Is My Hand and Wrist Pain Caused by Carpal Tunnel Syndrome or Something Else? Br J Sports Med. WebThe inflamed tendon may be painful and swollen. On clinical exam, findings include intense pain on passive supination, pain on palpation of the ECU tendon at the distal ulna, and localized swelling.5, If an acute ECU subluxation/dislocation is not appropriately treated, chronic ECU instability may result. 2006;40(5):4249; discussion 429. Sign up for the latest wellbeing ideas, health trends, partner offers and taboo-busting stories. Most people are able to: Your hand therapist or surgeon can give you a more detailed estimate of your likely recovery time. Reduced grip strength. ECU tendon is an important structure that contributes to gently lifting a finger away from the splint with your other hand, gently bending your finger joints while sliding your nails along the splint towards your palm, resume light activities, such as using a keyboard or writing with a pen, after six weeks, drive a car or motorcycle after eight weeks, resume medium activities, such as light lifting or shelf stacking, after eight weeks, drive a heavy goods vehicle (HGV) after eight weeks, resume heavy activities, such as heavy lifting or building work, after 10 weeks, resume sporting activities after 10-12 weeks, gently bending your fingers into your palm with your other hand, gently straightening your fingers so that your fingernails touch the splint, resume light activities after eight weeks, a high temperature (fever) of 38C (100.4F) or above. WebFlexor Carpi Ulnaris (FCU) Tendinosis Non Surgical & Surgical Treatment Options Houston TX Dr. Jeffrey E. Budoff M.D. At a median follow-up of 8.4 years, the median PROMIS UE Physical Function score among 10 patients was 56, the median score for pain 0.5, and the median score for satisfaction 9.5. Extensor carpi ulnaris tendon rupture. Tendon injuries: basic science and clinical medicine. You should link your CPT code with diagnosis codes 718.83 ( Other joint derangement, not elsewhere classified, forearm ), 718.03 ( Articular cartilage disorder; forearm) and 726.4 ( Enthesopathy of wrist and carpus ). xj5_l~Q}]Ngt>;:=_ab4)>a{9V3WC9Bhvx|hvv3D[,I5;A/ F(S@G~=Q?EK b&1nR80U 'ZuKwesL;hfJZOH'^tC>TadM.aT%+8*V{;e4?b- 6\@\&z7cpnXGS]iKv|3 IsP e6@N;!es8 B8VODPS3sqO5"f xpx ;,tq=2*} gXpSrP6F'Y8udp,P0tJr!@w@g(;",_PE"3l ~ohAaVm'WP When refering to evidence in academic writing, you should always try to reference the primary (original) source. Flexor tendon repair is usually performed under a regional or. The procedure also treats SLAP tears tears in your labrum (cartilage that lines the inner part of your shoulder joint.) WebDuring surgery, the groove that the ECU sits in is deepened and the ECU sheath is reattached to bone. MacLennan et al. WebFollowing surgery, the wrist is immobilized in extension for 4-6 weeks to promote healing. Most patients report restored range of motion and an improvement in pain during daily activities and sports following their procedure. Tenosynovitis and tendinosis of the ECU are not uncommon, with these abnormalities being a frequent early finding in patients with rheumatoid arthritis.2 In athletes, the ECU is the second most common site of wrist tendinopathy,3 typically associated with rowing, racquet sports, and golf. Denise Paige, CPC, is the coding and billing manager at Beach Orthopedic Associates Fortunately, surgical stabilization of the ECU tendon is very effective. Thats because these conditions, and the pain associated with them, are all similar. WebThe ECU tendon sheath can be irritated by repetitive flexion and extension of the wrist, depending on the extent of surgery. Coronal T1. 2023 Mark E. Pruzansky, MD, PC. Subsequent therapy and monitoring by the doctor will guarantee that your injury heals correctly and in the proper time frame. Which is really the most important thing., Hand and Wrist Institute. 2, 3) In this case, the The ECU muscle plays an active role in movements of wrist extension and ulnar deviation. Report of case in a professional athlete. Therapists can also teach patients safe ergonomics for avoiding future issues. All Rights Reserved. WebTendon release surgery may be performed under local or general anesthesia, depending on the muscles location. Local steroid injections may also be beneficial, though they must be used with caution due to an increased risk of tendon and ligament degeneration and tearing. Do not inject directly into a tendon. Depending on the location of the injury, recovery can take between one and three months. Ganglion Cysts ANATOMY Ganglion cysts account for approximately 60 percent of soft tissue, tumor-like swelling affecting the hand and wrist. Just avoid drinking other beverages, like soda, juice, or milk. Extensor Carpi Ulnaris (ECU) muscle primary functions at the wrist