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.
| Location | Ulnar side of the dorsal wrist, over the distal ulna |
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Holds the ECU tendon in its groove throughout forearm rotation; subsheath tears allow painful ECU subluxation.
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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