Article ID: JNMS.2020_87-410
Ulnar-sided wrist pain is a common issue among athletes subjecting their wrists to forceful rotational movements. Injury to the numerous complex structures in the ulnar wrist, including the extensor carpi ulnaris (ECU) tendon and the triangular fibrocartilage complex (TFCC), can result in ulnar-sided wrist pain. Although differentiating between ECU tendinitis and TFCC injury is necessary, concurrent ECU tendon disorders and TFCC injury occur occasionally in some patients. Subluxation or dislocation of the ECU tendon is considered rare, but occasionally may cause symptoms in athletes subjecting their wrists to forceful rotational movements. We present a case of a 21-year-old male university-league ice hockey player with recurrent dislocation of the ECU tendon and ulnar-sided TFCC injury. He initially underwent stabilization of the ECU; however, his ulnar wrist pain persisted, which adversely affected his sports performance. Subsequently, he underwent additional surgery to repair the TFCC, which led to definitive resolution of his symptoms and resulted in his return to competitive level performance 3 months postoperatively. The treatment of symptomatic dislocation of the ECU remains controversial. In our patient, recurrent dislocation of the ECU tendon with concurrent ulnar-sided TFCC injury resulted in ulnar-sided wrist pain. Combined reconstruction of the tendon's subsheath using the extensor retinaculum and repairing the TFCC injury was required for full recovery of our patient's sports performance.