Brave man to argue with dear old Dr Gray! You are right on one point; it is of course an adductor and
that was a typo by me. "It can be identified in the living subject immediately lateral to the groove
which overlies the posterior border of the ulna" are the precise words.
> ----- 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
>
>
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>
> 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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> > South Warwickshire General Hospitals NHS Trust unless explicitly
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>
Best wishes,
Rowley Cottingham
[log in to unmask]
http://www.emergencyunit.com
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