Extensor Carpi Ulnaris Subluxation

Revision of Failed Nonanatomic Extensor Retinacular Stabilization of the Unstable ECU Tendon: Surgical Technique and Case Series

“…Interestingly, it has been reported that the only contraindication to extensor retinacular flap reconstruction was, in the authors view, a history of prior wrist surgeries with scarring of the extensor retinaculum. 4 We believe that the technique we describe is safe and feasible to undertake, even after previous multiple wrist surgeries.…”

“…Use of the entire proximal to distal dimension of the retinaculum has been previously reported. 6 Byrd and colleagues described a 3 cm proximal to distal flap size, 4 but we believe even this size of retinacular flap is more likely to defunction the extensor retinaculum and would be unnecessarily large. In our view, a retinacular flap measuring no > 20 mm from proximal to distal provides sufficient stability in the primary situation.…”

“…The technique of nonanatomic ECU stabilization using a local flap of extensor retinaculum has been previously reported and is regularly employed for cases of ECU subluxation 3,5 . In all cases in our study, the original surgeon had used a retinacular flap 4 that was harvested with its base at the Vth/VIth extensor compartment junction and with its radial limit extending to Lister tubercle (Figs. 4 and 5).…”

Treatment of Chronic Extensor Carpi Ulnaris Stenosing Tenosynovitis Using Ultrasound-Guided Retinaculum Release

“…Therefore, instability is a potential concern in some cases. However, the concern for instability or further tenosynovitis is based on the experience of open surgical releases in which the incision through the subsheath is made after completing a gross dissection of the overlying soft tissue and the extensor retinaculum and retraction of these layers to be able to visualize the tendon sheath 9 . Because all the soft tissue layers can be visualized with live ultrasound imaging (i.e., the overlying soft tissue, the extensor retinaculum, the tendon sheath, and the tendon), there is no need to do a retraction of the overlying layers, which is hypothetically the main reason why the ECU tendon may have instability after the subsheath release.…”

Der ulnarseitige Handgelenksschmerz

“…Nicht selten können tastbare Defekte im Sehnenverlauf festgestellt werden; bildgebende Verfahren spielen dennoch eine entscheidende Rolle bei der Bestätigung der Diagnose und der Festlegung der nachfolgenden Behandlungsstrategien. Isolierte Rupturen der Sehnenscheide prädisponieren für eine ECU-Sehnen-Instabilität, die sich durch eine (dynamische) Luxation der Sehne aus der dorsalen Ulnakopfgrube bemerkbar macht [31].…”