Article

De Quervain disease is a common pathology resulting in pain caused by
resisted gliding of the abductor pollicis longus and extensor pollicis brevis
tendons in the fibro-osseous canal. In a situation of wavering assumptions and
expanding medical knowledge,
a treatment guideline is useful because it can aid
in implementation of best practices, the education of health care professionals,
and the identification of gaps in existing knowledge. The aim of this
study was to achieve consensus on a multidisciplinary treatment guideline for de
Quervain disease. DESIGN: A Delphi consensus strategy was used. METHODS: A
European Delphi consensus strategy was initiated. A systematic review reporting
on the effectiveness of surgical and nonsurgical interventions was conducted and
published and was used as an evidence-based starting point for this study. In
total, 35 experts (hand therapists and hand surgeons selected by the national
member associations of their European federations and physical medicine and
rehabilitation physicians) participated in the Delphi consensus strategy. Each
Delphi round consisted of a questionnaire, an analysis, and a feedback report.
RESULTS: Consensus was achieved on the description, symptoms, and diagnosis of de
Quervain disease. The experts agreed that patients with this disorder should
always receive instructions and that these instructions should be combined with
another form of treatment and should not be used as a sole treatment.
Instructions combined with nonsteroidal anti-inflammatory drugs (NSAIDs),
splinting, NSAIDs plus splinting, corticosteroid injection, corticosteroid
injections plus splinting, or surgery were considered suitable treatment options.
Details on the use of instructions, NSAIDs, splinting, corticosteroid injections,
and surgery were described. Main factors for selecting one of these treatment
options (ie, severity and duration of the disorder, previous treatments given)
were identified. A relationship between the severity and duration of the disorder
and the choice of therapy was indicated by the experts and reported in the
guideline. LIMITATIONS: One of the limitations of a Delphi method is its
inability to forecast future developments. It investigated current opinions of
the treatment of people with de Quervain disease. CONCLUSIONS: This
multidisciplinary treatment guideline may help in the treatment of and research
on de Quervain disease.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS