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. 2009 Dec;53(4):282-9.

Conservative management of symptomatic Carpal Bossing in an elite hockey player: a case report

Peter Kissel  1
Affiliations

Conservative management of symptomatic Carpal Bossing in an elite hockey player: a case report

Peter Kissel. J Can Chiropr Assoc. 2009 Dec.

Abstract
in English, French

Objective: To present the characteristics and create awareness of symptomatic carpal bossing and discuss potential etiologies and the role of conservative management through the presentation of an athlete with traumatic onset of symptomatic carpal bossing.

Clinical features: This case report outlines the presentation and conservative management of an elite eighteen year old hockey player with symptomatic carpal bossing after a traumatic on ice collision. Carpal bossing is a bony, dorsal prominence in the quadrangular joint of the wrist that is inconsistently symptomatic.

Intervention and outcome: A conservative treatment plan consisting of education, reassurance, avoidance of aggravation, and soft tissue therapy allowed return to play in two weeks without restrictions or need for surgical consultation.

Conclusion: With inconsistent recurrence rates and surgical complications, the role of conservative management for symptomatic carpal bossing deserves further exploration. The conservative practitioner should be aware of the signs and symptoms of symptomatic carpal bossing to institute suitable treatment.

Objectif :: Présenter les caractéristiques et faire de la sensibilisation concernant le carpe bossu symptomatique et discuter des étiologies potentielles et du rôle du traitement conservateur par la présentation d’un athlète avec une apparition traumatique du carpe bossu symptomatique.

Caractéristiques cliniques :: Ce rapport de cas indique la présentation et le traitement conservateur d’un joueur de hockey d’élite de 18 ans présentant un carpe bossu symptomatique à la suite d’une collision traumatique sur la glace. Le carpe bossu est une protubérance osseuse dorsale de l’articulation quadrangulaire du poignet qui est symptomatique de façon non constante.

Intervention et résultats :: Un plan de traitement conservateur de sensibilisation, de rassurance, d’évitement de l’aggravation et de traitement des tissus mous a permis un retour au jeu après deux semaines sans restrictions ou besoin de consultation chirurgicale.

Conclusion :: Des taux de récidive non constants et des complications chirurgicales font en sorte que le rôle du traitement conservateur pour le carpe bossu symptomatique mérite qu’on s’y attarde davantage. Le praticien conservateur doit savoir reconnaître les signes et symptômes du carpe bossu symptomatique afin de prodiguer le traitement approprié.

Keywords: athlete; boss; carpal; hockey; trauma.

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Figures

Figure 1
Figure 1
The dorsal wrist with the white arrow illustrating the quadrangular joint. (Image courtesy of and copyright to Primal Images ltd)
Figure 2
Figure 2
x-ray imaging series with white arrow showing a dorsal projection on the lateral view at the area of the quadrangular joint diagnosed as an os styloideum.
See this image and copyright information in PMC

References

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