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Liberación de De Quervain

Un plan de recuperación con movilización temprana tras la liberación quirúrgica del primer compartimento dorsal para el tratamiento de la tenosinovitis de De Quervain; incluye un breve período de alivio del dolor, movimientos suaves del pulgar y la muñeca desde el inicio para evitar la rigidez, cuidado de la cicatriz, y una recuperación gradual de la fuerza de agarre y de pinza alrededor de las cuatro a seis semanas.

Ilustración del lado del pulgar de la muñeca, en la que se muestra el primer compartimento dorsal que contiene los dos tendones del pulgar (el abductor largo del pulgar y el extensor corto del pulgar); este compartimento se abre durante una liberación de De Quervain.
La liberación de De Quervain abre el estrecho túnel (el primer compartimento dorsal) que se encuentra sobre los dos tendones del lado del pulgar en la muñeca, permitiendo que se deslicen libremente. Kieran Hirpara 4.0

Esta página se tradujo automáticamente y todavía no la ha revisado un médico. La versión en inglés es la versión oficial.

Este protocolo le servirá de guía para su recuperación tras una liberación de De Quervain, una intervención quirúrgica menor mediante la cual se abre el túnel estrecho que rodea los tendones del lado del pulgar en su muñeca; el procedimiento fue realizado por el Dr. Kieran Hirpara en el Mater Private Hospital Rockhampton. El proceso comienza con un programa de ejercicios para realizar en casa, seguido del protocolo clínico estructurado redactado para su terapeuta de mano; lleve esta página o su versión en PDF a su primera sesión de terapia para garantizar una rehabilitación coordinada. Su terapeuta de mano podrá modificar el plan según el progreso de su recuperación.

Si tiene alguna duda respecto a la herida quirúrgica, no dude en ponerse en contacto con el consultorio. A menudo resulta útil tomar una fotografía de la herida y enviarla por correo electrónico para su evaluación.

Qué esperar

La tenosinovitis de De Quervain consiste en una irritación de los dos tendones que van hacia el pulgar (el abductor largo del pulgar y el extensor corto del pulgar) en el tramo donde atraviesan un túnel estrecho (el primer compartimento dorsal) en la cara del pulgar de la muñeca. La liberación tendinosa es una intervención quirúrgica menor que consiste en abrir dicho túnel para que los tendones puedan deslizarse libremente, aliviando así el dolor y los bloqueos en el movimiento.

Como no se sutura ni se tensa nada (el túnel simplemente se abre y debe permanecer abierto), la recuperación implica un movimiento temprano, sin necesidad de un largo período de inmovilización. No existe ninguna estructura que requiera meses para cicatrizar. El objetivo principal de la rehabilitación es mantener el movimiento de los tendones a través del tejido quirúrgico en proceso de curación, para evitar que se adhieran, mientras la pequeña herida y los nervios cutáneos de esa zona se estabilizan.

El plan de recuperación es sencillo: durante los primeros días y hasta una o dos semanas se usa un vendaje suave (a veces una férula ligera para el pulgar, únicamente para mayor comodidad); luego se inician movimientos suaves del pulgar y la muñeca. Una vez cicatrizada la herida, se procede al cuidado de la cicatriz, y posteriormente se incrementa gradualmente la fuerza de agarre y de pinza. La mayoría de los pacientes vuelven a realizar sus actividades cotidianas sin problemas en un plazo de cuatro a seis semanas.

Después de esta intervención se vigilan dos aspectos en particular. El primero es un pequeño nervio cutáneo, el nervio sensitivo radial, cuyas ramas discurren justo por la zona frontal de la incisión; durante un tiempo puede provocar sensación de hormigueo o sensibilidad, y la rehabilitación temprana tiene como fin su estabilización. El segundo aspecto es la posición de los tendones: si el túnel se abre en exceso hacia la palma, en ocasiones un tendón puede desplazarse hacia adelante (subluxarse) al mover el pulgar. Ambas situaciones son poco frecuentes, y su terapeuta de mano estará atento a ellas.

