Abstract
In brief A 27-year-old mountain biker noticed right wrist pain while shifting gears on his mountain bike. He experienced pain with full extension and forced flexion-adduction of his right thumb, maneuvers required when shifting on strenuous off-road rides. The Finkelstein and axial compression tests were used to diagnose de Quervain's disease (tenosynovitis of the first dorsal compartment of the wrist). The patient responded successfully to conservative treatment consisting of rest, a thumb spica splint, and range-of-motion exercises. Ergonomic gear shift designs recently introduced by bicycle component manufacturers may prove effective in treating and reducing the incidence of this condition.
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