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The flexor carpi ulnaris (FCU) is a muscle in the forearm that flexes and adducts at the wrist joint. It is the most medial flexor muscle in the superficial compartment of the forearm and the only muscle in the anterior compartment that is fully innervated by the ulnar nerve. The FCU is susceptible to overuse and misuse, particularly in racquet sports, which can lead to tendinitis. It is also involved in Volkmann's contracture, where ischemic damage causes fibrosis and contracture, resulting in deformities and impaired function in the affected limb.
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What You'll Learn
The FCU is a forearm muscle
The flexor carpi ulnaris (FCU) is a muscle of the forearm. It is the most medial flexor muscle in the superficial compartment of the forearm. It is also the most medial of the tendons that are visible superficially in this region. The FCU is a major wrist flexor, particularly in an ulnar direction, and is supplied by branches both above and below the elbow.
The FCU has two heads: a humeral head and an ulnar head. The humeral head originates from the medial epicondyle of the humerus via the common flexor tendon. The ulnar head originates from the medial margin of the olecranon of the ulna and the upper two-thirds of the dorsal border of the ulna by an aponeurosis. The FCU inserts at the base of the pisiform bone, hook of hamate, and base of the fifth metacarpal.
The FCU is innervated by the ulnar nerve, with corresponding spinal nerves C8 and T1. It receives its arterial blood supply via three different routes: proximally, a branch of the posterior ulnar recurrent artery supplies the muscle, while branches of the ulnar artery supply the middle and distal parts of the muscle. An accessory supply is also present distally via the inferior ulnar collateral artery.
The FCU can be palpated by locating the bony landmarks associated with the muscle, including the medial epicondyle, the olecranon process, and the pisiform bone. After identifying these landmarks, the person is asked to perform ulnar deviation and wrist flexion simultaneously to locate the FCU muscle.
The FCU is susceptible to involvement in Volkmann's contracture, where ischemic damage compromises the muscle, leading to fibrosis and contracture. This can result in deformities and impaired function in the affected limb. The FCU tendon may also develop tendinitis after overuse or misuse, especially in activities requiring repeated flexion and adduction of the hand, such as racquet sports.
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It flexes and adducts the wrist
The flexor carpi ulnaris (FCU) muscle is a major wrist flexor. Located in the forearm, it is the most medial flexor muscle in the superficial compartment of the forearm. The FCU has two heads: a humeral head and an ulnar head. The humeral head originates from the medial epicondyle of the humerus, while the ulnar head originates from the medial margin of the olecranon of the ulna and the upper two-thirds of the dorsal border of the ulna.
The FCU flexes and adducts the wrist, allowing movement of the hand sideways as well as flexing it. It works in tandem with the flexor carpi radialis to flex the wrist and with the extensor carpi ulnaris to adduct the wrist. The FCU is innervated by the ulnar nerve, receiving arterial blood supply through three different routes.
The FCU is susceptible to overuse or misuse, especially in activities requiring repeated flexion and adduction of the hand, such as racquet sports. Tendinitis in the FCU tendon can occur, causing pain on the ulnar side of the wrist and into the palm.
To locate the FCU, a person can be asked to perform ulnar deviation and wrist flexion simultaneously. The FCU can be palpated by identifying the associated bony landmarks: the medial epicondyle, the olecranon process, and the pisiform bone.
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The FCU is innervated by the ulnar nerve
The flexor carpi ulnaris (FCU) is a muscle of the forearm that flexes and adducts at the wrist joint. It is the most medial flexor muscle in the superficial compartment of the forearm. The FCU is innervated by the ulnar nerve, which passes deep to the tendinous arch between the muscle's humeral and ulnar heads. The ulnar nerve provides innervation to the FCU from the brachial plexus, with corresponding spinal nerves C8 and T1.
The FCU is the most proximal muscle innervated by the ulnar nerve. This means that the ulnar nerve supplies the FCU with nerve fibres that are closer to the trunk of the nerve, which branches off to supply other muscles. The ulnar nerve provides innervation to the FCU from the brachial plexus, a network of nerves formed by the anterior rami of the lower cervical and first thoracic spinal nerves.
The FCU is a major wrist flexor, particularly in an ulnar direction, and is involved in adduction of the hand at the wrist. It acts in tandem with the flexor carpi radialis to flex the wrist and with the extensor carpi ulnaris to adduct the wrist. The FCU is the only muscle in the anterior compartment of the forearm that is fully innervated by the ulnar nerve.
