A Double-blinded, Randomized Controlled Trial Assessing Outcomes in Standard De Quervain Surgery Versus Surgery With Intraoperative Corticosteroid Injection Adjunct

Background: De Quervain tenosynovitis is a condition affecting the first dorsal compartment of the wrist. While corticosteroid injections offer fast but short-term pain relief, surgery remains the gold standard, yielding excellent long-term clinical outcomes. However, postoperative pain, identified in multiple studies, has been implicated in prolonged recovery. Methods: This study aimed to assess the effectiveness of standard open surgery versus surgery with adjunct intraoperative local corticosteroid injection in De Quervain tenosynovitis through a double-blinded, randomized controlled trial conducted from 2019 to 2022. The trial included 108 patients, with 54 in the standard open surgery group and 54 in the adjunct intraoperative local corticosteroid injection group. The evaluation comprised preoperative and postoperative assessments using the Visual Analog Scale (VAS) and quick disabilities of the arm, shoulder, and hand (QuickDASH) scores. Results: The mean postoperative VAS score in the adjunct intraoperative local corticosteroid injection group significantly improved from the first day to the 14th day postoperation ( P < 0.05). The mean QuickDASH score demonstrated significant improvement at 7th and 14th days of follow-up ( P < 0.05). However, after the 28th day of follow-up, no significant differences in mean VAS and QuickDASH scores were observed. Notably, 2 patients in the adjunct local corticosteroid group experienced postoperative skin hypopigmentation. Conclusions: Surgical release stands as the gold standard treatment for De Quervain disease, ensuring complete symptom relief. The adjunct treatment with local corticosteroid injection showed promise in providing earlier symptom relief and expediting recovery, particularly in the initial 2 weeks postsurgery. Levels of Evidence: Level IV—therapeutic study.