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Duke Orthopaedics
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Wheeless' Textbook of Orthopaedics

Extensor Carpi Radialis Longus   


- See: Forearm Extensors:

- Anatomy:
    - origin: lower 1/3 of lateral epicondyle & supracondylar ridge;
    - insertion: posterior surface of base of second metacarpal;
    - action: extends and abducts the hand at the wrist;
    - synergists: ECRB, ECU;
    - nerve supply: radial, C6 > C7;


- Discussion:
    - tunnel II: includes contains ECRL & ECRB ;
    - to palpate them, have the pt clench his fist;
    - osteophyte from 2nd & 3rd carpal metacarpal joint (capal boss) is just beneath ECRB & ECRL, and may cause tendonitis;

- Exam:
    - evaluated by asking the pt to make a fist and bring your wrist back;
    - palpate the tendons as the M.D. provides resistance;

- Tendon Transfers:
    - either ECRL or ECRB may be used for tendon transplants;
    - ECRL can be transferred  from its dorsal attachment to volar aspect of forearm and can function as
           substitute for FDP or as primary motor muscle for the opposition of the thumb;
    - it can be used as wrist flexor if other flexors have been used for transfer elsewhere;

- Avulsion of the ECRL
    - diff dx:
    - avulses from base of 2nd metacarpal occurs as result of forceful injury w/ hand in ulnar deviation;
    - there is pain around anatomic snuffbox near location that is painful
         w/ scaphoid fracture, however, palmar aspect of wrist is not painful



Excursion of prime wrist tendons.

Lateral extensor release for tennis elbow. A prospective long-term follow-up study.

Microscopic histopathology of chronic refractory lateral epicondylitis.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, December 12, 2011 4:06 pm