Precauciones y limitaciones

  • Mantenga el pulgar y la muñeca en movimiento desde el inicio: el movimiento suave es el tratamiento adecuado, no el reposo. Lo que más queremos evitar es la rigidez provocada por la falta de movimiento.
  • Utilice cualquier férula de confort únicamente según las indicaciones y solo durante los primeros días o una o dos semanas: su finalidad es brindar comodidad, no protección; debe quitársela para realizar los ejercicios.
  • Mantenga la herida limpia y seca hasta que cicatrice; no comience a masajear la cicatriz hasta que se hayan retirado los vendajes y la piel esté cerrada.
  • Evite realizar agarres fuertes, pellizcos enérgicos, levantar objetos pesados o girar el brazo (como retorcer un paño, abrir frascos difíciles de abrir o usar herramientas pesadas) durante unas tres a cuatro semanas; después, vaya aumentando gradualmente la actividad.
  • Informe a su terapeuta o al personal si nota hormigueo, entumecimiento o una sensación punzante en el dorso del pulgar y la muñeca, o si percibe que algún tendón se “traba” o se desliza al mover el pulgar.

Para información sobre el cuidado de la herida, la reducción de la hinchazón y el manejo de la cicatriz, consulte las pautas de cuidado de heridas de nuestra consulta.

Sus ejercicios

Estos son los ejercicios que aparecen en su folleto. Comience a realizarlos según las indicaciones del Dr. Hirpara y de su terapeuta de mano. Los ejercicios iniciales (movimiento del pulgar, movimiento de la muñeca y deslizamiento de tendones) mantienen todo en movimiento para evitar que los tendones liberados se adhieran; se inician en los primeros días, siempre dentro de los límites del confort. El masaje de la cicatriz se comienza una vez que la herida haya sanado. El fortalecimiento de la prensión y el pellizco se añade más tarde, generalmente a partir de las tres o cuatro semanas. El deslizamiento nervioso solo se incorpora si la piel sobre la muñeca presenta sensación de hormigueo o sensibilidad. Interrumpa cualquier ejercicio que provoque dolor agudo o punzante en la zona lateral del pulgar de la muñeca.

Su protocolo clínico

El resto de esta página describe el protocolo clínico por etapas para la rehabilitación tras la liberación del compartimento dorsal primero en el síndrome de De Quervain. Esta sección debe entregarse a su terapeuta de mano; cada fase comienza con una explicación sencilla en lenguaje coloquial sobre lo que se está realizando. Se trata de una descompresión, no de una reparación: el compartimento dorsal primero se divide y debe permanecer dividido; por lo tanto, no existe ninguna estructura que proteger. El programa es, por tanto, un protocolo de movilización temprana basado en el deslizamiento: se busca que los tendones APL y EPB se deslicen a través del lecho quirúrgico para prevenir adherencias, controlar el edema, gestionar la cicatrización y la situación del nervio sensitivo radial, y recuperar la fuerza de agarre y el movimiento de pinza.

Antes de iniciar el tratamiento, revise el informe operatorio del paciente y consulte con el cirujano responsable sobre la técnica de liberación empleada (incisión longitudinal/dorsal, si se identificó y liberó una subvaina o septo del tendón EPB), la posición dorsal de la incisión para evitar la subluxación de los tendones volares, y el manejo del nervio sensitivo radial. El Dr. Hirpara realiza la liberación mediante abordaje dorsal/longitudinal, protegiendo las ramas del nervio sensitivo radial y manteniendo la incisión en zona dorsal para evitar la subluxación volar; la inmovilización se emplea únicamente por comodidad (vendaje blando, posiblemente con férula de pulgar durante unos días hasta ~1–2 semanas), siendo la movilización temprana del pulgar y la muñeca la práctica recomendada.

Fase I — movilización temprana, control del edema y cuidado de la herida (semana 0 a ~2)

Durante la primera o segunda semana se protege la herida y se controla la hinchazón, mientras que la movilización comienza de inmediato. No existe ningún rango de movimiento restringido: el objetivo es lograr que los tendones liberados deslicen desde el principio. Cualquier férula se utiliza únicamente para mayor comodidad y se retira durante los ejercicios.

