Assessing Methylprednisolone Acetate Injection Adjunct to Casting Versus Casting Alone in De-Quervain’s Tenosynovitis Management: A Comparative Study

Abstract

Background: De Quervain's tenosynovitis is a prevalent source of wrist pain that results in impaired function of the affected hand. Objective: To assess the efficacy of methylprednisolone acetate injection adjunct to casting versus casting alone in de-quervain’s tenosynovitis management. Study Design: Randomized Controlled Trail. Settings: Department of Orthopedic Nishtar Hospital, Multan Pakistan. Duration: From Nov 2022 to April 2023. Methods: Our study enrolled patients of both genders, aged between 30 to 50 years, who presented with De Quervain’s disease, diagnosed based on operational definitions. Subsequently, these patients were randomly allocated into two groups using a lottery approach. In our study, we divided participants into two groups, Group A: Consisting of 40 cases, participants received treatment with a Thumb Spica cast along with Methylprednisolone acetate injection. Group B: Also comprising 40 cases, participants were treated solely with a Thumb Spica cast without additional medication. Data collected was analyzed using SPSS version 22. Results: The patients' ages ranged from 30 to 50 years, with a mean age of 37.16±5.15 years. The study group comprised 23 male patients, representing 28.8% of the total, and 57 female patients, representing 71.2% of the total. The male to female ratio was 1:2.5. The initial pain VAS score ranged from 1 to 10, with a mean of 5.25±2.40. The rate of successful therapy was markedly greater in patients who had a thumb spica cast combined with an injection of methylprednisolone acetate (85.0% vs. 37.5%; p=0.000) compared to those who only received a thumb spica cast. Conclusion: Patients treated with thumb spica cast along with methylprednisolone acetate injection had a considerably greater success rate of 85.0% compared to 37.5% in patients treatment with thumb spica cast alone (p=0.000). This discrepancy was notable in all age groups, genders, and baseline pain severity categories.