Do You Really Need a Hand Surgeon? Common Tendinopathies of the Upper Extremity.

ABSTRACT

Lateral epicondylitis, de Quervain tenosynovitis, and trigger finger are among the most common tendinopathies of the upper extremity. Lateral epicondylitis is a common condition with a prolonged course that can be frustrating for patients. Nonetheless, most patients improve with a simple wait-and-see approach. Therapy has been shown to be helpful and surgical management is usually successful in recalcitrant cases. Cortisone, although commonly used in the past, has been shown to have worse results than placebo in the medium and long term. de Quervain tenosynovitis responds well to nonsurgical measures including bracing treatment, therapy, and cortisone. Surgery is effective, although neuritis of the radial sensory nerve is a notable complication. Trigger finger is strongly associated with diabetes and is typically treated with cortisone or surgery. With a thoughtful and well-researched approach, any of these conditions can be successfully managed by a community orthopaedic specialist.