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DOI: 10.1055/s-0043-1764354
Operative Management of Extensor Carpi Ulnaris Instability: A Systematic Review
Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Abstract
Background Posttraumatic extensor carpi ulnaris (ECU) instability is an increasingly recognized cause of ulnar-sided wrist pain that occurs when the ECU subsheath is disrupted.
Purpose The purpose of this systematic review was to assess outcomes of operatively treated posttraumatic ECU instability.
Methods A systematic search of Medline, Embase, Web of Science, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases was performed using “extensor carpi ulnaris” as the keyword. Studies were systematically screened and data extracted independently by two reviewers.
Results Eight retrospective studies met the inclusion criteria with a total of 97 wrists. The mean age was 32 years (13–61). Patients underwent either primary repair (40%) using sutures and anchors, or reconstruction (60%) using extensor retinaculum flaps. One study performed deepening of the osseous ulnar groove. Two studies compared preoperative and postoperative values. They both reported a significant improvement in pain scores, functional scoring instruments, satisfaction, and grip strength. The rest of the studies reported similarly favorable outcomes across the same outcomes. Concomitant pathologies were identified in 66% of the study population. Complications occurred in 9% of the sample size, including ECU tendinitis, ulnar sensory nerve irritation, and reintervention for concomitant pathology. None of the studies reported recurrence or reruptures. However, five patients (6.7%) did not return to their previous activity level.
Conclusion Patients can expect favorable outcomes with a potentially low complication rate. Nevertheless, the heterogeneity of the sample population, operative techniques, and outcome measures warrant further standardized studies.
Level of Evidence IV.
Keywords
extensor carpi ulnaris - instability - subluxation - dislocation - operative treatment - outcomes - repair - reconstructionAuthors' Contributions
All authors have agreed to the submission of the current version of the manuscript and that all authors have made substantial contributions to the work submitted in the forms of; design, data acquisition, analysis, writing, editing, reviewing, and final approval of the version to be published.
Ethical Approval
No ethical approval was required for the purpose of this study.
Authors' Declaration
We, the authors of this submission confirm that we have not published the same or a very similar study with the same or very similar results and major conclusions in any other journals. These include English or non-English language journals and journals that are indexed or not indexed in PubMed, regardless of different words being used in the article titles, introduction, and discussion.
Publication History
Received: 05 October 2022
Accepted: 03 February 2023
Article published online:
10 April 2023
© 2023. Thieme. All rights reserved.
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