Para su terapeuta de mano:

Educación y precauciones - Se trata de una descompresión: no hay estructura que proteger; la movilización activa temprana es el procedimiento habitual. - Solo para apoyo y comodidad: vendaje blando, acompañado de una férula tipo “spica” para el pulgar durante los primeros días, hasta aproximadamente 1–2 semanas; se retira para realizar ejercicios y lavarse. - Mantenga la herida limpia y seca hasta que cicatrice; posponga cualquier tratamiento de la cicatriz hasta que la piel esté completamente cerrada. - En este período, evite el agarre fuerte, la pinza, levantar objetos y la torsión de la muñeca. - Evalúe la distribución del nervio sensitivo radial (región dorsal del pulgar y muñeca) en busca de parestesias, hipersensibilidad o signo de Tinel; asimismo, revise la posible subluxación de los tendones APL/EPB durante la extensión y abducción activa/resistida del pulgar.

Manejo - Herida: utilice los apósitos quirúrgicos según indicaciones; vigile posibles signos de infección. - Edema: mantenga la extremidad elevada, realice masajes retrógrados suaves y aplique hielo según sea necesario. - Ejercicios: movilidad activa del pulgar (flexión/extensión, abducción palmar y radial, oposición), movilidad activa de la muñeca, deslizamiento de los tendones APL/EPB, movilidad activa completa de los dedos; además, permita un uso funcional leve de la mano siempre que sea cómodo.

Criterios para avanzar a la siguiente fase - La herida ha cicatrizado o está en proceso de curación; el edema está controlado; la movilidad activa del pulgar y la muñeca resulta cómoda.

Fase II: Restauración del movimiento y manejo de las cicatrices (semanas ~2 a 4)

Una vez que la herida haya cicatrizado, se retira la férula de confort y el enfoque se desplaza hacia lograr un movimiento completo y cómodo, así como la desensibilización activa de la cicatriz y los nervios. Hacia el final de este período se inicia un ligero fortalecimiento.

Para su terapeuta de mano:

Evaluaciones - Amplitud de movimiento activo/pasivo del pulgar y la muñeca; calidad de la cicatriz; síntomas del nervio sensorial radial; evaluación de subluxación

Educación y precauciones - Dejar de usar cualquier férula de confort; fomentar el uso normal y ligero de la mano - Seguir evitando el agarre o la pinza fuertes/hinchados hasta aproximadamente 3–4 semanas

Manejo - Cicatriz: masaje y aplicación de silicona/hidratante una vez cicatrizada; desensibilización si hay hipersensibilidad - Nervio: ejercicios de deslizamiento y desensibilización del nervio sensorial radial si está irritado; estabilizarlo antes de aplicar carga - Ejercicios: avanzar hacia una amplitud de movimiento completa del pulgar y la muñeca; continuar con los ejercicios de deslizamiento tendinoso; iniciar el agarre/pinza ligera (masa plástica, pelota blanda) a partir de las 3–4 semanas aproximadamente

Criterios para avanzar - Amplitud de movimiento completa y sin dolor del pulgar y la muñeca; cicatriz curada y móvil; síntomas nerviosos en vía de resolución

Fase III: Fortalecimiento y retorno a la actividad (semanas ~4 a 6 y posteriores)

Una vez recuperado el movimiento y cicatrizada la herida, se incrementa la fuerza de agarre y de pinza, y el paciente vuelve a realizar todas sus actividades habituales. La mayoría alcanza un uso normal sin dificultades alrededor de las cuatro a seis semanas; para actividades manuales más exigentes se necesita un poco más de tiempo, y el retorno depende de ciertos criterios clínicos.

Para su terapeuta de mano:

Evaluaciones - Fuerza de agarre y de pinza en comparación con el lado contralateral; presencia de dolor al realizar esfuerzos; pruebas funcionales o laborales según corresponda

Educación y precauciones - Retorno gradual al agarre, pinza, levantamiento y torsión; reinicio total de actividades cuando el paciente lo tolere según su confort y fuerza - Si persiste el dolor o hormigueo en la zona dorsorradial, o si se percibe un chasquido tendinoso → derivar nuevamente al cirujano tratante (considerar posibilidad de neuroma, liberación incompleta o subluxación volar)

Manejo - Ejercicios: fortalecimiento progresivo del agarre y la pinza; cargas específicas según tareas y actividades laborales; continuar con cualquier tratamiento residual para cicatrices o nervios - Considerar el alta cuando la fuerza sea casi simétrica y la función esté restaurada - Derivar nuevamente al médico tratante si la recuperación se estanca o el resultado no es satisfactorio

