De Quervain's release is a minor surgical procedure to treat De Quervain's tenosynovitis — a painful condition affecting the tendons on the thumb side of the wrist. The operation involves opening the tight tendon sheath to relieve pressure.
A small incision (2–3 cm) is made over the thumb side of the wrist. The thickened tendon sheath (first dorsal compartment) is identified and divided to release the tendons. Care is taken to identify and protect the sensory branch of the radial nerve. The wound is closed with stitches. The procedure takes approximately 15–20 minutes.
Surgery is recommended when De Quervain's tenosynovitis causes persistent pain and swelling at the thumb side of the wrist that has not responded to splinting, activity modification, and corticosteroid injection.
Thumb spica splinting, anti-inflammatory medication, activity modification, and corticosteroid injection. Injection is effective in approximately 70–80% of patients and is usually tried before surgery.
Day-case procedure under local anaesthetic. Normal eating and drinking. Remove jewellery from the affected hand.
The aim is to relieve pain and restore normal thumb and wrist function. Success rates are very high, with over 90% of patients experiencing complete relief.
Tenderness at the incision site for several weeks.
Thumb grip may feel weak initially.
The superficial branch of the radial nerve is at risk. Injury can cause numbness or painful sensitivity on the back of the thumb and hand.
If a separate sub-compartment is not released, symptoms may persist.
The tendons may slip out of the groove if too much of the sheath is released.
Wound infection.
Usually performed under local anaesthetic. Regional or general anaesthesia may be used if preferred.
Gentle thumb and wrist movements from the day of surgery. Stitches removed at 10–14 days. Most patients return to normal activities within two to four weeks. Heavy gripping takes four to six weeks.
Suture removal at 10–14 days. Further follow-up only if needed.
Injections are effective for most patients but may not work if there is an anatomical variant (a separate sub-compartment) that the injection did not reach.
Recurrence after surgery is rare.