3/11/2023 0 Comments Extensor compartmentsImmediately superior to the antecubital fossa, the brachial artery branches into ulnar and radial arteries. It then becomes the brachial artery once it passes the lower edge of the teres minor muscle. As it traverses towards the upper extremity, it becomes the axillary artery at the lateral border of the first rib. The subclavian artery branches off from the aortic arch. Below is a description of the extensor tendon zones: Įxtensor tendon zones are a helpful way to identify the region where injuries to the extensor tendons occur in the hand and wrist. Independent small finger extension is accomplished by the extensor digiti minimi (EDM) muscle. Independent index finger extension can be carried out by the extensor indicis proprius (EIP) muscle. When referencing the dorsal aspect of the wrist, the EPB and EPL tendons create the medial and lateral borders of the anatomic snuffbox, respectively.Įxtension of the second (index finger), third (long finger), fourth (ring finger), and fifth (small finger) digits occurs via the extensor digitorum communis (EDC) muscles. Thumb extension is carried out by abductor pollicis longus (APL), extensor pollicis brevis (EPB), and extensor pollicis longus (EPL). Thus, in various clinical pathologies that may cause a dynamic imbalance between the radial-based extensors (ECRL and ECRB) versus the ulnar-based extensor (ECU), wrist extension will occur with simultaneous and involuntary radial/ulnar deviation. It does not store any personal data.To achieve neutral wrist extension movements, the extensor carpi radialis brevis (ECRB), extensor carpi radialis longus (ECRL), and the extensor carpi ulnaris (ECU) muscles act synergistically based on each muscle's insertion and dynamic function. The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. The cookie is used to store the user consent for the cookies in the category "Performance". This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other. The cookies is used to store the user consent for the cookies in the category "Necessary". The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". The cookie is used to store the user consent for the cookies in the category "Analytics". These cookies ensure basic functionalities and security features of the website, anonymously. Necessary cookies are absolutely essential for the website to function properly. This involves a transverse or longitudinal incision made and the tendon sheath split in the central aspect in a longitudinal direction, thus allowing the tunnel roof to form again as it heals but wider and with more space for the tendons to move.Ĭomplications from surgical decompression include failure to resolve, reduce range of movements in wrist or hand, neuroma formation, and nerve impingement. 2) may be used to exclude other diagnoses (such as CMC joint arthritis)Ĭonservative management of De Quervain’s tenosynovitis involves lifestyle advice (avoiding repetitive actions) and a wrist splint. Steroid injections will reduce swelling and relieve pain in most cases, and can be repeated several times if a good response is observed.įor those failing to respond to conservative management, surgical decompression of the extensor compartment can be performed under local or general anaesthetic. Figure 2 - A normal wrist X-ray, as seen in cases of De Quervain’s tenosynovitis Investigationsĭe Quervain’s tenosynovitis is a clinical diagnosis, with no investigations required.
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