Extensor Tendon Injury Due to Repetitive Wrist Dorsiflexion: Morphological Study of Extensor Retinaculum and Extensor Tendon

Most etiological studies of extensor tendon injury were based on the normal anatomy of extensor tendon and extensor retinaculum of the wrist. Further understanding of the morphological changes of the extensor tendon and extensor retinaculum during wrist dorsiflexion might contribute to improved and more accurate understanding of the etiology. The morphology of the extensor tendon of the mid-finger and the fourth compartment of the wrist extensor retinaculum was studied by sonography, and the anatomy was studied in 15 extremities from 11 young male cadavers. Compared with anatomical images, ultrasonography provides similar morphological observations of the extensor retinaculum of the wrist and extensor tendon. Ultrasonography findings revealed that as the dorsiflexion angle changed, the extensor retinaculum of the wrist formed different shaped trochleas. The trochlea guides the rotation of the extensor tendon at the wrist, but it does not form a sharp corner with the extensor tendon; thus, the extensor tendon is not compressed. As the dorsiflexion angle increased from 0° to 60°, the length of the trochlea gradually decreases. The shortening of the trochlea length will lead to a smaller frictional contact area between the extensor tendon and the extensor retinaculum. Consequently, the friction is centralized. During wrist dorsiflexion, the extensor retinaculum provides a trochlea for the extensor tendon. Extensor tendon injury of repetitive wrist dorsiflexion might be caused by centralized friction at the small contact area.