Case Report: At Rare Case of Ulnar Sided Wrist Pain Secondary to Extensor Carpi Ulnaris Split Tear Respond Well to Prolotherapy

Abstract

This is the first case report that describes the successful treatment of an extensor carpi ulnaris (ECU) split tear using prolotherapy. Our objective is to outline our comprehensive rehabilitation approach in a non-athlete population. A 43-year-old preschool school presented with ulnar-sided wrist pain for 1 month and did not respond well to initial physiotherapeutic modalities and oral analgesics. Clinical examination revealed tenderness over the ECU tendon, underneath the ulnar styloid, with a positive synergy test. Ultrasound of her right wrist revealed a swollen ECU with a split tear and tenosynovitis. She initially received tendon sheath steroid injection, followed by prolotherapy 2 weeks later. We initiated a comprehensive rehabilitation programme for her that consisted of activity modification, brace, physiotherapeutic modalities, range of motion, and strengthening exercises. The details of the rehabilitation programme are outline in the case report. After 6 months of treatment, she successfully returned to work with minimal pain. Prolotherapy combined with comprehensive rehabilitation provided a good outcome for our patients.