Extensor carpi radialis brevis origin,nerve supply and its role in lateral epicondylitis |
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Authors: | Soubhagya R Nayak Lakshmi Ramanathan Ashwin Krishnamurthy Latha V Prabhu Sampath Madhyastha Bhagath Kumar Potu Anu Vinod Ranade |
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Institution: | (1) Department of Anatomy, Centre for Basic Sciences, Kasturba Medical College, Manipal University, Bejai, Mangalore, 575004, Karnataka, India;(2) Department of Anatomy, Chettinad Hospital and Research Institute, Rajiv Gandhi Salai, Kanchipuram Dist, Kelambakkam, 603103, TamilNadu, India;(3) Department of Anatomy, Centre for Basic Sciences, Kasturba Medical College, Manipal University, Manipal, Karnataka, India;(4) Department of Anatomy, Gulf Medical University, P.O Box 4184, Ajman, United Arab Emirates |
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Abstract: | Lateral epicondylitis (LE) or tennis elbow has been the subject of concern during the last 60 years, but the pathogenesis
of the LE remains unclear. The LE can be due to the tendinogenic, articular or neurogenic reasons. Numerous theories have
been put fourth in the recent past, out of which one of the most popular theories is that the condition results from repeated
contraction of the wrist extensor muscles, especially the extensor carpi radialis brevis (ECRB) which may compress the posterior
branch of the radial nerve (PBRN) at the elbow during pronation. We studied 72 upper limbs (36 formalin-fixed cadaver) for
the origin, nerve supply and the course of PBRN in relation to the ECRB as one of the goal for the present study. The possible
presence of an arch of the ECRB around the PBRN was also observed and recorded. The nerve to ECRB was a branch from the radial
nerve in 11 cases (15.2%); from the PBRN in 36 cases (50%) and from the superficial branch of the radial nerve in 25 cases
(34.7%), respectively. The ECRB had a tendinous arch in 21 cases (29.1%); a muscular arch in 8 (11.1%) cases and the arch
was absent in 43 cases (59.7%). When the ECRB had a tendinous or muscular arch around the PBRN, it may compress the same and
this condition may worsen during the repeated supination and pronation as observed in tennis and cricket players. The presence
of such tendinous or muscular arch should be considered by orthopedicians and neurosurgeons, while releasing the PBRN during
LE surgery. |
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