Corticosteroid injection for treatment of de Quervain's tenosynovitis: a pooled quantitative literature evaluation.

Overview

BACKGROUND: There have been many approaches described to treat de Quervain's tenosynovitis, but no definite consensus emerges in the literature. We conducted a pooled quantitative literature evaluation to review the therapeutic studies in the English language to determine the various reported cure rates. METHODS: All citations in the MEDLINE and Ovid databases that addressed de Quervain's tenosynovitis were independently reviewed. Appropriate studies from the bibliographies of these articles were then obtained. Of the 35 articles on de Quervain's temosynovitis that were found in the modern literature, only seven allowed for comparison among potentially effective treatments. Studies were included if they evaluated or compared treatment options among patients and had defined criteria for diagnosis and successful treatment. These seven studies were descriptive, not comparative. In other words, each study reported the proportion of successful outcomes with different treatments, without a comparison to a specified control group. Four hundred fifty-nine wrists were subjected to one of several therapeutic modalities. RESULTS: There was an 83% cure rate with injection alone. This rate was much higher than any other therapeutic modality (61% for injection and splint, 14% for splint alone, 0% for rest or nonsteroidal anti-inflammatory drugs). CONCLUSION: It seems that injection alone is the best therapeutic approach to de Quervain's tenosynovitis.