Description
The presentation is delivered by Alistair Hunter, a consultant surgeon specializing in hand, wrist, and elbow surgery at University College London hospitals. The discussion focuses on the challenges surrounding ulnar-sided wrist pain notably affecting athletes in tennis and golf. Alistair begins with an overview of the case study of a 34-year-old male tennis player who sustained a twisting injury leading to pain on the ulnar side of his wrist.
He outlines the importance of understanding the anatomy and differential diagnoses of ulnar sided wrist pain, which may involve a range of conditions from common TFCC tears to less common injuries like DRUJ instability and hook of hamate fractures. Using diagrams, he explains the anatomical structures involved, emphasizing the significance of the triangular fibrocartilage complex (TFCC) in wrist stability and load transmission.
Alistair then discusses examination techniques to identify TFCC damage, using specific signs like the ulna foveal sign and ulna grind test. Imaging methods, particularly MRI, are highlighted as critical in diagnosing TFCC tears, yet he notes arthroscopy remains the gold standard for certain cases. Management strategies differ between acute and chronic conditions, involving both non-operative measures, such as splinting and physiotherapy, and operative interventions when conservative treatment fails.
Throughout the talk, he presents various treatment approaches based on injury type, detailing both non-invasive and surgical methods. Alistair concludes by reiterating the importance of careful diagnosis and management of ulnar-sided wrist pain, providing a summary of key anatomical insights and the significance of comprehensive examination in clinical practice.