The sixth extensor compartment is a fibro-osseous groove on the dorsal ulnar head containing the ECU tendon. The subsheath within the sixth compartment anchors the ECU tendon within the groove during forearm rotation.
Constrains the ECU in its groove during forearm rotation, prevents ECU subluxation from the groove, and allows the tendon to maintain its wrist extensor and ulnar deviator function throughout the rotation arc.
ECU subsheath disruption allows the tendon to snap out of the groove during supination-ulnar deviation (racquet sports position), producing a painful clunk. MRI and dynamic ultrasound demonstrate subluxation. Subsheath repair or groove deepening restores stability.
Sixth compartment subsheath disruption allowing ECU subluxation from the groove during supination-ulnar deviation, producing a painful snap on the dorsal ulnar wrist managed by subsheath repair or reconstruction.
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