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Golf is growing in popularity, with some 20 million players predicted to be playing in China alone by 2020.1 Its inclusion as an Olympic sport will only serve to increase the sport's international profile and popularity. At the pinnacle of the sport is a small group of elite professional golfers who, when compared with amateurs, have more reproducible swing mechanics, and generate greater forces and increased repetitive loads, which are thought to result in differing injury rates and patterns from those of the amateur.2 A study carried out by Hawkes et al3 on professional golfers reported that the majority of injuries were in the leading wrist, with ulnar-sided injury most common.
This article will review the biomechanics, clinical presentation and imaging findings in the commonest wrist injuries encountered by the examining sports physician in the elite golfer. We classify these wrist injuries by the anatomical localisation of symptoms; ulnar-sided, radial-sided and dorsal injuries will be described. The reader is also encouraged to review the YouTube video on wrist examination.4
The golf swing
The wrists link the body to the golf club and form the final component of a kinetic chain—composed of the hips, spine and shoulders—which powers and controls the golf swing. The lead side of the body is generally viewed as being more active during the golf swing, providing power to the golf swing; as a result, it is generally more prone to injury. A detailed analysis of wrist biomechanics during the golf swing is beyond the scope of this paper, and this work has already been described several times previously.5–7 An overview of wrist movement through the swing does, however, provide a useful framework on which to consider pathology.
The lead (or non-dominant wrist) begins the golf swing in a position of ulnar deviation when addressing …