Extensor tenosynovitis of the wrist is an overuse injury (and compartment syndrome) that can be seen in rowers.
Anatomy:
(1) The extensor pollicis brevis and abductor pollicis longus tendons are in the first dorsal compartment at the wrist.
(2) The extensor carpi radialis longus and brevis are in the second dorsal compartment.
(3) The extensor pollicis brevis and abductor pollicis longus cross over the extensor carpi radialis longus and brevis to reach their insertions in the thumb.
Mechanism:
(1) repetitive movements of the wrists while rowing can cause swelling of the abductor pollicis longus
(2) swelling of the abductor pollicis longus can compress the underlying extensor carpi radialis longus and brevis at the point where the abductor pollicis longus crosses over them.
Risk factors:
(1) intense rowing
(2) cold weather
(3) failure to protect the forearms and wrist from the cold
Presentation:
(1) wrist pain
(2) swelling
(3) crepitus with motion of the affected tendons
(4) functional disability
Prevention: keeping the hand, wrist and forearm warm
In severe cases relief can be achieved by surgical decompression of the extensor pollicis brevis and abductor pollicis longus tendons.
