Degenerate tears of the ECU

Unstable ECU tendons with longitudinal degenerate tears are rare. 6 cases were identified in a retrospective study over a 2-year period. The degenerate tears of the ECU tendon were repaired and the ECU sheath reconstructed with a retrograde posterior interosseous artery ‘sliding’ fascial fat flap. Supination and pronation strength improved by 56% and 81% respectively. Gross grip improved by 7.5%. Range of motion was equivalent to the contralateral wrist except for wrist flexion which was reduced by 13%. Patient rated outcome measures (PRWE, DASH and pain VAS) were improved. These injuries are part of a global injury to the wrist. 3 of the 6 cases had a tear of the TFCC, 1 had scapholunate instability and 1 had a tear of the TFCC and scapholunate instability. Only 1 case had an isolated longitudinal tear of the ECU tendon. There were no recurrent instabilities or revisions.