Initial diagnosis was a sprain of the wrist. Radiographs of the wrist showed no abnormalities according to her age. Carpometacarpial joint and metacarpophalangeal joint of the thumb were without abnormalities. There was neither limitation of the pronation/supination (90º-0-90º).
#DR TRAVERSO HAND SURGEON FULL#
Physical examination showed tenderness on the radial styloid with a limitation of the range of motion of the radial and ulnar deviation: 20º-0º-20º (movements became painful after 20 degrees of ulnar deviation) and full active flexion of the wrist was paint full but without flexion-extension limitation (85º-0-75º). Clinical history revealed compression of the left wrist 3 years ago without any apparent clinical effect few weeks after the past trauma. We report radiological findings, the orthopaedic following and the clinical outcome in a case of De Quervain tenosynovitis in a 12-years-old girl.Ī right-handed 12-years-old girl presented herself with persistent pain of her left wrist after a trauma on her hand five weeks before. A high index of suspicion is needed to avoid missing such an injury. Tenosynovitis is very rare in children due to a young and soft tendon which does well with the tension. Recently, its association with texting has been shown.
Rather than acute inflammation of the synovial lining, it has been histologically attributed to myxoid degeneration with fibrous tissue deposit and increased perfusion, causing tendon sheath thickening and tendons entrapment. It might be due to an acute trauma or it may more commonly be the result of cumulative microtrauma. Bilateral involvement is often reported in new mothers. Its prevalence is about 0.5% in men and 1.3% in women with peak prevalence among those in their forties and fifties. It is associated with repetitive thumb movements, especially abduction. Usual complain is pain in the first extensor compartment of the wrist, exacerbated by thumb movement and ulnar deviation of the wrist. Tenosynovitis of the thumb is a common diagnosis in hand surgery, historically described in 1895 by Fritz De Quervain. Tenosynovitis, De Quervain, Children, Ultrasound The purpose of this report is to make the physicians aware of this problem that may be common in the future, especially in the young population. Repetitive movements and strain injuries of the thumb and wrist can produce musculoskeletal problems of the upper limb as De Quervain's disease. The excessive mobile phone use with active texting probably increases the problem.
After a four-week immobilization and NSAID usage, the patient was pain free. The diagnosis after clinical and echo graphic examinations was a De Quervain's tenosynovitis which has never been reported before in pediatric orthopedic literature. Wrist X-ray was obtained, and no abnormalities were appreciated. The problem had lasted for 5 weeks after a trauma, and was getting worse. We reported a case of 12-years-old girl with isolated pain in of the left wrist. 2017 De Quervain Tenosynovitis in a 12-Year-Old Child: A Generation's Disease? J Orthop Surg Tech 2017 Traverso AM, et al © This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 24 October 2017 26 October 2017 Traverso AM, Douek P, Schivo D, et al. CASE REPORT 1 2 OPEN ACCESS De Quervain Tenosynovitis in a 12-Year-Old Child: A Generation's Disease? Author-1 Aurélien Michel Traverso Department of Orthopaedics and Traumatology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland Department of Musculoskeletal Health, University Hospital Vaudois, Switzerland Author-2 Pauline Douek Department of Radiology, University Hospital of Lausanne, CHUV, Lausanne, Switzerland Author-3 Debora Schivo Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne, CHUV, Lausanne, Switzerland Author-4 Clémence Bruyère Department of Radiology, University Hospital of Geneva, HUG, Genève, Switzerland Author-5 Camillo Théo Müller Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne, CHUV, Lausanne, Switzerland Author-6 Swenn Maxence Krühenbühl Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne, CHUV, Lausanne, Switzerland Corresponding-Author Aurélien Michel Traverso MD, Département de l'appareil locomoteur, Centre Hospitalier Universitaire Vaudois, Service d'orthopédie et de traumatologie de l'appareil locomoteur, Avenue Pierre-Decker 4, CH-1005 Lausanne, Vaud, Switzerland.
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