23 Extensor Carpi Ulnaris—Flexor Carpi Ulnaris Tenodesis Stabilization of the Resected Distal Ulna

• Make an incision along the subcutaneous ulnar border to the level of the distal wrist crease (Fig. 23-1).

Pitfall

Avoid cutting or traction injury to the dorsal cutaneous branch of the ulnar nerve, which passes obliquely over the ulnar border of the wrist.

• Expose the extensor carpi ulnaris (ECU) and flexor carpi ulnaris (FCU) tendons over the full extent of the incision.
  
• Split the ECU and FCU tendons in half longitudinally (Fig. 23-1).
  
• Cut one half of the ECU tendon distally and one half of the FCU tendon proximally.
  
• Resect the ulnar head if not already removed, but retain the ulnar styloid with its triangular fibrocartilage complex (TFCC) attachments.

Pearl

Maintain the ECU subsheath in continuity with the TFCC.

Related posts:

Intra-articular Fractures of the Distal Radius Treated with Dorsal Plate Nonunion of an Ulnar Neck Fracture Percutaneous Screw Fixation of Scaphoid Fractures Flexor Carpi Radialis Tendon Stabilization of the Scapholunate Joint (Brunelli Procedure) Closed Reduction and Internal Fixation of Bennett’s or Rolando’s Fractures Capitate Shortening with Capitohamate Fusion

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