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Lister Tubercle

tuberculum dorsale radii

Lister tubercle (dorsal radial tubercle) is a bony prominence on the dorsal surface of the distal radius, in the midline, at approximately the level of the wrist joint. The extensor pollicis longus tendon uses this tubercle as a pulley, changing direction around its radial side to reach the thumb. It is easily palpated on the dorsal wrist and serves as the central landmark for dorsal wrist approaches.

Region: Hand & Wrist

Clinical Relevance

Clinical Notes

Lister tubercle is a critical landmark in wrist surgery and interventional procedures. The radiocarpal joint injection is performed just ulnar to Lister tubercle between the extensor digitorum communis and EPL tendons. EPL tendon rupture, occurring weeks after distal radius fracture, is caused by ischaemia and attrition of the tendon in its groove around the tubercle. In dorsal wrist arthroscopy, the third portal is placed just ulnar to Lister tubercle. SLAC wrist reconstruction and wrist fusion approaches also use this tubercle as a starting point.

Pathology

Common Injuries & Conditions

EPL Tendon Rupture

Delayed rupture of the extensor pollicis longus tendon in its groove around Lister tubercle, occurring 4-12 weeks after distal radius fracture from attrition on fracture callus or ischaemia from haematoma, produces sudden loss of thumb IP extension requiring immediate EI to EPL tendon transfer.

Third Compartment Tenosynovitis

Inflammatory tenosynovitis of the EPL tendon in the third extensor compartment around Lister tubercle produces dorsal radial wrist pain and crepitus with thumb extension, managed with splinting, injection, and tenosynovectomy for refractory cases.