Radially Based Extensor Retinacular Sling Reconstruction for Extensor Carpi Ulnaris Subsheath Injuries

Area of Science:

• Orthopedic Surgery
• Hand Surgery
• Musculoskeletal Research

Background:

• Extensor carpi ulnaris (ECU) subsheath injuries cause ulnar-sided wrist pain and are often associated with intrinsic ECU pathology and ulnocarpal injuries.
• Limited surgical outcome data exists for various ECU subsheath pathologies and reconstruction methods.

Purpose of the Study:

• To evaluate the surgical outcomes of ECU subsheath reconstruction using a radially based extensor retinacular sling.
• To assess improvements in wrist range of motion, grip strength, and return to sports after surgery.

Main Methods:

• Retrospective review of 33 patients undergoing ECU subsheath reconstruction between April 2010 and April 2021.
• Data collected included preoperative and intraoperative findings, magnetic resonance imaging results, and postoperative outcomes.
• Statistical analysis utilized a 2-tailed paired t test.

Main Results:

• The median age of patients was 44 years, with 60.6% undergoing reconstruction on their dominant wrist.
• Significant improvements were observed in grip strength, wrist flexion-extension, and pronosupination arcs (P < .05).
• Mean postoperative pain was low (0.39 ± 0.55 VAS), and athletes returned to sports in an average of 97.3 days with no major complications.

Conclusions:

• Radially based extensor retinacular sling reconstruction provides satisfactory improvements in wrist range of motion and grip strength.
• The study demonstrates statistically significant postoperative improvements, though clinical significance requires further definition.
• This technique shows promise for managing ECU subsheath injuries and associated ulnar-sided wrist pain.