joint is to move the joint into extension and ulnar deviations whilst also providing a stabilising force at the ulnar side of the joint. Conservative treatments are often beneficial for ECU injuries. The person will remain awake during the procedure, but local The tendons are then stitched back together and the wound in the hand closed. (13a) T1-weighted and (13b) STIR axial images following an acute twisting injury with documented ECU tendon dislocation. The normal ECU (asterisk) should be of diffusely low signal intensity on T1 or T2-weighted images. The ECU subsheath (red arrowheads) is diffusely fragmented. If you have researched your pain, you may have explored DeQuervains Tendinitis or trigger finger in addition to ECU Tendonitis. x]SH*F9W$[y8+pl#1pUFWjz1A$MSn%Lk2)XY|~;ryxsjx*? If your tendon was damaged due to a wound, the wound will be thoroughly cleaned out with water. When the sheath is inflamed, it's called tenosynovitis. 7 Inoue G, Tamura Y. Surgical treatment for recurrent dislocation of the extensor carpi ulnaris tendon. Veritas Health, LLC, 520 Lake Cook Road, Suite 350, Deerfield, IL, 60015, Recovering from De Quervains Tenosynovitis Surgery, Nonsurgical Treatment for De Quervains Tenosynovitis. This will cause the tendon to stick to its tendon sheath, which prevents it from gliding smoothly and functioning properly; Subsidence: With joint implants, the body can produce an Recovery Phase 1: Passive Motion. WebReturn to the clinic at 6 weeks from surgery for cast removal and re-evaluation. The tendon sheath can also be called synovial liningor fibrous sheath. The procedure also treats SLAP tears tears in your labrum (cartilage that lines the inner part of your Possible complications include infection, blood loss, and nerve damage as with any surgery. You will need to take painkillers, such as. The tendon itself, passes under the extensor retinaculum within a synovial sheath that forms the 6th compartment of the wrist, within a grove lateral to the ulna styloid process. Initial conservative treatment consists of forearm immobilization in pronation with the wrist immobilized in a position of extension and radial deviation for 4 to 6 weeks. Rehabilitation involves protecting your tendons from overuse using hand splints. If your flexor tendons are damaged, you will be unable to bend one or more of your fingers. Call Drs. The distal aspect of the TFCC is also exposed between the ECU tendon sheath and the ulnotriquetral ligament. After surgery, a short arm cast is worn for 4 weeks. Clearance for returning to work is much more variable, depending on the nature of the job and whether the patients dominant hand was affectedtime off work may be anywhere from a few days to several weeks. Weba tendon sheath (lining) or strain of a tendon to the wrist, the (sheath). (1a) Gradient echo coronal, (1b) T1-weighted axial, and (1c) STIR axial images of the wrist. To try to give a patient the best chance of recovery, activities requiring rotation of the wrist and elbow are limited during this time. Associated patchy area of bone marrow edema is seen involving the ulnar styloid process evoking a high STIR signal. WebConclusions:Treatment with PXL01 in sodium hyaluronate improves hand recovery after flexor tendon repair surgery. Most individuals who undergo this procedure will be able to drive again as soon as they are no longer taking opioid medications. 11 Rowland SA. The ECU arises from a common extensor origin on the lateral epicondyle of the humerus. The surgery was performed according to the technique described by Drs. Mild edema is also evident within the palmar aspect of the distal ulna (arrowhead). It has a single distal insertion upon the posterior aspect of the base of the fifth metacarpal. WebSnapping ECU is a clinical condition characterized by pain over the ulnar wrist caused by instability and tendonitis of the ECU tendon secondary overuse. Reconstruction consisted of using the extensor retinaculum as a A hand splint is a rigid support worn around the hand, which is designed to hold your hand securely in position to prevent excessive movements that could cause the tendon to rupture while it is healing. endobj If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. 