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Flexor Carpi Ulnaris

- See: Forearm Flexors

- Anatomy:
    - origin: 2 heads from medial epicondyle of humerus & medial border of olecranon;
    - insertion: palmar surface of pisiform, hamate, and bases of 5th metacarpal;
    - action: flexes and adducts the hand at the wrist;
    - synergists: flexor carpi radialis;
    - nerve supply: ulnar - C8 > T1;

- Discussion:
      - Flexor Carpi Ulnaris inserts into the pisiform bone;
      - tendon is covered > 50% by muscle fibers at wrist level & extends to volar capsule ligament, joining this structure to form a roof for ulnar artery and nerve;
      - FCU tendon protects  ulnar nerve & artery at wrist level and provides point of recongnition of these structures when local nerve block is performed;

- FCU Tenosynovitis:
      - assoc w/ chronic repetitive trauma and may be bilateral;
      - characterized by tenderness directly over tendon at wrist & pain worsen by wrist flexion, or ulnar deviation against resistance;
      - painful palpation of pisiform;
      - ulnar flexion against resistance painful;
      - calcification may be painful;
      - in most instances x-rays are normal, but calcific deposits in region of tendon may occasionally be seen;
      - diff dx:
           - pisotriquetrial arthritis
           - ulnar neuritis
      - treatment
           - splinting
           - Nsaids
           - Injection - steroid

- Calcific Tendinitis:
    - common type of calcific tendinitis which occurs at its insertion into pisiform;
    - x-ray:
           - forearm is held in mid-supination to demonstrate calcific deposits just proximal to the pisiform

The use of a flexor carpi ulnaris muscle flap in the treatment of an infected nonunion of the proximal ulna. A case report.

Excursion of prime wrist tendons.

Surgical treatment of medial epicondylitis. Results in 35 elbows.