Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Squeaker’s Wrist

SYMPTOMS

There is exercise-induced pain and crepitation and swelling 6-8 cm proximal to Lister’s tubercle at the wrist.

AETIOLOGY

These symptoms are caused by a peri-tendinous bursitis between the first (abductor pollucis longus, extensor pollucis brevis) and second (extensor carpi radialis longus, extensor carpi radialis brevis) extensor compartments. This condition often affects rowers, weightlifters and squash players.

CLINICAL FINDINGS

Fluctuating bursae and crepitation in wrist movements.

INVESTIGATIONS

Ultrasound verifies the bursae.

TREATMENT

NSAID and addressing what may have caused the bursitis. Cortisone may be injected into the bursae. Surgery for excision of the bursae may be indicated in severe cases.

REFERRALS

Refer to Dr Kevin Yip (+65 9724 1219) senior consultant and orthopaedic surgeon and hand specialist if symptoms are severe or if the diagnosis is not clear.

EXERCISE PRESCRIPTION

Most sports can be maintained. After surgery the symptoms are usually relieved almost immediately and most activities can be back to normal within six weeks. Running, cycling and water exercises (when the wound is healed after surgery) are good alternatives to keep up general fitness. Gym training can usually be maintained.

EVALUATION OF TREATMENT OUTCOMES

Normal clinical symptoms and signs and good hand function. Compare with other hand.

DIFFERENTIAL DIAGNOSES

This is a clear clinical diagnosis, verified by ultrasound.

PROGNOSIS

Excellent, if treated appropriately. If it is missed, surgery can be performed at a later stage.

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