DeQuervain's Tenosynovitis Clinical Trial
Official title:
A Clinical Trial of Full Time vs. As Needed Splint Wear for DeQuervain's Tenosynovitis
DeQuervain's tenosynovitis is characterized by pain on the pain on the radial (thumb) side of the wrist problems with thumb function. At this point, the standard care is to change daily activities, use a thumb brace, and the possible use of painkillers. There is a difference in opinion among physical therapists about how to use the splint in the treatment of DeQuervain tenosynovitis. Some physicians tell patients to wear the brace at all times while other therapists encourage patients to exercise and use the brace as needed. Both approaches to using the splint are accepted as standard. The purpose of this study is to test and evaluate these two ways of splinting and assess which one is better for patients with DeQuervain tenosynovitis.
De Quervain's tenosynovitis (stenosing tenosynovitis of the first dorsal extensor
compartment) is characterized by pain on the radial (thumb) side of the wrist and impairment
of thumb and wrist function. Histological evaluation is consistent with a chronic rather
than an acute tenosynovitis consistent with the often prolonged course of this disease.
Nonoperative treatments include modification of activities, splint immobilization, icing and
anti-inflammatory medication, and corticosteroid injections. Long opponens splinting (or
short arm thumb spica splinting; a splint that immobilizes the wrist and the thumb) is
standard and well accepted. There is no consensus on the best protocol for use of the
splint. Some authors advocate full time splinting for 4 - 6 weeks, with the rationale that
tendonitis will resolve with strict rest. Other authors, perhaps aware of histological
evidence that De quervain's is a chronic rather than acute inflammatory condition, feel that
the splint serves merely to relieve symptoms and is best used as best suits each individual
patient. To our knowledge, there are not data available regarding these disparate views.
The ultimate prognosis for recovery in the condition seems satisfying, regardless of the
treatment, and spontaneous recovery is the rule. Psychological and personality factors, such
as pain anxiety, catastrophizing, and depression are strongly related to upper extremity
specific health status and may also influence recovery.
The primary goal of this study is to determine which protocol of splinting leads to better
outcome in non-surgical treatment of DeQuervain's tenosynovitis. As a secondary goal and to
generate hypotheses for later studies we would like to evaluate the influence of
psychosocial factors on both objective (grip strength) and subjective (DASH questionnaire)
measures of outcome.
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Observational Model: Cohort, Time Perspective: Prospective
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Terminated |
NCT02038634 -
Ultrasound-guided Injection for DeQuervain's
|
Phase 4 |