DeQuervian’s Tendonitis (Mommy’s Thumb)

Overview

Many individuals suffer from pain over the wrist just below the thumb in an area known as the first extensor compartment (tendons that lift the thumb up). This is known as DeQuervian’s tenosynovitis, or colloquially, as mommy’s thumb.

The symptoms often occur in women who have just delivered a baby and are now repetitively picking up the baby. It can occur in others who perform repetitive motion. A sheath causes compression around the two extensor tendons known as the EPB and APL leading to pain with thumb and wrist motion. Our approach is to start off with a steroidal injection and perform surgery as a last resort.

Dr. Anup Patel Advantage

Dr. Anup Patel uses plastic surgery techniques to provide a minimal incisional area with a plastic surgery closure to minimize scar.

With precise dissection to avoid injury to the dorsal sensory branch of the radial nerve, Dr. Patel identifies sheath that is causing the compression and releases it in an oblique fashion to prevent the tendons from subluxing. He uses stitches that internal preventing any stitches to be removed afterwards.

Symptoms

  • Pain and swelling over the wrist (radial aspect near the thumb)
  • Pain with thumb extension


Causes

  • Inflammation
  • Repetitive lifting including a baby (mommy’s thumb)
  • Trauma


Treatment: Non-Surgical

  • Activity modification
  • Splinting
  • Steroidal injection


Treatment: Surgical

  • Release of the first extensor compartment and any subsheaths

Patient 1

43 year old female who failed steroidal injection presents with severe left DeQuervian’s tenosynovitis. She underwent release with the video showing the oblique incision of the tendon sheath and complete release.

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Dr. Anup Patel

Dr. Anup Patel is a board-certified plastic and reconstructive surgeon trained in aesthetic, hand/upper extremity and reconstructive surgery. He completed his plastic and reconstructive surgery training at the premier Yale University followed by a hand and microsurgery fellowship at the New York University Institute of Reconstructive Plastic Surgery and Mount Sinai Department of Orthopedics. Dr. Patel received his MD and MBA from the Yale University School of Medicine and Yale University School of Management, respectively. He graduated as the valedictorian of his class at the University of Florida majoring in economics, biochemistry and molecular genetics and valedictorian of his high-school class at Lake Highland.

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