Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
di Vora, T.
The course of the extensor pollicis longus tendon considering the different functional positions of the wrist and the first ray - an anatomical study
Humanmedizin; [ Diplomarbeit ] Medical University of Graz; 2021. pp. 55
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Hohenberger Gloria
- Lipnik Georg
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- Abstract:
- Introduction: The extensor tendons of the radiocarpal region are important landmarks during surgical procedures. The course of the extensor pollicis longus (EPL) tendon, which courses around the Lister tubercle in a radial-distal direction, plays a special role. The EPL tendon shows a high variability in terms of range of motion, anatomical variations and course. This variability is of high importance during clinical practice. The aim of the following anatomical study was to evaluate the course of the extensor pollicis longus tendon and its positional relationship to adjacent structures, taking various functional positions and the resulting clinical relevance into account. Material and Methods: Twenty upper extremities from ten adult human cadavers embalmed with Thiel’s method were used for this study. In a first study series, the functional positions which lead to the greatest possible extension of movement of the EPL tendon were defined. Here, the distance between the center of the first carpometacarpal joint (reference point [RP] 1) and the center of the EPL tendon and the interval from the tip of the radial styloid process (reference point [RP] 2) to the EPL tendon center were evaluated. In a second study series, the angle at which the EPL tendon wraps around Lister’s tubercle and courses across the extensor carpi radialis longus and brevis (ECRL and ECRB) was recorded and defined in all functional positions. In the third study series, the slippage of the EPL tendon was determined. Results: Range of movement: For the wrist in extension and thumb in opposition, the value for RP 1 was 19.62 mm and for RP 2 20.55 mm. With the wrist in flexion and thumb in extension, the mean distances to RP 1 and 2 were 15.14 mm and 10.55 mm, respectively. For the wrist in flexion and thumb in opposition, the values were 13.79 mm (RP 1) and 10.33 mm (RP 2). The values for the wrist in radialduction and thumb in extension were 15.90 mm for RP 1 and 14.94 mm for RP 2. For the wrist in ulnar induction and thumb in adduction the values were 14.64 mm for RP 1 and 17.12 mm for RP 2. Angle around Lister’s tubercle: The largest possible angle was achieved for the wrist in extension and thumb in abduction (mean: 46°) and the wrist in radialduction and thumb in abduction (55°). The smallest possible angle was achieved with the wrist in ulnarduction and thumb in adduction (13.5°) and the wrist in ulnarduction and thumb in opposition (14°). Tendon gliding: The value for the wrist in neutral position and thumb in opposition showed a distal tendon movement of 10.41 mm. The value for the wrist in extension and thumb in opposition showed a mean of 10.64 mm. For the wrist in radialduction and thumb in opposition the mean value was 10.41 mm. With the wrist in flexion and thumb in extension, the mean was -6.34 mm and for the wrist in ulnarduction and thumb in extension the mean value was -7.71 mm (negative values represent tendon gliding in a proximal direction). Conclusion: In summary, knowledge of the anatomical course of the extensor pollicis longus tendon and the possible extent of movement and resulting change in position is therefore an essential basis during diagnostics and surgical treatment of patients with complaints/injuries in the dorsoradial wrist region.