US-Guided Percutaneous Release of the First Compartment of Extensor by Using 21-Gauge Needle in De Quervain’s Disease: A Prospective Study of 47 Cases

Purpose: To evaluate the efficacy of ultrasonography (US)-guided percutaneous treatment of de Quervain tenosynovitis by releasing the retinaculum of the first extensor compartment tendons with a 21G needle.
Materials and methods: This work, which completes a series already published by our team (1) is divided into 2 parts. The first part consisted of 10 procedures on cadaver wrists followed by dissection to analyze the effectiveness of the retinaculum release and detect any collateral damage.
The second part was performed during a 36-month period starting in January 2015. It was a prospective clinical study of 47 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 analog scale (VAS pain), the QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) and the PRWE (Patient Rated Wrist Evaluation). Patient satisfaction questionnaires were administered during the final follow-up call.
Results: No complications were found during the cadaver study. However, the release was considered “partial” in all wrists. In the clinical portion of this study, significant improvement was observed in 93.6% of cases (44/47) 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 3 patients who eventually required surgical treatment.
Conclusion: US-guided treatment of de Quervain’s disease using a 21-gauge needle is effective and feasible in current practice, with minimal complications.