Criterios para el alta o retorno a la actividad plena - Fuerza de agarre y pinza casi simétrica; uso funcional y laboral sin dolor

Volver al trabajo y a las actividades cotidianas

Se recomienda comenzar desde el principio con un uso ligero de la mano en actividades diarias (comer, escribir, vestirse, tareas sencillas), siempre dentro de los límites de la comodidad. Dado que la intervención se realizó en la muñeca y la mano debe moverse libremente y agarrar objetos de forma segura, la mayoría de las personas pueden volver a conducir en la primera o segunda semana, siempre que la herida no les cause molestias, hayan retirado cualquier férula de protección y puedan agarrar y girar el volante con confianza; esto se confirmará en su consulta de seguimiento.

El agarre fuerte, el pellizco, el levantamiento de pesos y los giros deben esperar hasta aproximadamente tres o cuatro semanas, momento en el cual se irán introduciendo gradualmente. El trabajo de oficina y las tareas ligeras suelen reanudarse en unos días o una o dos semanas; en cambio, el trabajo manual más pesado que requiere fuerza y movimientos repetitivos del pulgar y la muñeca suele retomarse alrededor de las cuatro a seis semanas, según la fuerza y comodidad recuperadas, evaluadas por el Dr. Hirpara y su terapeuta de mano, y no únicamente en función del tiempo transcurrido.

Después de seguir este protocolo

Este protocolo complementa las recomendaciones generales de recuperación de la consulta: consulte control del dolor postoperatorio, cuidado de la herida y manejo de las cicatrices. El plan por fases descrito anteriormente se basa en las guías de rehabilitación publicadas tras una liberación de De Quervain; además, el Dr. Hirpara y su terapeuta de mano supervisarán su recuperación de forma individualizada según la evolución de su mano.


Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

de Quervain's Release — Procedure Outcomes & Post-operative Rehabilitation (First Dorsal Compartment Release)

Topic scope: post-operative rehabilitation after surgical release of the first dorsal compartment of the wrist (abductor pollicis longus, APL, and extensor pollicis brevis, EPB) for refractory de Quervain's tenosynovitis. This is a decompression, not a reconstruction: the fibro-osseous tunnel is opened and is meant to stay open, so the rehabilitation is an early-motion pathway built around tendon gliding, oedema and scar control, and protection of the overlying radial sensory nerve — rather than months of protected healing.

Defining principle of the rehab here: de Quervain's release relieves a tendon entrapment and does not create a construct that needs protection. The divided extensor retinaculum is meant to stay divided. So (unlike a tendon or ligament repair) immediate, gentle active thumb and wrist motion is the default, and the only deliberate restraints are brief comfort support and a short window of heavy-grip/pinch/twist avoidance while the wound heals. The therapy programme exists to keep the APL/EPB tendons gliding through the healing surgical bed so they do not adhere, to settle the radial sensory nerve branches that cross the incision, and to rebuild grip and pinch — not to immobilise. The single branch points are (1) whether a separate EPB sub-sheath/septum was present and released (its retention is a classic cause of failed release) and (2) keeping the release dorsal so the tendons do not subluxate volarly.


A. PROCEDURE OUTCOMES (open release; endoscopic and retinaculum-sparing variants)

Surgical release of the first dorsal compartment is a reliable operation for de Quervain's that has failed non-operative care: the great majority of patients obtain durable symptom relief, and the principal debates are over technique details (incision orientation, completeness of EPB sub-sheath release, whether to preserve/lengthen the retinaculum) rather than whether to decompress.

