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Operative Management of Extensor Carpi Ulnaris Instability: A Systematic Review.

Ali Lari1, Waleed Burhamah2, Mohammad Alherz3

  • 1Department of Orthopaedic Surgery, Al Razi National Orthopedic Hospital, Kuwait City, Kuwait.

Journal of Wrist Surgery
|May 29, 2024
PubMed
Summary

Operative treatment for posttraumatic extensor carpi ulnaris (ECU) instability shows favorable outcomes. Surgical repair or reconstruction of the ECU subsheath effectively improves pain and function, with a low complication rate.

Keywords:
dislocationextensor carpi ulnarisinstabilityoperative treatmentoutcomesreconstructionrepairsubluxation

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Area of Science:

  • Orthopedic Surgery
  • Hand and Wrist Surgery
  • Sports Medicine

Background:

  • Posttraumatic extensor carpi ulnaris (ECU) instability results from disruption of the ECU subsheath.
  • It is an increasingly recognized cause of ulnar-sided wrist pain.
  • Surgical intervention is often necessary for this condition.

Purpose of the Study:

  • To systematically review the outcomes of surgical treatment for posttraumatic ECU instability.
  • To assess the effectiveness of operative management in improving patient function and reducing pain.

Main Methods:

  • A systematic literature search was conducted across major medical databases (Medline, Embase, Web of Science, CINAHL).
  • Keywords included "extensor carpi ulnaris".
  • Eight retrospective studies with a total of 97 wrists met the inclusion criteria.

Main Results:

  • Patients underwent primary repair (40%) or reconstruction (60%) of the ECU subsheath.
  • Significant improvements were reported in pain scores, functional outcomes, satisfaction, and grip strength.
  • Complications occurred in 9% of cases, with no reported recurrences, though 6.7% did not return to their previous activity level.

Conclusions:

  • Surgical treatment for posttraumatic ECU instability yields favorable outcomes with a low complication rate.
  • Operative techniques like primary repair and reconstruction are effective.
  • Further standardized studies are needed due to heterogeneity in populations, techniques, and outcome measures.