WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Anfal Dahish Hamid, Dr. Zaid Muayad Yassen

ABSTRACT

De Quervain’s tenosynovitis is a stenosing tenosynovitis of the first dorsal compartment of the wrist, caused by thickening and myxoid degeneration of the tendon sheaths surrounding the abductor pollicis longus and extensor pollicis brevis tendons; corticosteroid injection is widely regarded as the most effective nonsurgical treatment, although outcome data from Iraq and the wider Middle East remain limited. This case series study aimed to assess the functional outcome of corticosteroid injection in managing De Quervain’s tenosynovitis. A total of 150 patients aged 18 years and above, diagnosed clinically based on history and positive Finkelstein and Eichhoff tests, were recruited from the Orthopedic Department of Al-Jumhoori Teaching Hospital, Mosul, Iraq, between 2 January and 30 June 2025; each received a single injection of 40 mg methylprednisolone acetate with 1% lidocaine into the first dorsal compartment and were followed for three months, with pain and function assessed using the Visual Analog Scale (VAS) and the QuickDASH score. Most patients were aged 18–45 years (52.67%) and female (73.33%); heavy manual work (48.6%) and pregnancy (24.6%) were the leading associated factors, and the right, dominant hand was most frequently affected (62.00% and 85.33%, respectively). Before injection, all patients had radial-sided wrist pain and tenderness, with positive Finkelstein and Eichhoff tests in 92.00% and 82.00%; by three months, these fell to 19.33%, 14.00%, and 12.67%, respectively. Severe pain decreased from 63.33% to 4.00%, and pain-free patients increased from 0% to 52.67% (P < 0.0001); QuickDASH scores showed a parallel improvement, with patients reporting no or mild difficulty rising from 11.33% to 72.66% (P < 0.0001). Post-injection complications occurred in 36.67% of patients, most commonly injection-site pain (25.33%) and transient paraesthesia (5.33%), with skin hypopigmentation (4.67%) and subdermal atrophy (1.33%) being the least frequent late effects. Corticosteroid injection into the first dorsal extensor compartment is an effective and generally safe treatment for De Quervain’s tenosynovitis, producing rapid, statistically significant improvement in pain and hand function, and should be considered as a first-line intervention before surgical referral, particularly in resource-limited settings.

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