# Extensor Carpi Ulnaris (ECU) Stabilization



## MI_CODER (Jul 14, 2018)

Hello

My provider is performing a ECU stabilization and distal ulna ostectomy craterization for painful subluxation. I'm thinking that CPT 25275 is the correct code for the ECU stabilization but I'm not sure what code to use for the ostectomy (or if this is even billable)?

Thanks in advance.

The extensor retinaculum identified over the distal ulna. This was incised volar and more ulnar and then flipped back. The subsheath of the ECU was identified. We then released the subsheath from the periosteum volarly and the ulna just volar to the ulnar groove. The ECU was taken with the subsheath and then retracted back radially, identifying the groove. The groove was quite shallow. We then used a bur to deepen the groove approximately 2  mm, making sure we smoothed out any edges. We then placed two 1 mm JuggerKnot suture anchors on the volar aspect of the groove. We then tied down the ECU subsheath, imbricating it ulnarly, so as to reduce of any redundancy. We then incorporated the extensor retinaculum repair in with the same sutures of the JuggerKnot, closing the extensor retinaculum nicely. Taking the wrist in pronation and supination, this held the ECU nicely in position in  the groove and radial, as it should be. We then went ahead, thoroughly irrigated and closed skin using a 4-0 Vicryl followed by interrupted 4-0 Prolene. The arm was splinted in supination to protect the ECU subsheath repair.


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