  • Open release gives durable, high-quality long-term outcomes. A series of 80 cases with a mean 9.5-year follow-up reported sustained relief with a low complication profile, establishing the long-term reliability of open release [Garçon et al., Orthop Traumatol Surg Res 2018]. Moderate (long-term cohort).
  • Functional recovery is good and objectively measurable. A series using DASH scores to evaluate first-extensor-compartment release for refractory disease documented good functional outcomes, and emphasised identifying and releasing a separate EPB sub-compartment (septum) when present [Lee et al., Clin Orthop Surg 2014]. DASH is a validated, widely used outcome instrument across hand and wrist conditions [Baltzer, Novak & McCabe, J Hand Surg Am 2014 — scoping review]. Moderate (cohort) + instrument SR.
  • Endoscopic and open release are broadly comparable. A comparative study of endoscopic versus open release found favourable results for the endoscopic approach with attention to the radial sensory nerve, while open release remains the standard reference technique [Kang et al., Bone Joint J 2013]. Moderate (comparative).
  • The retinaculum can be partly resected, simply divided, or reconstructed. Partial resection of the extensor retinaculum gives good short-term results [Altay et al., Orthop Traumatol Surg Res 2011]; simple release and Z-plasty (retinaculum-lengthening) reconstruction give comparable outcomes, with Z-plasty proposed to reduce subluxation risk at the cost of complexity [Kim, Baek & Lee, J Hand Surg Eur 2019]. A longitudinal-incision technique series likewise reports good functional outcomes [Mangukiya et al., Musculoskelet Surg 2019]. Moderate (comparative/cohort).
  • Dissatisfaction does occur and is worth counselling for. A focused study of dissatisfaction after first dorsal compartment release found that a minority of patients remain dissatisfied, often linked to residual pain, nerve symptoms or incomplete relief — a reminder that outcomes are good but not universal [Rogozinski & Lourie, J Hand Surg Am 2016]. Moderate (cohort).

B. REHABILITATION / THERAPY EVIDENCE

The central rehab questions are (1) whether to immobilise the thumb/wrist afterwards and for how long, and (2) whether formal hand therapy changes the outcome. The published base specific to post-de-Quervain-release rehabilitation is thin and consensus-driven: there are no high-quality trials comparing immobilisation regimens or therapy protocols. Practice converges on brief comfort support and early motion, with hand therapy used selectively.

  • Early motion is the rationalised default; prolonged immobilisation is not supported. Because the release is a decompression with no construct to protect, early active thumb and wrist motion is used to keep the APL/EPB tendons gliding and prevent adhesion. Immobilisation, where used, is a soft dressing or short thumb spica for comfort only for days to ~1–2 weeks. The supporting evidence is mechanistic/consensus, mirroring the well-established early-motion rationale after other upper-limb decompressions. Weak–moderate (mechanism strong, outcome data sparse).
  • De Quervain's is not always an isolated problem — therapy assessment matters. A hand-therapy review highlights that de Quervain's syndrome may coexist with other dorsoradial/wrist pathology, so post-operative therapy should reassess rather than assume a single diagnosis — relevant when symptoms persist after release [Redvers-Chubb, Hand Therapy 2015]. Consensus (narrative/therapy review).
  • Hand therapy focus is glide, scar and nerve, then strength. The programme priorities are tendon gliding (adhesion prevention), oedema control, scar management and radial sensory nerve desensitisation, and graded grip/pinch strengthening. The benefit of formal supervised therapy over a home programme is not established by trial data; selective therapy is defensible. Weak / consensus.

Recovery trajectory (expected, evidence-anchored)

Phase Window Restraint Hand use / therapy focus Strength / load Notes
I — Early motion, oedema & wound care Week 0–~2 Comfort support only (soft dressing ± short thumb spica) Immediate active thumb + wrist motion; APL/EPB tendon glides; elevation/oedema control; screen radial sensory nerve + subluxation Light functional use only No construct to protect; motion is the treatment. Keep wound clean/dry
II — Restore motion & scar/nerve care Week ~2–4 Splint discarded once healed Full thumb + wrist ROM; scar massage once wound healed; radial sensory nerve glides/desensitisation if irritable Begin light grip/pinch (putty, ball) from ~3–4 wk Avoid forceful grip/pinch/twist until ~3–4 wk
III — Strengthening & return Week ~4–6+ Restrictions lifted, graded Progressive grip/pinch and task-specific loading Return to near-symmetrical grip/pinch; full activity as strength allows Light/desk work days–1–2 wk; manual work ~4–6 wk, criterion-based

(Phase windows are typical clinical guides, not trial-derived deadlines. Driving resumes once the wound is comfortable, any comfort splint is off, and the patient can grip and steer confidently — commonly within 1–2 weeks.)


