Acute true trigger wrist following partial extensor carpi radialis brevis tendon rupture

Abstract

Triggering in association with movements of the wrist or "true trigger wrist" due to the extensor tendon is rare. There are only few case reports in literature, but none were associated with the acute partial tendon rupture. We present a case of true trigger wrist originating from partial rupture of extensor carpi radialis brevis tendon (ECRB). In contrast to the other reports, the interval between an initial injury and development of triggering was short because the partial tendon rupture was bunching and forming a nodule. The triggering was attributed to the snapping of the nodule under the extensor pollicis longus tendon (EPL).

Trigger Wrist and Carpal tunnel syndrome caused by a flexor tendon-related ganglion in a teenager: A case report

“…[2] (Table 1), our case belongs to type A (caused by a tumor). When we reviewed the literature, we found that triggering at the wrist may also have been the result of other causes such as partial flexor [8] or extensor [9] tendon laceration, and other mechanical causes [10], [11]. All these causes may occur in the pediatric age group and hence, an extended classification may be offered (Table 2).…”

“…Anomalous muscles (Type B and C) are usually associated with a bulge in the distal forearm which is more apparent on passive hyper-extension of the wrist [2]. A history of a laceration is suggestive of type D [8], [9], while a history of carpal tunnel release is suggestive of Type E [10], [11].…”

“…If there was a history of a laceration on the dorsal aspect of the wrist, exploration of the area of laceration and release of the extensor retinaculum should be done [8], [9]. In all other cases, carpal tunnel release is indicated [1], [2], [3], [4], [5], [6], [10], [11].…”

“…The outcome of management is generally good with resolution of triggering [1], [2], [3], [4], [8], [9], [10], [11] and improvement of symptoms related to median nerve compression [5], [6]. Children with juvenile arthritis remain at risk of recurrence and hence control of synovitis by appropriate medications is mandatory.…”

Snapping of the Upper Limb: a Clinical Overview

“…Historically, the snapping wrist has been considered a condition in which movement of the wrist or fingers leads to the triggering of the wrist. However, in 1986, Desai et al (67) proposed to use the term trigger wrist to indicate triggering which occurs following the movement of the wrist and not that of the fingers (68). This is true trigger wrist while the condition in which triggering at the wrist is associated with finger movements would be more appropriately described as trigger finger at the wrist (6).…”