The ECU groove space is the osseoligamentous tunnel on the dorsal aspect of the ulnar head, through which the ECU tendon passes in the sixth extensor compartment. The groove is covered by the ECU subsheath and the extensor retinaculum. The ECU tendon changes its mechanical angle here as the forearm rotates, making this a site of tendon instability and subsheath tears.
ECU tendon subluxation from the ulnar groove produces a snapping ulnar wrist pain in forearm rotation, particularly in racquet sport athletes. The ECU subsheath tears at this groove level, allowing the tendon to sublux ulnarly in supination. Dynamic ultrasound confirms subluxation during forearm rotation. Conservative management with a splint holding the forearm in pronation allows subsheath healing; surgical subsheath reconstruction is required for chronic instability.
Tendon displacement from the ECU ulnar groove from subsheath tear producing a painful dorsal ulnar wrist snap in forearm rotation, confirmed by dynamic ultrasound and managed by immobilisation or surgical subsheath repair.
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