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The care of the hand in the post-operative period is very important in helping to ensure a good result. Initially the aims are comfort and elevation. These are met by keeping the hand up (elevated) especially in the first few days and by use of a long acting local anaesthetic (Bupivicaine). The local anaesthetic lasts at least 12 hours and sometimes 48 hours. Patients should start taking painkillers before the pain starts . on return home and for at least 24 hours from there. This way most of our patients report little or any pain.
The patient is reviewed in clinic within 2 weeks of the operation. Typically dissolvable stitches are used so they should not require to be removed. A splint may be provided. Careful follow up is required to ensure a successful result with good relief of pain and a good range of movement.
The hand can be used for gentle activity after the first few days out of the dressing/plaster. Most patients can drive after a 2-3 weeks. Most patients return to work in 5-6 weeks, but this varies with occupation; heavy manual work usually takes about 3 months if ever. The wound should be massaged by the patient 3 times a day with a bland soft cream for 3 months once the wound is well healed (typically after 2 weeks). This reduces the scar sensitivity which can be a nuisance. If this is marked a Physio may be organised to help reduce the scar tenderness but this is rarely required. Patients should avoid pressing heavy use of the hand for a good 3 months from surgery.

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Regarding diagnosis:

  • Does individual complain of pain at the base of the thumb with wrist or thumb motion?
  • Is there a visible swelling or a lump on the thumb side of the wrist, and a catching or snapping sensation?
  • Does individual complain of inability to grip?
  • Has diagnosis of radial styloid tenosynovitis been confirmed?
Regarding treatment:
  • Do symptoms persist despite avoidance of aggravating motion?
  • If conservative measures failed to provide symptom relief, is individual now a candidate for surgical intervention?
  • Has individual been involved in a comprehensive rehabilitation program?
  • Has individual and/or job requirements been evaluated by an occupational and/or physical therapist?
  • Is a splint or adaptive equipment warranted and available?
Regarding prognosis:
  • Has adequate time passed to allow conservative measures to resolve symptoms?
  • Has individual been involved in a comprehensive rehabilitation program?
  • Is individual now a candidate for surgical intervention?
  • Has protective splinting been provided?
  • Does individual have an underlying condition that may impact recovery?
  • Would individual benefit from reassignment or vocational retraining?
Source: Medical Disability Advisor

De quervain's steroid injection video

de quervain's steroid injection video

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