Patient-specific factors associated with conservative treatment failure in de Quervain tenosynovitis

Most patients with de Quervain tenosynovitis are well managed with nonsurgical treatments, however, wrist pain persists or recurs in some patients, affecting activities of daily living. This study aimed to identify patient-specific factors associated with persistent or recurrent symptoms after conservative treatment of de Quervain tenosynovitis.

We retrospectively collected data from patients with de Quervain tenosynovitis who had been conservatively treated. The failure group comprised 28 patients who had received surgical intervention and had persistent or recurrent symptoms for >1 year. The improvement (control) group included 84 patients who experienced pain relief and regained thumb abduction and extension function. We used multivariable logistic regression to assess patient factors including age, sex, body mass index, history of smoking, and comorbidities, namely diabetes mellitus, hyperlipidaemia, psychiatric illness, trigger finger, carpal tunnel syndrome, and osteoarthritis of the wrist.

In univariate analysis, body mass index, diabetes mellitus, trigger finger, and carpal tunnel syndrome were significantly different between the failure and improvement groups. The multivariable analysis identified diabetes mellitus as an independent patient-specific factor significantly associated with the failure of conservative treatment.

Patients with diabetes mellitus are more likely to require surgical intervention and have persistent or recurrent symptoms following conservative treatment for de Quervain tenosynovitis.