In most cases a single cortisone shot will remedy a painful case of 1st extensor compartment tendonitis between 50 and 80% of the time. When unsuccessful, a second shot, 4-6 weeks later, may be helpful in 25-50% of cases.
After 2 unsuccessful shots, additional cortisone is of little value, and surgical release of the retinaculum--the tissue overlying the APL and EBB tendons, may be required.
Surgery is performed as an outpatient under a local anesthesia, with or without sedation. A postoperative dressing is removed 1 week later and therapy is started. Usually by 6 weeks the wrist feels better, and in most cases, return to normal activity is allowed. The surgery is successful in the vast majority of patients--greater than 95%.