C. KEY CONTROVERSIES / EVIDENCE QUALITY

  1. The EPB sub-sheath (septum) must be sought and released. A separate EPB sub-compartment is common and, if missed, is a classic cause of persistent symptoms / failed release. Series that emphasise identifying and releasing it report good outcomes [Lee 2014]. Moderate — strong mechanistic consensus.
  2. Volar tendon subluxation if released too volar. Dividing the retinaculum too far towards the palmar side can let the APL/EPB tendons subluxate volarly with thumb motion. Keeping the release dorsal, and retinaculum-lengthening (Z-plasty) reconstructions, are described specifically to mitigate this [Kim 2019; Altay 2011]. Moderate (technique-comparative).
  3. Radial sensory nerve injury is the signature complication. The superficial radial nerve branches cross the operative field; injury or scar entrapment produces dorsoradial numbness, hypersensitivity or painful neuroma and is a leading driver of dissatisfaction [Ilyas et al., J Am Acad Orthop Surg 2007; Rogozinski 2016]. Careful exposure with nerve protection is emphasised across open and endoscopic techniques [Kang 2013]. Moderate.
  4. Immobilise or move early? No trial settles the optimal post-operative regimen; consensus favours brief comfort support and early motion (decompression logic) over prolonged splinting. Weak — consensus, not trial-derived.
  5. Outcomes are good but not universal. A measurable minority remain dissatisfied, usually from residual pain, nerve symptoms or incomplete release — worth explicit pre-operative counselling [Rogozinski 2016]. Moderate.

D. EVIDENCE STRENGTH FLAGS (summary)

  • MODERATE (cohort / comparative): durable long-term relief from open release (9.5-yr cohort); good DASH-measured functional outcomes; comparability of endoscopic vs open and of simple release vs Z-plasty / partial retinaculum resection; radial sensory nerve injury as the signature complication; a real, defined dissatisfaction rate.
  • WEAK / CONSENSUS: the early-motion, glide-based rehabilitation programme itself (mechanistically rationalised; no trial comparing immobilisation regimens or therapy protocols after de Quervain's release); the role of formal supervised therapy vs a home programme; exact phase timings and return-to-activity windows (typical guides, not trial-derived). Outcomes and the two signature complications (radial sensory nerve injury; volar subluxation) are better studied than the rehabilitation protocol.

CITATIONS

RAG corpus (180,000+ Orthopaedic articles)

  • Garçon JJ, Charruau B, Marteau E, et al. Results of surgical treatment of De Quervain's tenosynovitis: 80 cases with a mean follow-up of 9.5 years. Orthop Traumatol Surg Res. 2018. DOI: 10.1016/j.otsr.2018.04.022 (PMID 29909297)
  • Lee HJ, Kim PT, Aminata IW, et al. Surgical Release of the First Extensor Compartment for Refractory de Quervain's Tenosynovitis: Surgical Findings and Functional Evaluation Using DASH Scores. Clin Orthop Surg. 2014. DOI: 10.4055/cios.2014.6.4.405
  • Ilyas AM, Ast M, Schaffer AA, et al. de Quervain Tenosynovitis of the Wrist. J Am Acad Orthop Surg. 2007. DOI: 10.5435/00124635-200712000-00009 (PMID 18063716)
  • Kang HJ, Koh IH, Jang JW, et al. Endoscopic versus open release in patients with de Quervain's tenosynovitis. Bone Joint J. 2013. DOI: 10.1302/0301-620X.95B7.31486 (PMID 23814248)
  • Altay M, Ertürk C, Işıkan UE. De Quervain's disease treatment using partial resection of the extensor retinaculum: A short-term results survey. Orthop Traumatol Surg Res. 2011. DOI: 10.1016/j.otsr.2011.03.015
  • Kim J, Baek J, Lee J. Comparison between simple release and Z-plasty of retinaculum for de Quervain's disease: a retrospective study. J Hand Surg Eur Vol. 2019. DOI: 10.1177/1753193418818341 (PMID 30669923)
  • Mangukiya HJ, Kale A, Mahajan NP, et al. Functional outcome of De Quervain's tenosynovitis with longitudinal incision in surgically treated patients. Musculoskelet Surg. 2019. DOI: 10.1007/s12306-018-0585-1
  • Rogozinski B, Lourie GM. Dissatisfaction After First Dorsal Compartment Release for de Quervain Tendinopathy. J Hand Surg Am. 2016;41(1). DOI: 10.1016/j.jhsa.2015.09.020 (PMID 26481556)
  • Baltzer H, Novak CB, McCabe SJ. A Scoping Review of Disabilities of the Arm, Shoulder, and Hand Scores for Hand and Wrist Conditions. J Hand Surg Am. 2014. DOI: 10.1016/j.jhsa.2014.07.050 (PMID 25227601)
  • Redvers-Chubb K. De Quervain's syndrome: It may not be an isolated pathology. Hand Therapy. 2015. DOI: 10.1177/1758998315599796

de Quervain's release literature (URLs)

