Dr. Kevin Yip

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

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Wartenberg’s Syndrome

SYMPTOMS

There is a burning diffuse pain over the dorsal aspect of the thumb aggravated by pronation-supination and ulnar deviation.

AETIOLOGY

These symptoms are caused by entrapment of a superficial branch of the radial nerve between the brachi radialis tendons. It is common in racket sports; wrist sweat bands have been suspected of causing this injury.

CLINICAL FINDINGS

Pain is provoked on ‘fisting’ the hand, associated with ulnar and palmar flexion and hyper-pronation of the lower arm. Tinel’s sign is often positive.

INVESTIGATIONS

Injection of local anaesthetic relieves the symptoms.

TREATMENT

Assessment of causative factors is essential. Physiotherapy may relieve symptoms. If there are severe or persistent symptoms surgical
nerve release may be needed.

REFERRALS

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

EXERCISE PRESCRIPTION

Most sports can be maintained during healing. After surgery the symptoms are usually relieved almost immediately and most activities can be back to normal within a few weeks. Running, cycling and water exercises are good alternatives to keep up general fitness. Gym training can 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 but is often missed.

PROGNOSIS

Excellent, if treated appropriately.

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