Extensor retinaculum impingement in the athlete: a new diagnosis

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Repetitive hyperextension activities in athletes predispose them to wrist pain.
• Extensor retinaculum impingement is a newly described diagnosis for this condition.

Purpose of the Study:

• To define extensor retinaculum impingement in athletes.
• To explore the anatomical basis of this condition through cadaveric dissection.
• To report treatment outcomes for affected athletes.

Main Methods:

• Retrospective chart review of 7 athletes (8 wrists) treated for extensor retinaculum impingement.
• Analysis of presenting symptoms (dorsal wrist pain) and signs (extensor tendon synovitis, tenderness).
• Cadaveric dissection of 10 wrists to assess anatomical factors.

Main Results:

• Eight wrists were reviewed, with a mean age of 19.6 years.
• Two wrists treated with corticosteroid injections; six wrists treated operatively.
• Operative treatment involved distal resection of the extensor retinaculum for impingement, with pathologic findings of retinacular and synovial thickening.

Conclusions:

• Repetitive wrist extension with axial load predisposes athletes to extensor retinaculum impingement.
• Dorsal wrist pain and tenosynovial thickening exacerbated by hyperextension suggest this diagnosis.
• Surgical resection provides complete pain relief and allows athletes to return to sport.