A 3-part retrospective study was done to review the long-term results of surgery for de Quervain's tenosynovitis. Forty-three involved wrists in 43 consecutive patients who had surgery from 1991 to 1996 were followed by chart review, phone interview, and outpatient examination. At an average length of follow-up of 3 years there were 2 patients with recurrence of de Quervain's tenosynovitis (5%), 1 with radial sensory nerve injury (2%), and 1 with severe scar tenderness (2%). Complication was found to be significantly associated with patient dissatisfaction after surgery. A long duration of symptoms before surgery (> or = 10 months) was significantly associated with patient satisfaction. The cure rate of surgery, defined as the percentage of patients without postoperative complication, was 91%, with 88% of patients indicating full satisfaction. These findings suggest that (1) patient dissatisfaction is significantly associated with long-term complication after surgery, (2) surgery is more likely to be satisfactory for patients with a long duration of symptoms, and (3) surgical intervention is effective as definitive therapy for de Quervain's tenosynovitis.