Both muscular origins are from within the deep extensor compartment and are innervated by the posterior interosseous nerve. The first dorsal compartment contains the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons ( Fig. (Copyright: Leversedge FJ, Goldfarb CA, Boyer MI. Appreciation for anatomic variation compels the clinician to query the diagnostic dilemmas-unexplained clinical findings not supported by “normal” anatomy-and to recognize the implications of such variations, such as the radiologist’s reading of “longitudinal tearing” of the abductor pollicis longus tendon in the presence of multiple tendon slips as opposed to a single tendon, and the influences of such variations on postinjury rehabilitation programs.Ĭomprehension of anatomy about the wrist enhances our abilities as clinicians and as surgeons, providing a foundation on which we are able to accurately evaluate and treat disorders of the wrist. Variations in musculotendinous anatomy are not uncommon and should be considered during the diagnostic evaluation of patients and during surgical exposure. Disorders of the musculotendinous system, such as tendinopathy and deficit due to trauma, may affect wrist function however, pathologic conditions of the wrist may influence musculotendinous function, such as tendon rupture in the rheumatoid patient with caput ulnae syndrome. At the wrist, musculotendinous anatomy involves motor units acting directly on the wrist and those that cross or originate at the wrist to act indirectly on the radiocarpal and distal radioulnar joints. Similar to art, anatomy must be understood to appreciate its beauty, but it must be appreciated to understand its intricacies and variations. The clinical evaluation and treatment of conditions afflicting the wrist are assisted greatly through a detailed knowledge of local and regional anatomy. Boyer, MD, and their collaborative efforts in creating the anatomic dissections used in this chapter. ∗ The author wishes to recognize the contributions of Charles A.
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