Preoperative Indicators of the Effectiveness of Surgical Release in Patients with de Quervain Disease: A Prospective Cohort Study

Plast Reconstr Surg. 2024 May 1;153(5):952e-961e. doi: 10.1097/PRS.0000000000010445. Epub 2023 Nov 23.

Abstract

Background: A significant proportion of patients report persistent pain after surgical release for de Quervain disease (DQ). This study aimed to investigate the effectiveness of a surgical release for DQ and to identify the preoperative factors associated with pain after a surgical release for DQ.

Methods: This prospective cohort study included 707 patients who underwent surgical release and completed a visual analogue scale questionnaire (VAS; range 0 to 100). We used a paired t test to analyze the effectiveness of the surgical release on pain at 3 months postoperatively compared with the preoperative measure. A hierarchical multivariable linear regression model was created to investigate the contribution of patient-related and disease-related characteristics to postoperative pain.

Results: All VAS domains showed improvement after surgical release. On average, the mean VAS pain decreased by 44 points (95% CI, 42, 46). Smoking (B = 6.37; P < 0.01), younger age (B = -0.35; P < 0.01), longer duration of complaints (B = 0.13; P < 0.01), concomitant surgery (B = 14.40; P < 0.01), and higher VAS pain scores at intake (B = 0.15; P < 0.01) were associated with worse VAS pain scores postoperatively. Together, the variables explained 11% of the variance in mean VAS pain score at 3 months follow-up.

Conclusions: This study confirms that surgical treatment for DQ significantly reduces patient-reported pain. Smoking, younger age, concomitant surgery, duration of complaints, and higher VAS pain scores at intake are associated with worse patient-reported pain 3 months after surgical release. However, the small effects suggest that these factors should not be considered the only important factors.

Clinical question/level of evidence: Risk, III.

MeSH terms

  • Adult
  • Aged
  • De Quervain Disease* / surgery
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement* / statistics & numerical data
  • Pain, Postoperative* / diagnosis
  • Pain, Postoperative* / etiology
  • Preoperative Period
  • Prospective Studies
  • Treatment Outcome