The tendon, however, remains beneath the subsheath. Ulnar sided wrist pain is both a frequent patient complaint and a common indication for MR imaging. Snapping ECU is more common in athletes, and generally follows a traumatic injury to the wrist. Symptomatic tears of this subsheath and subluxation of the ECU tendon often require reconstruction of the subsheath. Hitting a powerful backhand during tennis where the forearm is reuired to create top spin by moving forcefully from pronation to supination, Hitting a solid object during the golf swing whilst the golf club moves from a radially deviated position to neutral, and the ECU contracts isometrically to stabilize the joint, Contact sports like rugby that require the athlete to hold the ball (and thus contract the ECU isometrically in maximal supination) to maintain possession when entering a contact. When the tendon occupies the wrong space within the sheath or is moved to an extreme degree within this sheath, it is known as subluxation. In supination, flexion, and ulnar deviation within the ulnar groove, the tendon is tense and becomes predisposed to subluxation or dislocation. Acute extensor carpi ulnaris (ECU) subsheath injury and chronic subsheath insufficiency may result in symptomatic ECU instability at the level of the distal ulna osseous sulcus. The muscles function will be affected by the position of the forearm as forearm pronation and supination affect the muscles angle of pull. When diagnostic measures fail to show ECU tendon damage, an accessory of the extensor pollicus brevis may be the source of the snapping sensation (Subramaniyam SD, et al 2017). Cunha J, Martins , Gomes D, Matos J, Moreira J, Aguiar-Branco C. P-45 Conservative treatment of traumatic Extensor Carpi Ulnaris instability in a tennis player: case report. It's held in this position by a ligament. Br J Sports Med 2006; 40:424-429. 2021;22(1):387. doi: 10.1186/s12891-021-04271-z, Adams J, Habbu R. Tendinopathies of the hand and wrist. Extensor carpi ulnaris subluxation | Radiology Case | Radiopaedia.org Extensor Carpi Ulnaris : Wheeless' Textbook of Orthopaedics 10 Xarchas KC, Leviet D. Non rheumatoid closed rupture of extensor carpi ulnaris tendon. Uncommon; occurs more commonly with widely displaced styloid fractures at the time of injury. Long-Term Outcomes after Extensor Carpi Ulnaris Subsheath
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