11 November 2021. Commonly athletes/patients present complaining of persistent ulnar wrist pain aggravated by activities requiring pronation and supination, which may be associated with a clicking or "snapping" sensation. Initial treatment is the same as for when the ECU tendon gets pinched: a splint, a steroid injection, and avoiding lifting with the palm down. The overlying extensor retinaculum (blue) courses over the ECU and distal ulna to attach to the pisiform and triquetrum. Am J Sports Med 2205; 33:1910-1913. De Quervains procedure is a minor surgical intervention to excise the fibro-osseous sheath surrounding the extensor tendons of the thumb. Extensor Carpi Ulnaris Subsheath Tears are a fairly common injury involving people who play golf, contact, and racket sports. ECU tendon tears are repaired at the same time. WebIn some cases, particularly where the tendon split is pathological, there is frequently increased Doppler is very degenerate or the groove is narrow and irregular, the signal within the tendon and surrounding tendon sheath. Resting the arm during sports activities can aid in the prevention of substantial tears. A schematic axial representation of the ECU subsheath, indicated in red. Sometimes, it is obvious that you have snapped the tendon because you notice a sudden snapping or pinging sensation in your hand. Are there any medications that are effective against developing ECU subluxation or treating it? Links to third party sites, products and services do not constitute endorsement. The extensor carpi ulnaris provides stability to the distal radioulnar joint by its dorsal position and the overlying extensor retinaculum [3-5]. Due to the mobility required around the wrist the muscle relies on specific stabilising structures such as the fibro-osseous groove, tendon subsheath and extensor retinaculum to maintain its position at the wrist[1]. Progression to the next phase based on the clinical criteria and/or time frames, as appropriate. Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. WebThey will use forceps to bring the two ends of the damaged tendon together. Tenderness over the back of the wrist. Existing patients, click here. More serious cases of tendon adhesion require surgery to free the stuck tendon. Surgery and physical therapy normally fix the pain and discomfort associated with the wrist. The wrist is the third most common joint to have this procedure. In some cases there are complications after surgery, such as infection or the repaired tendon snapping or sticking to nearby tissue. After extensor carpi ulnaris tendonitis surgery, you will wake up in a splint or cast to help stabilize your wrist and minimize unnecessary movement. These diagnostic tests will be followed by a thorough physical exam, so that the doctor can see the injury for himself and learn from you just how it affects your activities of daily life. % Early rheumatoid arthritis: a review of MRI and sonographic findings. Reactive marrow edema (asterisk) is seen within the adjacent ulna. Wrist loading with the ECU is in a vulnerable position (flexion during supination and ulnar deviation). WebMild cases of ECU Tendinitis can be treated with rest, splinting and non-steroidal anti-inflammatories, whereas severe instances can necessitate cortisone injection or surgery resume heavy activities, such as heavy lifting or building work, after 10 to 12 weeks. The patient had symptoms in the absence of any definitive tear of ECU sheath or SB. After surgery, there are no formal activity limitations, but its best to take it easy for a couple of weeks. Generally speaking, subluxation of the ECU should be treated under the supervision of a medical professional. Certain patterns of injury require operative repair, and thus MRI is a critical component of the treatment planning process. This usually sits the tendon back within the ulnar groove. During this surgery, we will make a small incision on your wrist and locate the tendon causing pain. Snapping can also be felt, as the misplaced tendon interacts with the bones of the wrist where it has been moved. Tendon repair of the hand is surgery to repair damaged or divided tendons. Three patients underwent a reoperation; 1 patient requested removal of a stitch, 1 patient underwent arthroscopic TFCC debridement because of persisting ulnar-sided wrist pain, and 1 patient underwent neurolysis of 2 branches of the dorsal sensory ulnar nerve. With radial sided subsheath rupture (14a), the tendon is more likely to relocate in a manner that leaves it lying atop the ruptured subsheath (12a), preventing functional healing of the subsheath. The overlying extensor retinaculum (blue arrowheads) is indicated. When you will be able to return home will depend on how badly your hand was damaged. If you attempt to use the repaired tendons before they have fully healed, it could cause them to split apart. After a flexor tendon repair it is quite common for some fingers not to regain full movement, although the tendon repair will still give a better result than no surgery. The sensation of tendon dislocation and an associated pop may accompany the injury. Orlando Hand Surgery Associates can relieve your pain with our extensor carpi ulnaris tendonitis surgery. WebGanglion of the Foot or Ankle. Br J Sports Med 1998; 32:172-177. endobj Our website services, content and products provide useful information. The ECU tendon and its