Surgery effective for pinched wrist tendons

NEW YORK (Reuters Health) - Gymnasts, shot putters, platform divers and other athletes who frequently bear weight on hyperextended wrists are at risk of developing pinched tendons in the joint, a team of orthopedic surgeons reports.

Dr. Ann E. VanHeest of the University of Minnesota in Minneapolis describe a new diagnosis for this type of pain, extensor retinaculum impingement, which they say should be considered in athletes who are experiencing pain at the back of the wrist. They report on seven patients successfully treated for the condition in the December issue of the American Journal of Sports Medicine.

While repeated hyperextension of the wrists is known to cause wrist pain and pinched tendons, VanHeest and her team write, the fibrous band running across the tendons at the wrist known as the extensor retinaculum has not previously been described as a source of this pinching, or impingement.

The patients described in the current study were all Division 1 college athletes. Four were gymnasts, two were platform divers and one was a shot-putter. All of the athletes had pain and swelling in just one of their wrists, except for one of the gymnasts, in whom both wrists were affected.

Corticosteroid injections were adequate to treat wrist pain and swelling in two of the athletes. The rest required surgery. All experienced full recovery after an operation to remove thickened tissue at the edge of the extensor retinaculum, which was pinching the tendons responsible for extending the fingers. Three went on to win Big 10 championships, and one won an Olympic medal.

When non-surgical treatment of extensor retinaculum impingement is not adequate, the operation "can eliminate pain and allow athletes to completely return to sport without diminishing the opportunity for significant athletic accomplishments," VanHeest and her team conclude.

SOURCE: American Journal of Sports Medicine, December 2007.