US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain's disease: a prospective study of 35 cases.

Autor: Lapègue F; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France. franck.lapegue@gmail.com.; ELSAN, Polyclinique Le Languedoc, Avenue de la Côte des Roses, 11100, Narbonne, France. franck.lapegue@gmail.com., André A; Laboratoire d'anatomie, faculté de médicine, 31062, Toulouse, France.; Service de chirurgie orthopédique, clinique Médipole Garonne, 45 rue de Gironis, 31036, Toulouse Cédex1, France., Pasquier Bernachot E; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Akakpo EJ; ISBA, Faculté de médecine du CNHU de Cotonou, Cotonou, Bénin., Laumonerie P; Laboratoire d'anatomie, faculté de médicine, 31062, Toulouse, France.; Institut de l'appareil locomoteur, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Chiavassa-Gandois H; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Lasfar O; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Borel C; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Brunet M; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Constans O; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Basselerie H; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Sans N; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France., Faruch-Bilfeld M; Service d'imagerie, CHU de Toulouse- Purpan, bâtiment Pierre Paul Riquet, Place du Dr Baylac, TSA, 40031-31059, Toulouse cedex 9, France.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2018 Sep; Vol. 28 (9), pp. 3977-3985. Date of Electronic Publication: 2018 Apr 04.
DOI: 10.1007/s00330-018-5387-1
Abstrakt: Purpose: To evaluate the efficacy of ultrasonography-guided percutaneous treatment of de Quervain tenosynovitis with the combination of a corticosteroid injection and release of the retinaculum of the first extensor compartment tendons with a 21-gauge needle.
Materials and Methods: The first part of our study consisted of ten procedures on cadaver wrists followed by dissection to analyse the effectiveness of the retinaculum release and detect any collateral damage. The second part was a prospective clinical study of 35 procedures. Outcomes were evaluated through a 6-month clinical follow-up and telephone interview at the end of the study. The following parameters were monitored over time: pain level on a visual analogue scale, the QuickDASH and the PRWE. Patient satisfaction questionnaires were also administered.
Results: No complications were found during the cadaver study. However, the release was confirmed as 'partial' in all wrists. In the clinical portion of this study, significant improvement was observed in 91.4 % of cases (32/35) within 1 month and the results were stable until the end of the study; all of these patients avoided surgery. The release procedure failed in three patients who eventually required surgical treatment.
Conclusion: US-guided partial release and simultaneous corticosteroid injection for treatment of de Quervain's disease using a 21-gauge needle is feasible in current practice, with minimal complications.
Key Points: • Ultrasound-guided treatment of de Quervain's disease is feasible with a 21G needle. • There was notable regression of clinical signs in 91.4 % of cases. • The procedure is very safe, no iatrogenic neurovascular or tendinous injuries occurred. • Our procedure requires only one session and 3 days away from work.
Databáze: MEDLINE
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