Purpose
To identify the unique anatomical characteristic of the extensor carpi radialis brevis
(ECRB) origin and points of differentiation from other extensors and to clarify the
specific relationship of the ECRB to the underlying structures.
Methods
We studied the origin of each extensor macroscopically for its muscular and tendinous
parts; to identify the relationship between the ECRB origin and the deeper structures,
we also examined the attachment of the joint capsule under the ECRB origin.
Results
The ECRB simply originated as a tendon without any muscle, whereas other extensors
originated as a mixture of tendon and muscle. At the anterior part of the ECRB origin,
the thin attachment of the joint capsule (average width, 3.3 mm) lay deep to the ECRB
and was distinct. However, at the posterodistal portion, the joint capsule, annular
ligament, and supinator were intermingled and originated as a single wide sheet from
the humerus (average width, 10.7 mm).
Conclusions
The anterior part of the ECRB origin was delicate, because the ECRB origin was purely
tendinous, and the attachment of the articular capsule was thin compared with that
of the posterodistal attachment. This thin attachment could be an initial factor leading
to the development of lateral epicondylitis.
Clinical relevance
The results of the current study may enhance magnetic resonance imaging understanding
and may help clarify the etiology of the lateral epicondylitis.
Key words
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References
- Tennis elbow.J Bone Joint Surg Am. 1973; 55: 1183-1187
- Surgical treatment of tennis elbow; a follow-up study.J Bone Joint Surg Am. 1965; 47: 1533-1536
- Radiocapitellar cartilage injuries associated with tennis elbow syndrome.J Hand Surg Am. 2012; 37: 748-754
- Symptomatic, lateral synovial fringe (plica) of the elbow joint.Arthroscopy. 1988; 4: 112-116
- Tennis elbow. The surgical treatment of lateral epicondylitis.J Bone Joint Surg Am. 1979; 61: 832-839
- Which morphologies of synovial folds result from degeneration and/or aging of the radiohumeral joint: an anatomic study with cadavers and embryos.J Shoulder Elbow Surg. 2001; 10: 169-181
- The synovial fold of the humeroradial joint: anatomical and histological features, and clinical relevance in lateral epicondylalgia of the elbow.Surg Radiol Anat. 2002; 24: 302-307
- Anatomical study of arthroscopic surgery for lateral epicondylitis.Hand Surg. 2008; 13: 85-91
- A method for quick decalcification [in undetermined language].Zentralbl Allg Pathol. 1952; 89: 252-254
- Anatomic factors related to the cause of tennis elbow.J Bone Joint Surg Am. 2007; 89: 1955-1963
- Lateral tennis elbow: “Is there any science out there?”.J Shoulder Elbow Surg. 1999; 8: 481-491
- Anatomical study of the proximal origin of hamstring muscles.J Orthop Sci. 2012; 17: 614-618
- Arthroscopic classification and treatment of lateral epicondylitis: two-year clinical results.J Shoulder Elbow Surg. 2000; 9: 475-482
- Snapping plicae associated with radiocapitellar chondromalacia.Arthroscopy. 2001; 17: 491-495
- Bony changes at the lateral epicondyle of possible significance in tennis elbow syndrome.J Shoulder Elbow Surg. 2001; 10: 158-163
- Arthroscopic treatment of lateral epicondylitis: clinical and cadaveric studies.Clin Orthop Relat Res. 2005; 439: 123-128
- Arthroscopic, macroscopic, and microscopic anatomy of the synovial fold of the elbow joint in correlation with the common extensor origin.Arthroscopy. 2008; 24: 34-38
- Molecular composition and pathology of entheses on the medial and lateral epicondyles of the humerus: a structural basis for epicondylitis.Ann Rheum Dis. 2004; 63: 1015-1021
- Reply to: “The superior capsule of the shoulder joint complements the insertion of the rotator cuff”.J Shoulder Elbow Surg. 2013; 22 (e20-e21)
- The superior capsule of the shoulder joint complements the insertion of the rotator cuff.J Shoulder Elbow Surg. 2012; 21: 867-872
- Location and initiation of degenerative rotator cuff tears: an analysis of three hundred and sixty shoulders.J Bone Joint Surg Am. 2010; 92: 1088-1096
- Lateral elbow tendinopathy: correlation of ultrasound findings with pain and functional disability.Am J Sports Med. 2010; 38: 1209-1214
- Magnetic resonance imaging findings of refractory tennis elbows and their relationship to surgical treatment.J Shoulder Elbow Surg. 2005; 14: 172-177
Article info
Publication history
Accepted:
November 20,
2013
Received:
September 4,
2013
Footnotes
This study was partly supported by Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports (C) (No. 24791525).
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