vital, retaining subsheath ligament are vulnerable due to its position subcutaneously. However, human bites are a more common cause and most often occur when a person punches another person in the teeth, cutting their hand in the process. Most tendon damage is caused by cuts to the hands from glass or knives. Inflammation: For the first 35 days, the area may feel swollen while the body works to 4 0 obj The muscles function will be affected by the position of the forearm as forearm pronation and supination affect the muscles angle of pull. WebPrevent complications during your wrist surgery recovery. I may be intensified by repeated impact to the wrist during racket sports or golf, can irritate this ligament and cause this condition to develop. Read more about. Extensor carpi ulnaris tendon rupture in an ice hockey player. In such patients, chronic stress upon the tendon results in inflammation of its synovial lining, causing tenosynovitis.4 Over time, stress may also lead to tendon degeneration and altered collagen content, resulting in tendinosis with or without partial tears (8a). The tendons of the wrist are commonly symptomatic and can be injured, infected, or inflamed; this article reviews their normal appearance at MR imaging and US, discusses relevant anatomy, and gives an overview of common pathologic conditions that affect the wrist tendons. WebAnatomy ECU tendon normally held within groove of ulna head by sub sheath (deep retinaculum) Sub sheath resists the normal tendency for tendon to sublux Indications Ulnar sided wrist pain is a common clinical complaint and indication for MR imaging. MR is able to detect and diagnose numerous ulnar sided abnormalities that may account for patient symptoms. A not uncommon site of injury is the sixth extensor compartment, home of the extensor carpi ulnaris (ECU). Immobilization with a splint or cast in extension and radial deviation is a common treatment. Introduction Operative techniques to treat symptomatic extensor carpi ulnaris (ECU) tendon subluxation include direct repair of the subsheath, reattachment of the subsheath using suture anchors, reconstruction of the sheath using extensor retinaculum, or a free graft to reconstruct the extensor retinaculum. endobj ECU tendinosis and tenosynovitis can often be managed conservatively. If non-operative treatment doesnt work, surgery is very effective. With radial sided tears, the tendon is more likely to lie atop the torn subsheath following relocation. Uncommon, ruptures are typically repaired using a local graft, primarily the palmaris longus. They will use forceps to bring the two ends of the damaged tendon together. Complex surgery for more severe injuries could take much longer. The growth is a gel-filled cyst that typically forms off of a joint lining or tendon sheath. Underlying Medical Conditions: Individuals suffering from Conservative treatment is a real possibility in the case of ECU subluxation, with casting or splinting indicated if the injury to the ECU tendon sheath is not too severe. Degree of damage dictates restrictions. The ECU tendon lies in the Tendon adhesion is a medical term which means that the tendons have become stuck to nearby tissue and have lost some of their range of movement, specifically the ability to move around bones. The movements and strain associated with tennis and golf are the most common culprits when it comes to developing ECU subluxation, but trauma to the lower forearm where the tendon sheath is may also create the problem. In August 2019, pexidartinib was approved by the US Food and Drug Administration (FDA) for tenosynovial giant cell tumor (TGCT), the first systemic therapy to be approved for this condition. 5) This case had concomitant extensor tendon subluxation at the long finger MP joint. Physical therapy to optimize range of motion and strength is recommended. J Hand Surg 1986; 11A:809-811. Triangular FibroCartilage Complex (TFCC) Injury, Extensor Carpi Ulnaris Tendonitis Surgery, Triangular Fibrocartilage Complex (TFCC) Injury Surgery. The ECU tendon is the anchor of the ECU muscle, which is important for straightening the wrist and bending it to the side of the little finger. You will usually be advised to wear the splint at all times for at least four to five weeks, then during the night for a further two weeks. