Tenosynovectomy for Chronic Flexor Tenosynovitis at the Wrist

Journal of the Korean Society for Surgery of the Hand 2004;9(2):83-88.
Published online June 1, 2004.

Jun-Mo Jung, Jong-Oh Kim, Yeo-Heon Yun, Young-Do Koh, Jae-Doo Yoo, Dong-Hea Jung, Myeung-Cheol Shin, Kyu-Bok Kang

수근부의 만성 굴곡건 건막염에 대한 건막 절제술

정준모, 김종오, 윤여헌, 고영도, 유재두, 정동해, 신명철, 강규복

Abstract

Introduction: Wrist flexor tenosynovitis is a common cause of chronic wrist pain and usually responds to the medication. But sometimes it is difficult to eradicate with medication only. Materials and Methods: We report eight cases, which have not responded to the medication for more than 3 months and eventually required tenosynovectomy. All the cases have tenderness, pain and weakness of grip over the volar aspect of wrist in spite of medication over 3 months. Compressive median nerve symptoms were combined in six cases, ulnar nerve in one case. One patient showed a bilateral involvement and trigger wrist. Results: Biopsy showed nonspecific chronic inflammation in four cases, tuberculosis in two, low grade infection in one, and pigmented villonodular synovitis in one. All were relieved by tenosynovectomy. In the two cases, the patients were proved to be tuberculosis, who were treated by anti-tuberculosis medication. Conclusion: It is difficult to make a differential diagnosis with imaging study between nonspecific tenosynovitis, rheumatoid arthritis, low grade infection, tuberculosis, PVNS, and etc. Therapeutic and diagnostic tenosynovectomy is strongly recommended for chronic flexor tenosynovitis at the wrist for more than 3 months.