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The Role of the Extensor Digitorum Communis Muscle in Lateral EpicondylitisFrom the Royal Melbourne Hospital, Parkville, and the Northern Hospital, Melbourne, Australia Correspondence: Dr Sian M Fairbank, Surgical Registrar, The Royal Melbourne Hospital Parkville, Australia 3050. E-mail: sianmf{at}mail.optusnet.com.au A common finding in tennis elbow is pain in the region of the lateral epicondyle during resisted extension of the middle finger (Maudsleys test). We hypothesized that the pain is due to disease in the extensor digitorum communis muscle, rather than to compression of the radial nerve or disease within extensor carpi radialis brevis. Thirteen human forearm specimens were examined. It was found that the extensor digitorum communis was separable into four parts. The part to the middle finger originated from the lateral epicondyle, but the muscle slips to the other fingers originated more distally. Pain ratings were measured in ten patients diagnosed with lateral epicondylitis during isometric finger and wrist extension tests. The results confirmed the high prevalence of a positive Maudsleys test in lateral epicondylitis, and also that the patients with tenderness at the site of origin of the extensor digitorum communis slip to the middle finger had the greatest pain during middle finger extension. These anatomical and clinical findings clarify the anatomy of extensor digitorum communis, and suggest that this muscle forms the basis for the Maudsleys test. The muscle may play a greater role in tennis elbow than previously appreciated.
Journal of Hand Surgery (British and European Volume), Vol. 27, No. 5,
405-409 (2002) |
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