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Systematic review and meta-analysis on steroid injection therapy for de Quervain's tenosynovitis in adults
Muhammad Omer Ashraf1, V G Devadoss
1The Royal Oldham Hospital, Oldham, UK, momerashraf@yahoo.co.uk.
Background:
de Quervain's tenosynovitis is a painful condition of the wrist which leads to difficulties in performing activities of daily living.
Aims:
This systematic review was conducted to examine the effectiveness of steroid injection therapy as compared to splinting for treatment of de Quervain's tenosynovitis in adults.
Methods:
The following databases were searched for relevant studies, MEDLINE, EMBASE, CINAHL, AMED and PsycINFO (via NHS Evidence), and Cochrane Library (via Cochrane Collaboration). Synonyms and free texts were used to locate studies. The reference lists of articles were checked for related papers. Hand searching was performed for important relevant journals. All searches found 89 studies, out of which 14 were relevant. Two studies were selected according to the inclusion criteria of the systematic review. Data were extracted and analysed for the two selected randomised trials using a fixed effect model at 95 % confidence intervals.
Results:
The meta-analysis demonstrated that the total effect estimate was 3 with a narrow 95 % confidence interval (1.89, 4.77). z score for overall effect was 4.66 which was highly significant (p < 0.01). Moderate heterogeneity with I-square test was found to be 64 % but was not significant (p > 0.05). Number needed to treat was 2, which showed that for every two persons treated with steroid injections, one person gets the benefit.
Conclusion:
Steroid injection is an effective form of conservative management for de Quervain's disease although more research is needed to establish the full benefits of the treatment.
