Challenge of the Week / Sports / 01.28.2022

A 26-year-old male patient who is a softball player presents with a history of painful snapping at the ulnar aspect of his wrist while batting over the last 2 months. Treatment with ice, rest, and anti-inflammatory medications has not been effective. He demonstrates palpable snapping at the dorsal and ulnar aspect of the wrist joint with active resisted supination. Radiographs are normal. Which of the following is the best treatment option?
    • Extensor carpi ulnaris subsheath corticosteroid injection and rest followed by physical therapy
    • He has tried 2 months of nonoperative management, which has been unsuccessful. Surgery should be recommended to stabilize the tendon.

 

    • Immobilization of the wrist in slight extension for 3 months
    • He has tried 2 months of nonoperative management, which has been unsuccessful. Surgery should be recommended to stabilize the tendon.

 

    • Operative reconstruction or repair of the extensor carpi ulnaris subsheath
    • He has tried 2 months of nonoperative management, which has been unsuccessful. Surgery should be recommended to stabilize the tendon.

 

    • Intra-articular corticosteroid injection and rest followed by physical therapy
    • He has tried 2 months of nonoperative management, which has been unsuccessful. Surgery should be recommended to stabilize the tendon.

 

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