Arthroscopic Treatment of Longitudinal ECU Tendon Tear: Technical Description

Pain in the dorsoulnar region of the wrist is a common complaint and may be caused by a variety of pathologies. Longitudinal tears of the extensor carpi ulnaris (ECU) tendon are among them, and it has recently been noted that these lesions are more frequent than previously thought. Most ECU injuries can be managed conservatively. Surgical treatment is indicated in cases of tendon rupture, especially when associated with instability or injury to the triangular fibrocartilage complex (TFCC). In such cases, the procedure should include tendon debridement with resection of inflammatory tissue, debridement of the lesion margins, and subsequent suture repair. Traditionally, ECU tendon repairshave been performed through open surgery. However, arthroscopy now allows access to the ECU tendon within the sixth extensor compartment through tenoscopy. On the basis of this, we describe and demonstrate a novel technique for the arthroscopic repair of longitudinal ECU tendon tears, combining wrist arthroscopy with ECU tenoscopy. This procedure enables debridement and tendon repair using horizontal, interrupted sutures in a minimally invasive manner, resulting in less damage to healthy tissues. Furthermore, it allows for the diagnosis and treatment of other ulnar-sided wrist injuries, which are frequently associated with ECU pathology.