1st Extensor Compartment Release

De Quervain's Tenosynovitis is a condition that affected the extensor pollicis brevis (EPB) and abductor pollicis longus (APL) tendons of the wrist, located on the thumb side (1st dorsal compartment). The tendons become inflamed and entrapped within the first extensor compartment, most commonly resulting from acute or repetitive trauma. The most common symptoms of De Quervain's tenosynovitis are pain near base of thumb, swelling, or difficulty moving thumb and wrist. 

Surgery to correct De Quervain's tenosynovitis is called a 1st Extensor Compartment Release. This involves a small incision over the thumb side of the wrist to access and release the 1st Extensor Compartment that is entrapped the EPB and APL tendons, causing pain and difficulty with movement. This is performed as an outpatient procedure or office procedure, meaning you will be able to go home that day. You will be discharged with an Ace wrap. Following discharge please ensure that the surgical site is kept clean and dry for 48 hours. After 48 hours you may remove the bandage and shower. While showering, you may use soap and water, but be sure to pat the incision dry. It is important that you do not submerge your surgical incision in water (i.e. no bath tubs, swimming pools, washing dishes, etc.). After patting dry, you can place a band-aid over incision line. It is important to elevate your arm on a couple of pillows to alleviate pain and swelling. You will follow up in our office 10-14 days after surgery, for suture removal.

You should immediately start to use the affected hand after surgery, as much as tolerated. Typically follow up appointments are scheduled in two-week intervals following surgery so we can monitor your recovery. Sutures are removed 10-14 days post op, and scar massage can be started when sutures are removed. This helps to flatten incision line, and reduced tenderness. Some patients may need Occupational Therapy for ROM (range of motion) and strengthening, which will be evaluated at post op visits.

You may resume your regular diet after surgery; however, you should start slow. It is a good idea to start with things like toast, Jell-O, crackers, and soup to see how your stomach tolerates food after anesthesia. Drink plenty of fluids such as water or Gatorade and limit your intake of sodas, coffee and other caffeinated beverages.  

We will send you home with a prescription for an antibiotic and a pain medication. It is important to take your antibiotic and pain medication with food to prevent nausea (unless you are instructed otherwise). Do not take your pain medication and antibiotic at the same time as this may upset your stomach; separate them by an hour or two. You cannot drive while taking pain medication.

Should you develop any of the following signs and or symptoms of possible infection, call our office immediately:

  1. Fever over 100.3
  2. Chills or night sweats
  3. Unusual swelling, redness, or warmth to your incision site
  4. Purulent drainage from incision site.

Please do not hesitate to call our office with any concerns or questions you may have.

Please remember the above instructions are only a guide. Always listen to the instructions given by your healthcare provider and follow those if in conflict with any listed above.

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