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Diaper doer's hand: stenosing tenosynovitis in the postpartum period

Head Injury Unit, Harmarvile Rehabilitation Center Inc.

Dan A Welch

Staff Psychiatrist Harmarvile Rehabilitation Center Inc

George S Richardson

Hand Rehabilitation Unit, Harmarville Rehabilitation Center Inc., Pittsburgh

John J Nicholas

Division of Rehabilitation Medicine, University of Pittsburgh

Three cases of stenosing tenosynovitis occurred three to six months postpartum. Childcare activities aggravated the symptoms of pain and swelling in both patients. In two cases, a specific method of carrying the child was implicated as the mechanism of injury. Although there was no evidence of generalized inflammatory arthritis, all patients had very low positive titres of anti-nuclear antibodies. While it is likely that tenosynovitis was caused by mechanical factors, the possibility of increased susceptability to inflammatory disease in the postpartum period cannot be discounted. The patients were successfully treated with a low temperature plastic splint, superficial heat and gentle mobilization.

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