Indications

• Radial deviation of the wrist with reduced capacity for active ulnar deviation due to an inflammatory arthropathy.
  
• Post-traumatic extensor carpi ulnaris (ECU) disruption with radial deviation of the wrist.

Pitfall

Inability to passively correct the wrist deformity and diminished extensor carpi radialis longus (ECRL) or extensor carpi radialis brevis (ECRB) function are contraindications.

Technique

• A dorsal, midline, longitudinal 6–8 cm incision is made, centered over the rim of the radius.
  
• Full-thickness skin flaps are raised, including the veins, nerves, and subcutaneous fat.
  
• The sixth extensor compartment is opened, the ECU is extracted, and a tenosynovectomy is performed.

Pearl

The entire retinaculum is raised as a radially based flap to the septum between the first and second compartments if a more complete dorsal tenosynovectomy is necessary.