Extensor Retinaculum Impingement in the Athlete
Background: Athletes with repetitive weightbearing hyperextension activities are predisposed to wrist pain. Purpose: To describe extensor retinaculum impingement of the extensor tendons as a new diagnosis for wrist pain for the athlete performing repetitive wrist hyperextension, to present cadaveric...
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Veröffentlicht in: | The American journal of sports medicine 2007-12, Vol.35 (12), p.2126 |
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Zusammenfassung: | Background: Athletes with repetitive weightbearing hyperextension activities are predisposed to wrist pain.
Purpose: To describe extensor retinaculum impingement of the extensor tendons as a new diagnosis for wrist pain for the athlete performing
repetitive wrist hyperextension, to present cadaveric dissections to further understand the anatomical basis for extensor
retinaculum impingement, and to report treatment outcomes of extensor retinaculum impingement.
Study Design: Case series; Level of evidence, 4.
Methods: A retrospective chart review was performed for athletes treated from 1987 to 2006 for wrist pain due to extensor retinaculum
impingement. Eight wrists in 7 athletes were reviewed with a mean presenting age of 19.6 years. The hallmark symptom was dorsal
wrist pain, and signs were extensor tendon synovitis and tenderness at the distal border of the extensor retinaculum, provoked
by wrist hyperextension. Ten cadaveric wrists were dissected and examined to evaluate anatomical factors that may contribute
to extensor retinaculum impingement.
Results: Two athletes (2 wrists) were treated with corticosteroid injections. Five patients (6 wrists) were treated operatively, with
pathologic findings of thickening of the distal border of the extensor retinaculum and concomitant extensor tendon synovial
thickening or, in 1 patient, tendon rupture. Partial distal resection of the extensor retinaculum was performed to eliminate
impingement. All patients had complete relief of pain and full return to sport.
Conclusion: Competitive sports that require repetitive wrist extension with an axial load predispose the athlete to extensor retinaculum
impingement. Athletes with dorsal wrist pain and tenosynovial thickening worsened with wrist hyperextension should be considered
for the diagnosis of extensor retinaculum impingement. When nonoperative management fails, surgical resection of the distal
impinging border of the extensor retinaculum can eliminate pain and can still allow athletes to return to sport without diminishing
the opportunity for significant athletic accomplishments.
Keywords:
extensor retinaculum
impingement
wrist pain
tenosynovitis |
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ISSN: | 0363-5465 1552-3365 |
DOI: | 10.1177/0363546507305803 |