  • Lee HJ, et al. Surgical Release of the First Extensor Compartment for Refractory de Quervain's Tenosynovitis (DASH outcomes; EPB septum). Clin Orthop Surg 2014 (open access). https://doi.org/10.4055/cios.2014.6.4.405
  • Garçon JJ, et al. Results of surgical treatment of De Quervain's tenosynovitis: 80 cases, mean 9.5-year follow-up. Orthop Traumatol Surg Res 2018. https://doi.org/10.1016/j.otsr.2018.04.022
  • Ilyas AM, et al. de Quervain Tenosynovitis of the Wrist (review — radial sensory nerve, surgical technique, complications). J Am Acad Orthop Surg 2007. https://doi.org/10.5435/00124635-200712000-00009
  • Rogozinski B, Lourie GM. Dissatisfaction After First Dorsal Compartment Release for de Quervain Tendinopathy. J Hand Surg Am 2016. https://doi.org/10.1016/j.jhsa.2015.09.020

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Considerations for the public: By using one of our public licenses, a licensor grants the public permission to use the licensed material under specified terms and conditions. If the licensor's permission is not necessary for any reason--for example, because of any applicable exception or limitation to copyright--then that use is not regulated by the license. Our licenses grant only permissions under copyright and certain other rights that a licensor has authority to grant. Use of the licensed material may still be restricted for other reasons, including because others have copyright or other rights in the material. A licensor may make special requests, such as asking that all changes be marked or described. Although not required by our licenses, you are encouraged to respect those requests where reasonable. More considerations for the public: wiki.creativecommons.org/Considerations_for_licensees


Creative Commons Attribution-NonCommercial 4.0 International Public License

By exercising the Licensed Rights (defined below), You accept and agree to be bound by the terms and conditions of this Creative Commons Attribution-NonCommercial 4.0 International Public License ("Public License"). To the extent this Public License may be interpreted as a contract, You are granted the Licensed Rights in consideration of Your acceptance of these terms and conditions, and the Licensor grants You such rights in consideration of benefits the Licensor receives from making the Licensed Material available under these terms and conditions.

Section 1 -- Definitions.

a. Adapted Material means material subject to Copyright and Similar Rights that is derived from or based upon the Licensed Material and in which the Licensed Material is translated, altered, arranged, transformed, or otherwise modified in a manner requiring permission under the Copyright and Similar Rights held by the Licensor. For purposes of this Public License, where the Licensed Material is a musical work, performance, or sound recording, Adapted Material is always produced where the Licensed Material is synched in timed relation with a moving image.

b. Adapter's License means the license You apply to Your Copyright and Similar Rights in Your contributions to Adapted Material in accordance with the terms and conditions of this Public License.

c. Copyright and Similar Rights means copyright and/or similar rights closely related to copyright including, without limitation, performance, broadcast, sound recording, and Sui Generis Database Rights, without regard to how the rights are labeled or categorized. For purposes of this Public License, the rights specified in Section 2(b)(1)-(2) are not Copyright and Similar Rights.

d. Effective Technological Measures means those measures that, in the absence of proper authority, may not be circumvented under laws fulfilling obligations under Article 11 of the WIPO Copyright Treaty adopted on December 20, 1996, and/or similar international agreements.

e. Exceptions and Limitations means fair use, fair dealing, and/or any other exception or limitation to Copyright and Similar Rights that applies to Your use of the Licensed Material.

f. Licensed Material means the artistic or literary work, database, or other material to which the Licensor applied this Public License.

g. Licensed Rights means the rights granted to You subject to the terms and conditions of this Public License, which are limited to all Copyright and Similar Rights that apply to Your use of the Licensed Material and that the Licensor has authority to license.

h. Licensor means the individual(s) or entity(ies) granting rights under this Public License.

