Sports-related extensor carpi ulnaris pathology
The extensor carpi ulnaris (ECU) is an important muscle for the stability and function of the wrist. Due to its anatomical features it often gets involved in complex injuries during sports such as tennis, golf and rugby. Thus, this review aims to describe the functional anatomy of the ECU, link it to common injury mechanics and provide guidance for the clinicians on when and what treatment should be applied.
The forearm position is a key factor for the function of the ECU.. In full supination, the ECU contributes mainly to wrist extension whereas in full pronation to wrist flexion. The stability of the ECU is also dependent on forearm position; full forearm supination combined with wrist flexion and ulnar deviation (typical when holding an item close to the chest) exceeds the greatest tension on the ECU retinaculum and subsheath.
From the ECU injuries, a distinction between stable and unstable conditions should be made. Asymptomatic instability is common, thus it may be irrelevant to include in a treatment plan. Most injuries can be effectively treated conservatively and surgery is rarely required.
> From: Campbell et al., Br J Sports Med 47 (2014) 1105-1111. All rights reserved to BMJ Group. Click here for the Pubmed summary.