Snapping wrist due to multiple accessory tendon of first extensor compartment

Area of Science:

• Orthopedic Surgery
• Anatomy
• Musculoskeletal Disorders

Background:

• Snapping phenomena involve abrupt movement and noise from anatomical structure impingement.
• Snapping syndrome affects various joints, including the wrist, causing discomfort or pain.
• Cadaveric studies suggest accessory tendons in the first extensor compartment of the wrist are common.

Purpose of the Study:

• To report a case of snapping wrist syndrome caused by multiple accessory tendons.
• To highlight diagnostic challenges with non-dynamic imaging for snapping wrist.
• To emphasize accessory tendons as a differential diagnosis for snapping wrist.

Main Methods:

• A case presentation of a 19-year-old male with radial wrist pain and catching sensation.
• Diagnostic workup included radiography and MRI, with retrospective analysis revealing multiple tendons.
• Surgical intervention involved release of the first extensor compartment fibrous tunnel and tenotomy of accessory tendons.

Main Results:

• Intraoperative findings confirmed multiple accessory tendons of the extensor pollicis brevis as the cause of snapping.
• Post-operative assessment showed complete relief of catching sensation.
• The patient experienced no snapping during follow-up and resumed daily activities without difficulty.

Conclusions:

• Multiple accessory tendons are a potential cause of snapping wrist syndrome.
• Non-dynamic radiological investigations may fail to diagnose this condition.
• Dynamic imaging studies may improve diagnostic accuracy for snapping wrist.
• Surgical management, including first compartment release and accessory tendon tenotomy, yields favorable outcomes.