Page 111 - ASOP Orthopedic Casting Manual

2.5.1 Fracture Type(s) for Thumb

Spica Cast

DeQuer vainʼs Tenosynovitis LSoft Tissue Injur y)
✓ Clinical Relevant Anatomy: This condition involves inflammation of the

tendons in the first dorsal compar tment (abductor pollicis longus and
ex tensor pollicis brevis) and their synovial sheath.
✓ Epidemiology / Etiology / Mechanism of Injur y: De Quer vainʼs tenosynovitis is

common in repetitive strain injuries due to overuse or direct trauma. I t often
affects individuals per for ming repetitive wrist and thumb motions.
✓ Clinical Characteristics / Presentation: Patients present with pain and swelling

over the radial st yloid, worsened by thumb movements or ulnar deviation of
the wrist. The Finkelstein test reproduces symptoms.
✓ Fracture Diagnosis Process: This condition is primarily diagnosed clinically.

Imaging may be used to exclude under lying fractures or ar thritis.
✓ Differential Diagnosis / Associated Injuries:

✓ Intersection syndrome
✓ Scaphoid fracture

✓ Radial st yloid fracture

✓ Treatment / Management Considerations: A thumb spica splint or cast may be

used for immobilization to reduce inflammation. Conser vative treatment
includes NSAIDs, physical therapy, and cor ticosteroid injections. Surgical
inter vention is considered in refractor y cases.