----- Original Message -----
From: "Rowley Cottingham"
Subject: Re: Distal ulna injuries
> There isn't a great deal in this area, and about the only structure of
> note is the tendon of extensor carpi ulnaris that runs down the lateral
> aspect of the ulna, between the head and the styloid process of the ulna
> through its own little compartment of the extensor retinaculum before
> attaching distally to the base of the 5th metacarpal (I did have to look
> up the precise details, in case anyone thinks me terminally sad!) to act
> as an extensor, wrist stabiliser and abductor.
I'm a bit worried that you found this after looking it up. The ECU tendon
does indeed insert into the base of the 5th metacarpal, where it acts as an
extensor and synergistic stabiliser, but it adducts the wrist, not abducts.
Further, I'm dismayed that you found a text that describes the tendon
running down the lateral aspect of the ulna; if you really must take a view,
you should describe this as the radial side of the ulna. In any case, the
tendon actually runs dorsally over the ulnar head, preferring neither side
at the level of the wrist. OK, maybe I really am terminally sad...well,
someone's got to!
Adrian Fogarty
This is not usually
> involved, and so I have simply assumed that there has been a
> subcutaneous
> bruise with swelling. I have always assumed that the prolongation of the
>
> morbidity is because it is a fairly exposed area and keeps getting
> knocked.
>
> Best wishes,
>
>
> Rowley Cottingham
>
> [log in to unmask]
> http://www.emergencyunit.com
>
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]] On Behalf Of Dunn Matthew Dr. (RJC)
> ACCIDENT & EMERGENCY - SwarkHosp-TR
> Sent: 14 April 2003 15:40
> To: [log in to unmask]
> Subject: Re: Distal ulna injuries
>
>
> An embarrassing question that I probably should have asked 15 years ago,
> but here goes: You know how you get patients with wrist injuries with
> marked swelling and tenderness over the distal ulna (not the styloid,
> TFCC or ligaments, but about the last inch and a half of ulna apart from
> the styloid). What's actually going on there? No fracture (and if they
> present late, no periosteal elevation, so definitely no fracture;
> nothing that attaches there as far as I can see. It does seem pretty
> painful and doesn't get better all that quickly. Anyone got any thoughts
> (indeed is this something really obvious that everyone else knows
> about)? I've always muttered something about periosteal stripping to
> them (which is almost certainly a lie given the lack of periosteal
> elevation), advised topical NSAIDs and hoped they'd be sufficiently
> unimpressed to present to someone else when it failed to get better, but
> is there anything that works?
>
> Matt Dunn
> Warwick
>
>
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