Lunate stress fracture
He was placed in a Cock-up splint for 6 weeks.
Removed from playing tennis and upper extremity weight lifting.
Received bone stimulator treatments.
After splint removal, began grip strenthening exercises.
After four weeks of rest, he advanced to playing mini tennnis without return of pain. Two weeks later he progressed to ground strokes without spin, then over the following two weeks he sequentially added spin, serves, and overheads. He had lingering discomfort on his radial wrist with backhands and volleys, which is possibly secondary to scar tissue formation around the abductor pollicus longus tendon. This discomfort was alleviated with soft tissue mobilization treatments. After 9 weeks he was cleared for a full return to play. He continues to use wrist taping during play and receives sound assisted soft tissue mobilization treatments.
Though wrist overuse injuries are common in tennis, carpal stress fractures are rarely reported. This case highlights a carpal stress injury which presented as an acute injury following a mis-hit. This highlights the importance of maintaining a broad differential and thoroughly evaluating hand injuries in tennis players.
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