top of page

TENDINOPATHIES

Lateral epicondylitis

  • Tennis elbow

  • Presents with well-localized lateral elbow pain that is exacerbated by certain activities such as gripping

  • Physical examination will show point ten- derness directly over the lateral epicondyle

  • Pain will be increased with resisted wrist extension, especially in elbow extension

  • Treatment predominantly conservative:

    • ​Splinting

    • Counter force bracing

    • NSAIDs

    • Physiotherapy

    • Steroid injection

    • Simple observation without intervention

  • Surgical treatment:​

    • Debridement or tenotomy of the extensor carpi radialis brevis origin​

Lateral epicondylitis

De Quervain's tenosynovitis

  • Tenosynovitis of the first dorsal compartment

  • Well localised to radial side of the wrist

  • Finkelstein's test is sensitive test, point tenderness is a specific sign

  • Occasionally there may be small ganglion overlying the first compartment

  • Nonsurgical treatment

    • Oral non-steroidal anti-inflammatory​

    • Steroid injections

    • Splinting and physiotherapy

  • Surgical treatment

    • Decompression of first dorsal compartment​

    • Thumb spica splint for 10-14 days post op

De Quervain's tenosynovitis

Trigger finger

  • One of the most common disorders of the hand

  • Straightforward diagnosis based on history and physical examination

  • Management

    • Night time splinting​

      • For patients with no active triggering at presentation but wake up with locked fingers

    • Steroid injection​

      • Mainstay of initial management​

    • Surgical management​

      • Release of A1 pulley under direct vision​

Trigger finger
bottom of page