can be helpful in relieving symptoms of wrist tendonitis.

Surgical Treatment

Surgical treatment will be considered if other methods fail to solve your wrist pain and dysfunction. Although surgery is rarely needed, it may be recommended if nonsurgical treatments fail to relieve your wrist pain after 3 to 6 months. Tenosynovectomy is an operation to correct restricted or painful movement of a tendon due to thickening and adhesions within the tendon sheath. During surgery, the inflamed, thickened lining tissue (tenosynovium) is removed from around the tendons. This procedure will reduce joint inflammation and creates ample space for your tendon to move freely. Because this anatomical area is quite complex, it requires the care of an experienced wrist surgeon. The goal of the surgery is to remove damaged tissues, increase blood flow, and stimulate the body’s natural healing response in the hand and wrist.

Surgery may be done with an open or minimally invasive technique, depending on your specific condition and which tendon is being treated. Larger incisions may not be necessary if your doctor can complete the surgery using small needles and tubes through an arthroscopic technique. The arthroscope is a miniature camera inserted into an incision that displays images to a video screen and monitor that the wrist surgeon watches to guide tiny surgical instruments to repair the wrist tendonitis.

Most patients who need surgery for wrist tendonitis have excellent long-term results, and recovery usually takes about 3 to 4 weeks. A cast or splint will likely be necessary to prevent your wrist from moving as you heal, and physical therapy is often recommended to improve strength, functionality, and wrist movement.

Do you need a wrist surgeon?
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(949) 722-7038

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