Extensor Carpi Ulnaris Subluxation 842.00

synonyms:ECU subluxation, ECU dislocation

ECU Subluxation ICD-9

• 842.00 (unspecified sprain/strain of wrist)

ECU Subluxation Etiology / Epidemiology / Natural History

• More common in athletes in rowing, badminton, tennis and squash.

ECU Subluxation Anatomy

• ECU anatomy
• The ECU is maintained in its groove by the extensor retinaculum, the linea jugata and the ECU subsheath.
• ECU subsheath = 2cm stout fibroosseous tunnel encircling the ECU in the ulnar groove.
• linea jugata = soft tissue band running from the proximal medial border of the ulnar styloid and inserting on the extensor retinaculum.
• In full suppination the ECU is a wrist extensor. In full pronation the ECU produces ulnar deviation.

ECU Subluxation Clinical Evaluation

• More common in athletes in rowing, badminton, tennis and squash.
• Painful snapping occurs with forearm supination and ulnar deviation of the hand. Pronation of the forearm reduces the tendon back to its anatomic location. Best tested with elbow flexed and wrist in slight ulnar deviation.

ECU Subluxation Xray / Diagnositc Tests

ECU Subluxation Classification / Treatment

• Acute: Treatment = long arm cast in pronation with slight wrist extension and radial deviation for 6 weeks. (Burkhart S J Hand Surg 1982;7:1)
• Chronic: Treatment = reconstruction of the ECU subsheath, with local tissue reefing, deepening of the ulnar groove, or reconstruction of the the tunnel with free tissue form the neighboring extensor retinaculum. (Inoue G, J Hand Surg 2001;26Br:556)
• CPT: 26500(reconstruction of tendon pulley with local tissues), 26502(reconstruction with tendon or fascial graft), 26504(with tendon prosthesis, separate procedure)

ECU Subluxation Associated Injuries / Differential Diagnosis

• TFCCtear
• Lunotriquetral ligament tear
• see ulnar sided wrist pain differerential diagnosis

ECU Subluxation Complications

ECU Subluxation Follow-up Care

ECU Subluxation Review References

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