Orthotic care of De Quervain\u27s tenosynovitis – literature review

Uvod: De Quervain tenosinovitis je patologija, opisana kot vnetje tetiv extensor pollicis brevis in abductor pollicis longus, ki potekata na palčevem delu na hrbtišču zapestja v ozkem vezivnem kanalu. Patologija bolj prizadene ženske, kot pa moške potek je lahko kroničen ali akuten. Zdravljenje je usmerjeno k lajšanju simptomov in bolečin z namenom izboljšanja kakovosti življenja. Najpogostejši način konservativnega zdravljenja je uporaba ortoze za palec, ki imobilizira palec in omejuje gibanje, nato sledi še uporaba nesteroidnih protivnetnih zdravil ter kortikosteroidov. Namen: Namen diplomskega dela je s pomočjo že obstoječih raziskav ugotoviti uspešnost zdravljenja De quervain tenosinovitisa z uporabo ortoze za palec ter učinkovitost ortotične oskrbe v primerjavi z drugimi načini konservativnega zdravljenja. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela, pregled že obstoječe literature o ortotični oskrbi De Quervain tenosinovitisa. Literaturo smo iskali v angleškem jeziku z uporabo podatkovnih baz PubMed in Google Schoolar. Uporabili smo ključne besede: (Quervain* OR DeQuervain* OR De Quervain Disease OR tendinopathy OR tenosynovitis) OR (abductor AND pollicis) OR (extensor AND pollicis AND brevis) AND (orthosis OR orthoses) OR (thumb spica splint OR thumb spica cast) AND (hand orthos* OR wrist orthos*). Izbrali smo prosto dostopne članke, ki niso bili starejši od desetih let in so vključevali uporabo ortoze za palec. Rezultati: Na osnovi vključitvenih in izključitvenih kriterijev smo podrobneje pregledali 7 člankov. V štirih raziskavah avtorji opisujejo samo ortoze za palec. V dveh so poleg ortoz preučevali še zdravljenje s kortikosteroidi in v eni raziskavi so primerjali zdravljenje med ortozami in terapevtskim ultrazvokom. Skupni učinki ortoz za palec so imobilizacija palca in omejevanje gibanja ter razbremenitev pritiska na področju tetiv palca. Razprava in zaključek: Glede na pregledano literaturo sklepamo, da so pri pacientih z De Quervain tenosinovitisom najbolj pogosto uporabljene in učinkovite ortoze za palec. Ortoze za palec se lahko uporabljajo kot samostojni način zdravljenja ali v kombinaciji z nesteroidnimi protivnetnimi zdravili ter kortikosteroidi. Z namenom boljšega razumevanja bolezni v prihodnje priporočamo obsežnejše študije na področju ortotične oskrbe ter drugih načinov zdravljenja.Introduction: De Quervain\u27s tenosynovitis is a pathology described as an inflammation of the extensor pollicis brevis and abductor pollicis longus tendons, which occur on the thumb on the back of the wrist in a narrow connecting canal. The pathology is more common in women, and it can be chronic or acute. Treatment aims to relieve symptoms and pain to improve the quality of life. The most common method of conservative treatment is the use of a thumb orthosis, which immobilizes the thumb and restricts movement, followed by the use of nonsteroidal anti-inflammatory drugs and corticosteroids. Purpose: The purpose is to determine the effectiveness of treating De Quervain\u27s tenosynovitis with a thumb orthosis and the effectiveness of orthotic care compared with other methods of conservative treatment. Methods: We used a descriptive method, a review of the existing literature on orthotic care for De Quervain\u27s tenosynovitis. We searched the literature in English using PubMed and Google Schoolar databases with keywords: (Quervain * OR DeQuervain * OR De Quervain Disease OR tendinopathy OR tenosynovitis) OR (abductor AND pollicis) OR (extensor AND pollicis AND brevis) AND (orthosis OR orthoses) OR (thumb spica splint OR thumb spica cast) AND (hand orthos * OR wrist orthos *). We selected free articles no older than ten years that included the use of a thumb orthosis. Results: Based on the inclusion and exclusion criteria, we examined 7 articles in more detail. In four studies, the authors described thumb orthoses only. Two studies examined corticosteroid therapy in addition to orthotics, and one study compared treatment between orthotics and therapeutic ultrasound. The common effects of thumb orthoses were immobilization of the thumb and restriction of motion, and relief of pressure in the thumb tendon area. Discussion and conclusion: We found that thumb orthoses are most commonly used and most effective in patients with De Quervain\u27s tenosynovitis. Thumb orthoses can be used as sole treatment or in combination with nonsteroidal anti-inflammatory drugs and corticosteroids. In the future, we recommend more extensive research in this area to better understand the disease and, in turn, orthotic care and other treatments