Local Corticosteroid Injection Versus Open Surgical Release in De Quervain Tenosynovitis: A Single-Center Study

Comparative Effectiveness of Local Corticosteroid Injection and Open Surgical Release for Pain Outcomes in De Quervain Tenosynovitis: A Single-Centre Study

This quasi-experimental study compared pain outcomes following local corticosteroid injection (CSI) versus open surgical release in 100 patients with clinically confirmed De Quervain tenosynovitis unresponsive to conservative management. Patients were allocated to treatment based on clinician judgment and patient preference. Pain was assessed using the Visual Analog Scale (VAS) at baseline, one month, and six months post-intervention. The study was conducted at a single tertiary care centre in Rawalpindi, Pakistan between March 2023 and April 2025.

Study Overview

• Status: Completed
• Conditions: DeQuervain's Tenosynovitis
• Intervention / Treatment: Drug: Triamcinolone acetonide with lidocaine; Procedure: Open surgical release of first dorsal extensor compartment

Detailed Description

De Quervain tenosynovitis is a stenosing tendinopathy of the first dorsal extensor compartment of the wrist, causing radial-sided wrist pain. One hundred patients were enrolled and allocated to either corticosteroid injection (CSI; n=49) or open surgical release (n=51). The CSI protocol consisted of triamcinolone acetonide (40mg/mL, 1mL) combined with 1% lidocaine (1mL) injected into the first dorsal compartment under aseptic conditions. Surgical release involved longitudinal decompression of the fibro-osseous sheath overlying the APL and EPB tendons. The primary outcome was VAS pain score at baseline, one month, and six months. Statistical analysis included independent t-tests and linear mixed-effects modeling.

• Study Type: Interventional
• Enrollment (Actual): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Punjab Province
    • Rawalpindi, Punjab Province, Pakistan, 46000
      • Rawalpindi Teaching Hospital.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Clinical diagnosis of De Quervain tenosynovitis confirmed by positive Finkelstein test
• Age 18-70 years
• Pain sufficiently severe to impair activities of daily living
• Failure to respond to at least 4 weeks of conservative management

Exclusion Criteria:

• Concurrent inflammatory arthropathy (rheumatoid arthritis or gout)
• History of prior wrist injury
• Previous surgical or injection treatment for De Quervain tenosynovitis
• Coexisting upper limb pathology (rotator cuff pathology, epicondylitis, or carpal tunnel syndrome)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Corticosteroid Injection (CSI); Single injection of triamcinolone acetonide (40mg/mL, 1mL) combined with 1% lidocaine (1mL) administered into the first dorsal extensor compartment under aseptic conditions without ultrasound guidance.	Drug: Triamcinolone acetonide with lidocaine; Triamcinolone acetonide 40mg/mL (1mL) + 1% lidocaine (1mL) - single injection
Active Comparator: Open Surgical Release; Open decompression of the first dorsal compartment through a longitudinal incision over the radial styloid, with release of the fibro-osseous sheath overlying the APL and EPB tendons, closed with non-absorbable sutures.	Procedure: Open surgical release of first dorsal extensor compartment; Longitudinal decompression of the fibro-osseous sheath overlying APL and EPB tendons

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity - Visual Analog Scale (VAS)	Pain scored on a 0-10 VAS scale where 0 = no pain and 10 = worst imaginable pain, assessed by a blinded assessor	Time Frame: Baseline, 1 month, and 6 months post-intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Adverse events	Any complications or adverse events recorded in either treatment group	Throughout 6-month follow-up period

Collaborators and Investigators

• Sponsor: Rawalpindi Teaching Hospital, District Headquarter Hospital, Rawalpindi
• Investigators: Study Chair: Saad Riaz, FCPS Orthopedic Surgery, Rawalpindi Teaching Hospital.

Study record dates

Study Major Dates

• Study Start (Actual): March 3, 2023
• Primary Completion (Actual): April 3, 2025
• Study Completion (Actual): April 20, 2025

Study Registration Dates

• First Submitted: June 27, 2026
• First Submitted That Met QC Criteria: June 27, 2026
• First Posted (Actual): July 6, 2026

Study Record Updates

• Last Update Posted (Actual): July 6, 2026
• Last Update Submitted That Met QC Criteria: June 27, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: corticosteroid injection; tendinopathy; visual analog scale; De Quervain tenosynovitis; quasi-experimental study; wrist; surgical release
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Muscular Diseases; Wounds and Injuries; Tendon Injuries; Tendon Entrapment; Tendinopathy; De Quervain Disease; Organic Chemicals; Polycyclic Compounds; Anilides; Amides; Aniline Compounds; Amines; Acetanilides; Triamcinolone; Pregnadienes; Pregnanes; Steroids; Fused-Ring Compounds; Steroids, Fluorinated; Lidocaine; Triamcinolone Acetonide
• Other Study ID Numbers: RTH-DQT-2023

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data are not publicly available due to institutional privacy policies but are available from the corresponding author upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No