The FCU receives its arterial blood supply via three different routes. Proximally, a branch of the posterior ulnar recurrent artery supplies the muscle as it passes between the humeral and ulnar heads. Branches of the ulnar artery supply the middle and distal parts of the muscle, and there is also an accessory supply distally via the inferior ulnar collateral artery.
The FCU is susceptible to involvement in Volkmann's contracture, where ischemic damage compromises the muscle, leading to fibrosis and contracture. This condition can result in deformities and impaired function in the affected limb. The FCU tendon may also develop tendinitis due to overuse or misuse, especially in activities requiring repeated flexion and adduction of the hand, such as racquet sports.
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It is susceptible to Volkmann's contracture
The flexor carpi ulnaris (FCU) muscle is a fusiform muscle located in the anterior compartment of the forearm. It is the most medial flexor muscle in the superficial compartment of the forearm. The FCU is the only muscle in the anterior compartment that is fully innervated by the ulnar nerve. It is supplied by the ulnar collateral arteries along with the anterior and posterior ulnar recurrent arteries.
The FCU is susceptible to Volkmann's contracture, a deformity of the hand, fingers, and wrist caused by injury to the muscles of the forearm. This injury results in a lack of blood flow (ischemia) to the forearm, which can be caused by increased pressure due to swelling, or compartment syndrome. This prolonged decrease in blood flow injures the nerves and muscles, causing them to become stiff and shortened. This shortening of the muscles in the forearm results in a claw-like presentation of the hand, with the wrist fixed in a bent position.
Volkmann's contracture is often the result of trauma, such as fractures, crush injuries, burns, or arterial injuries. It can also be caused by animal bites, bleeding disorders, excessive exercise, or injections of medication in the forearm. The condition is named after the 19th-century German doctor Richard von Volkmann. It is a relatively rare condition, with an incidence of 0.105% of all orthopedic cases, and it most commonly occurs after pediatric upper limb trauma.
The prevention of Volkmann's contracture is the best management strategy. However, surgical intervention may be necessary in some cases. The treatment depends on the severity of the contracture, which can be mild, moderate, or severe. For mild contractures, muscle stretching exercises and splinting the affected fingers may be effective. Moderate contractures may require surgery to repair the muscles, tendons, and nerves. In severe cases, all muscles in the forearm that flex and extend the wrist and fingers are involved, resulting in a severely disabling condition with minimal movement of the fingers and wrist.
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The FCU has two heads
The flexor carpi ulnaris (FCU) muscle is a type 2 muscle flap that can cover small to medium-sized elbow defects in the posterior, medial, and anterior aspects of the elbow. It is the most medial flexor muscle in the superficial compartment of the forearm. The FCU has two heads: a humeral head and an ulnar head. The humeral head originates from the medial epicondyle of the humerus via the common flexor tendon. The ulnar head originates from the medial margin of the olecranon of the ulna and the upper two-thirds of the dorsal border of the ulna by an aponeurosis.
Between the two heads of the FCU passes the ulnar nerve and ulnar artery. The FCU is innervated by the ulnar nerve, which receives its arterial blood supply via three different routes. Proximally, a branch of the posterior ulnar recurrent artery supplies the muscle as it passes between the humeral and ulnar heads. Branches of the ulnar artery supply the middle and distal parts of the muscle, with an additional supply also present distally via the inferior ulnar collateral artery.
The FCU is a major wrist flexor, particularly in an ulnar direction, and is supplied by branches both above and below the elbow. It can adduct and flex the wrist simultaneously. It acts in tandem with the flexor carpi radialis to flex the wrist and with the extensor carpi ulnaris to adduct the wrist. The FCU is the only muscle in the anterior compartment that is fully innervated by the ulnar nerve.
The FCU is susceptible to overuse or misuse, especially during activities that require repeated flexion and adduction of the hand, such as racquet sports. It can be palpated by locating the bony landmarks associated with the muscle, including the medial epicondyle, the olecranon process, and the pisiform bone.
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Frequently asked questions
The flexor carpi ulnaris (FCU) muscle is a muscle of the forearm that flexes and adducts at the wrist joint. It is the most medial flexor muscle in the superficial compartment of the forearm.
The FCU muscle is a major wrist flexor, particularly in an ulnar direction. It can also move the hand sideways. The FCU is the only muscle in the anterior compartment that is fully innervated by the ulnar nerve.
The FCU muscle has two heads: a humeral head and an ulnar head. The tendon of the FCU muscle can be seen and palpated beneath the skin immediately proximal to the wrist joint.
