The APL tendon runs through the first extensor compartment with the EPB, and multiple slips of the APL insertion are common (up to 4 slips inserting on the trapezium, thenar fascia, and opponens pollicis). The APL and EPB together are involved in de Quervain's tenosynovitis at the first extensor compartment. APL also forms the radial boundary of the anatomical snuffbox with the EPB.
Thumb abduction and extension at the CMC joint; radial wrist deviation assistance
The multiple APL slip insertions into the trapezium, thenar fascia, and first metacarpal base have implications for de Quervain's surgery — separate subcompartments for APL and EPB slips require individual release. Post-surgical pillar pain over the radial styloid is the most common complication of first compartment release.
APL subcompartment tenosynovitis contributing to de Quervain's syndrome managed with compartment release including identification and release of all APL slip subcompartments.
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