De Quervain’s release is the surgical treatment for De Quervain’s disease when symptoms have failed to respond to non-surgical treatment. The operation releases the first extensor tendon compartment at the thumb side of the wrist, allowing the tendons to glide more freely.
It is a relatively minor operation which is usually performed under local anaesthetic as a day case procedure.
Mr Robert Farnell is an experienced specialist Consultant Orthopaedic Hand and Wrist Surgeon who has been working in Leeds for over 25 years. He exclusively treats conditions affecting the adult hand and wrist, including De Quervain’s disease, trigger finger and thumb, carpal tunnel syndrome and thumb arthritis.
What is De Quervain’s release?
De Quervain’s release is an operation to release the tight tunnel through which the thumb tendons pass at the wrist. This tunnel is called the first extensor tendon compartment.
Releasing this compartment reduces pressure on the tendons and allows them to move without catching or irritation.
Read more about De Quervain’s disease.
Before your surgery
You will receive a letter with details of the date and time of your operation. This will provide information about what to do and what to expect during your treatment.
Some hospitals routinely arrange pre-operative assessment clinics, where you will see a nurse and any relevant medical issues can be reviewed.
You will also be given advice about post-operative pain relief. De Quervain’s release is not normally a very painful operation and simple painkillers such as paracetamol are often sufficient.
Because the operation is usually performed under local anaesthetic, there are normally no restrictions on eating or drinking before surgery. However, you should always follow the specific advice provided by your hospital and surgeon.
On the day of your surgery
You should arrive at your allotted time. Your pre-operative letter will tell you whether you need to bring anything specific, although patients are commonly asked to bring a dressing gown and slippers.
The nursing team will complete some paperwork, check your medication and make sure you are ready for surgery.
Your surgeon will also see you before the operation, confirm that you understand what is going to happen and answer any questions you may have.
You will be asked to sign a consent form. An arrow will also be marked on your arm using a felt-tip pen. This is routine practice and is used to identify the correct side for surgery.
Local anaesthetic
Before surgery, local anaesthetic is injected to numb the skin and tissues around the operation site.
This is usually done in the operating theatre, although some surgeons may inject the local anaesthetic on the ward before you go into theatre.
Many patients worry that the injection will be painful. Generally, if it is administered carefully, the injection is not usually painful.
What happens during the operation?
Once the anaesthetic has worked, the surgery can take place. The skin is cleaned with antiseptic fluid and sterile towels are used to cover the area.
Some surgeons use a tourniquet to temporarily prevent blood from entering the arm. If this is used, you will be aware of a tight bandage on your upper arm, similar to the cuff used when your blood pressure is taken.
A small incision is made at the thumb side of the wrist. The first extensor tendon compartment is released and the underlying tendons are freed so that they can glide more easily.
On average, the operation takes less than ten minutes and is not usually painful. You may be aware of tugging or pulling sensations, but this should not hurt.
If you have a personal music player, you may be able to listen to music during the operation.
After the operation, a bandage is applied and you will return to the ward, where you can have a drink and something to eat.
After your surgery
Once the nurses are happy, you will be able to go home.
It is generally expected that someone accompanies you home, as it is not advisable to drive yourself or to be left alone immediately after surgery.
You will usually be given a sling so that you can keep your arm elevated for a day or two. You will also be given an appointment for your next outpatient clinic review.
De Quervain’s release is not normally a painful operation. If you experience discomfort, you should take your recommended pain relief medication.
You will need to keep your bandage dry. The bandage usually remains in place for up to two weeks.
At your follow-up appointment, the wound will be checked. Some stitches need removing, although Mr Farnell uses dissolvable stitches which do not usually need to be removed.
It is unusual to require physiotherapy after De Quervain’s release.
Read more about post-operative care.
Recovery after De Quervain’s release
Pain usually resolves gradually after surgery. Gentle movement of the thumb and fingers is encouraged to reduce stiffness and help restore normal hand function.
The scar may remain tender for several weeks and will gradually soften and fade with time.
Most people return to normal light activities within two to three weeks, although heavier gripping, lifting or repetitive thumb use may need to be restricted for longer.
Possible complications
Complications are uncommon and usually minor.
- Scar tenderness: this is the most commonly experienced problem. It can be a nuisance but usually resolves completely. Massaging the scar with moisturiser can help.
- Wound infection: this is seen in up to 1% of cases.
- Finger or thumb stiffness: this is uncommon and is best avoided by keeping the fingers and thumb moving.
- Nerve injury: this is uncommon.
Prognosis after surgery
The outcome is usually good after surgery and the pain should resolve gradually.
The surgical scar will fade with time.
Considering surgery for De Quervain’s disease?
If pain on the thumb side of your wrist is affecting grip, lifting or daily activities, Mr Robert Farnell can assess your symptoms and advise whether De Quervain’s release may be appropriate.
De Quervain’s release FAQs
What is De Quervain’s release?
De Quervain’s release is an operation to release the first extensor tendon compartment at the thumb side of the wrist, allowing the tendons to glide more freely.
Is De Quervain’s release performed under local anaesthetic?
Yes. De Quervain’s release is usually performed under local anaesthetic as a day case procedure.
How long does De Quervain’s release surgery take?
The operation usually takes less than ten minutes.
Is De Quervain’s release painful?
The operation is not usually painful. You may feel tugging or pulling sensations, but this should not hurt.
How long does the bandage stay on?
The bandage usually remains in place for up to two weeks and should be kept dry.
Will the stitches need removing?
Some stitches need removing, although Mr Farnell uses dissolvable stitches which do not usually need to be removed.
Will I need physiotherapy?
It is unusual to require physiotherapy after De Quervain’s release.
When does pain improve after De Quervain’s release?
Pain usually resolves gradually after surgery, although scar tenderness may persist for several weeks.
What are the risks of De Quervain’s release?
Risks include scar tenderness, wound infection, finger or thumb stiffness and uncommon nerve injury.