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. For your convenience, we do accept cash, personal checks, MasterCard and Visa. Magnetic resonance imaging in orthopaedics and sports medicine, 3rd edition, Lippincott Williams and Wilkins 2006:1828-1829. However, the vast majority of hand tumors (98-99%) are non-threatening. Montalvan B, Parier J, Brasseur JL, Le Viet D, Drape JL. See Symptoms and Risk Factors for De Quervains Tenosynovitis. A unique anatomical characteristic of the ECU is the fibro-osseous tunnel which stabilizes the tendon at the level of the distal ulna.1 This fibro-osseous tunnel is formed by the distal ulna and a 1.5 to 2cm in length band of connective tissue referred to as the ECU subsheath (5a, 6a). When an individual experiences an ECU subsheath tear, they may become more prone to further injury of the wrist and may have sustained additional damage that often occurs during the same injury. WebMicrosurgical techniques currently applied to embryos include removing embryonic cells from or transferring them into the zona pellucida, biopsy, cutting embryos in half, aggregating them, injecting nuclei, cytoplasm, or molecules into embryonic cytoplasm or nuclei, and removing material or structures such as pronuclei from embryos. Posterior interosseous branch of the radial nerve, Wrist extension along with extensor carpi radialis longus (ECRL) and brevis (ECRB), Ulnar deviation of the wrist along with flexor carpi ulnaris (FCU). 1 Maffuli N, Renstrom P, Leadbetter WB. Surgery will take around 20 minutes, and a person should not have to stay in the hospital overnight. An overview of the ECU at the level of the distal ulna with a cutaway of the extensor retinaculum reveals the band-like subsheath (red) which serves to stabilize the ECU tendon within its groove at the distal ulna. 6 Inoue G, Tamura Y. Recurrent dislocation of the extensor carpi ulnaris tendon. In some situations, strict box rest is necessary but in most cases hand grazing for 5-10 minutes twice daily is acceptable. That is why it is so important for individuals to seek medical attention when they notice discomfort, particularly with wrist rotation. A STIR axial image reveals fluid (arrowheads) surrounding the ECU tendon at the distal ulna, compatible with tenosynovitis. The ECU subsheath (arrowheads) is diffusely thickened and irregular and marked tenosynovitis is present. Webtime frames of phases I-IV are examples and can be adjusted based on the given procedure. During surgery, the groove that the ECU sits in is deepened and the ECU sheath is reattached to bone. Depending on the severity of injury, immobilization is necessary for six weeks to three months. How can Dr. Knight help you with ECU Subluxation? Occasionally, the ECU sheath is deficient or tears off the bone. It is important that athletes and individuals alike seek treatment from a highly qualified surgeon, with specialization in treating injuries of the hand and wrist in order to assess if they are getting the proper diagnosis and care. 216.444.2606. Available from: https://musculoskeletalkey.com/surgical-treatment-for-extensor-carpi-ulnaris-subluxation/. The tendon, however, remains beneath the subsheath. Musculoskeletalkey.com. The tendon is subluxed into the pouch formed by stripping of the subsheath at its palmar attachment. A T1-weighted axial image from a patient with an ECU subsheath stripping injury. ECU tendon insertion degeneration is also often due to overuse, and is very common in the left hand of golfers. STIR axial image from a baseball player who sustained an acute supination and hyperflexion injury. Before you leave hospital, a hand therapist will place your hand in a protective splint (a rigid support that is designed to protect the hand) to prevent the repaired tendons from being overstretched. ECU subsheath reconstruction +/- wrist arthroscopy, chronic cases may require an extensor retinaculum flap for ECU subsheath reconstruction, Wrist arthroscopy shows concurrent TFCC tears in 50% of cases. At the level of the proximal carpal row, the ECU tendon (arrow) is severely thickened and demonstrates increased signal intensity throughout its substance, compatible with severe tendinosis. Tendon sheaths help protect tendons from abrasive damage as they move. As discussed above, the subluxation of the ECU tendon may be visible to the naked eye after a physical examination of the injury. Depending on the type of injury, it may be possible to repair extensor tendons in an accident and emergency department using a, Repairing flexor tendons is more complex because they can be difficult to get to and, in many cases, are located near important nerves. Following surgery, a special cast is worn for 6 weeks. ECU subluxation is caused when the fibrous sheath through which the ECU tendon passes upon reaching the wrist joint become injured, whether through trauma or repetitive injury. MALLET FINGER: ZONE I: Over the distal phalangeal joint (DIP)-Mallet deformity ZONE II: Over the middle phalanx/triangular ligament Knowledge of the unique anatomy of the ECU and its subsheath must be gained in order to correctly diagnose patients with ECU tendon instability. The chronically unstable tendon, if used repetitively, may even cause osseous erosion of the distal ulna.8. Post operative rehab will follow similar