i. NonCommercial means not primarily intended for or directed towards commercial advantage or monetary compensation. For purposes of this Public License, the exchange of the Licensed Material for other material subject to Copyright and Similar Rights by digital file-sharing or similar means is NonCommercial provided there is no payment of monetary compensation in connection with the exchange.

j. Share means to provide material to the public by any means or process that requires permission under the Licensed Rights, such as reproduction, public display, public performance, distribution, dissemination, communication, or importation, and to make material available to the public including in ways that members of the public may access the material from a place and at a time individually chosen by them.

k. Sui Generis Database Rights means rights other than copyright resulting from Directive 96/9/EC of the European Parliament and of the Council of 11 March 1996 on the legal protection of databases, as amended and/or succeeded, as well as other essentially equivalent rights anywhere in the world.

l. You means the individual or entity exercising the Licensed Rights under this Public License. Your has a corresponding meaning.

Section 2 -- Scope.

a. License grant.

1. Subject to the terms and conditions of this Public License, the Licensor hereby grants You a worldwide, royalty-free, non-sublicensable, non-exclusive, irrevocable license to exercise the Licensed Rights in the Licensed Material to:

a. reproduce and Share the Licensed Material, in whole or in part, for NonCommercial purposes only; and

b. produce, reproduce, and Share Adapted Material for NonCommercial purposes only.

2. Exceptions and Limitations. For the avoidance of doubt, where Exceptions and Limitations apply to Your use, this Public License does not apply, and You do not need to comply with its terms and conditions.

3. Term. The term of this Public License is specified in Section 6(a).

4. Media and formats; technical modifications allowed. The Licensor authorizes You to exercise the Licensed Rights in all media and formats whether now known or hereafter created, and to make technical modifications necessary to do so. The Licensor waives and/or agrees not to assert any right or authority to forbid You from making technical modifications necessary to exercise the Licensed Rights, including technical modifications necessary to circumvent Effective Technological Measures. For purposes of this Public License, simply making modifications authorized by this Section 2(a) (4) never produces Adapted Material.

5. Downstream recipients.

a. Offer from the Licensor -- Licensed Material. Every recipient of the Licensed Material automatically receives an offer from the Licensor to exercise the Licensed Rights under the terms and conditions of this Public License.

b. No downstream restrictions. You may not offer or impose any additional or different terms or conditions on, or apply any Effective Technological Measures to, the Licensed Material if doing so restricts exercise of the Licensed Rights by any recipient of the Licensed Material.

6. No endorsement. Nothing in this Public License constitutes or may be construed as permission to assert or imply that You are, or that Your use of the Licensed Material is, connected with, or sponsored, endorsed, or granted official status by, the Licensor or others designated to receive attribution as provided in Section 3(a)(1)(A)(i).

b. Other rights.

1. Moral rights, such as the right of integrity, are not licensed under this Public License, nor are publicity, privacy, and/or other similar personality rights; however, to the extent possible, the Licensor waives and/or agrees not to assert any such rights held by the Licensor to the limited extent necessary to allow You to exercise the Licensed Rights, but not otherwise.

2. Patent and trademark rights are not licensed under this Public License.

3. To the extent possible, the Licensor waives any right to collect royalties from You for the exercise of the Licensed Rights, whether directly or through a collecting society under any voluntary or waivable statutory or compulsory licensing scheme. In all other cases the Licensor expressly reserves any right to collect such royalties, including when the Licensed Material is used other than for NonCommercial purposes.

Section 3 -- License Conditions.

Your exercise of the Licensed Rights is expressly made subject to the following conditions.

a. Attribution.

1. If You Share the Licensed Material (including in modified form), You must:

a. retain the following if it is supplied by the Licensor with the Licensed Material:

i. identification of the creator(s) of the Licensed Material and any others designated to receive attribution, in any reasonable manner requested by the Licensor (including by pseudonym if designated);

ii. a copyright notice;

iii. a notice that refers to this Public License;

iv. a notice that refers to the disclaimer of warranties;

v. a URI or hyperlink to the Licensed Material to the extent reasonably practicable;

b. indicate if You modified the Licensed Material and retain an indication of any previous modifications; and

c. indicate the Licensed Material is licensed under this Public License, and include the text of, or the URI or hyperlink to, this Public License.

2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.


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