principles to those described for conservative management. Depending on the nature of your injury, you may be given antibiotics and a, Extensor tendon repair is usually performed under a. A splint will be applied to protect the newly repaired tendons. Risk As with any surgical procedure, complications can occur, some possible complications may include, but are not limited to the following: Surgical repair may be recommended in some cases, especially in situations where an individual has an acute or chronic high-grade injury to the ECU. WebThe ECU tendon sheath can be irritated by repetitive flexion and extension of the wrist, depending on the extent of surgery. Extensor Carpi Ulnaris injuries in tennis players: a study of 28 cases. [cited 2021 Nov 28]. An ECU tenosynovitis occurs in sports such as rowing and racquet sports, requiring a snapping wrist (e.g. Physical therapy to optimize range of motion and strength is recommended. WebArthroscopic debridement is common for knees and shoulders. Common risk factors for ECU injury are[1]: Acute injuries are commonly associated with some form of 'trauma' that requires high levels of wrist extensor or ulnar deviation forces to be produced, such as: An athlete/patient may report that they felp a "snap", "pop" or a "tear" at the time of the trauma. The ECU functions to extend and adduct the hand, and is important in the ability to ulnar deviate the hand. Patients may receive a short-term prescription for an opioid (narcotic) pain reliever, which carries risks for side effects and dependency and needs to be taken only as directed. Start by clicking on the image below. Following surgery, a special cast is worn for 6 weeks. Clin Sports Med 1995; 14(2):289-297. Normally, for an elderly individual it takes upwards of 6 months to completely recover from Tendonitis. A tourniquet is a type of cuff that is used to constrict (squeeze) the blood supply. You may notice it more when you use it, especially if a repeated motion like swinging a hammer or a tennis racquet caused it. An incision will be made in your hand (or, in the case of a wound, the wound may be made larger) and the two ends of the ruptured tendon will be stitched together. WebAfter two to three years, the result of a synovectomy is dependent upon the course of the general disease activity and not the surgery. Dr. Knight welcomes you to any of our Dallas Fort-Worth accessible hand and wrist offices. An injection of 8 to 10 mL of 1% lidocaine (Xylocaine) into the subacromial space under sterile conditions should relieve the pain of rotator cuff tendinitis, but not that of biceps tendinitis. Reinforcement or reconstruction of the subsheath usies a strip of extensor retinaculum. In order to determine the full extent of the injury to the sheath and to ascertain the exact position of the ECU tendon, MRI or ultrasound imaging are used to look inside the wrist and locate all of the relevant body parts. The ECU tendon is the anchor of the ECU muscle, which is important for straightening the wrist and Acute traumatic subluxation of the extensor carpi ulnaris tendon at the wrist. Synovial fluid, produced by the tendon sheath, maintains a barrier of moisture, which protects and lubricates tendons and their tendon sheaths. <> After all the components are returned to their proper place, the sheath is then repaired, and the wrist is placed in a splint or cast so that the healing process can take place uninhibited. WebReturn to the clinic at 6 weeks from surgery for cast removal and re-evaluation. Original content Copyright Department of Health of the United Kingdom. If your extensor tendons are damaged, you will be unable to straighten one or more of your fingers. The ECU subsheath is diffusely torn and irregular. Tendon repair involves making an incision in your hand to locate the ends of the divided tendon, and then stitching the tendon ends together. Themes UFO. Pain worsens when bending the wrist sideways (little finger towards the forearm, called ulnar deviation) Swelling. Read more, Physiopedia 2023 | Physiopedia is a registered charity in the UK, no. An example of typical dosages of Humatrope, a popular HGH supplement produced by Eli Lily. Keeping the affected hand immobile and elevated whenever possible for the first 2 or 3 days. This means that only a physician or physical therapist should move your The subsheath is thickened (arrow) and appears chronically tornat its radial aspect (arrowhead). WebConclusions:Treatment with PXL01 in sodium hyaluronate improves hand recovery after flexor tendon repair surgery. Abbasi D. Snapping Extensor Carpi Ulnaris (ECU) [Internet]. It also provides stability to the ulnar side of the wrist. Lifting with the palm up stresses the ECU tendon less.
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ecu tendon sheath surgery recovery time