The brachioradialis tendon inserts on the distal end of the radius just proximal to the radial styloid process, after the long fleshy belly of the brachioradialis muscle tapers in the distal forearm. The tendon is flat and relatively broad, and is the most lateral structure in the distal forearm, serving as a reliable anatomical landmark for the radial artery and superficial radial nerve.
| Muscle | |
|---|---|
| Attachment | Lateral surface of the distal radius just proximal to the radial styloid process |
Flexes the elbow, most strongly with the forearm in mid-pronation
The brachioradialis tendon, the most distal insertion of any elbow flexor, is a key landmark during distal radius fracture surgery and radial artery harvesting for coronary bypass: the artery runs medial to the tendon throughout the distal forearm. Its pull on the radial styloid is a deforming force in distal radius fractures, and it is often released from the styloid during volar plating. The APL and EPB tendons of the first dorsal compartment cross superficial to its insertion. The tendon is also transferred in reconstructive surgery for radial nerve palsy, rerouted to restore wrist or finger extension function. Tendinopathy at the radial styloid insertion is uncommon but can mimic de Quervain tenosynovitis.
Insertional tendinopathy at the radial styloid producing localised tenderness and pain with resisted elbow flexion in mid-pronation, managed conservatively with activity modification, physiotherapy, and occasionally corticosteroid injection.
Rare avulsion fracture of the radial styloid by the brachioradialis during violent elbow flexion, producing radial-sided wrist pain and tenderness; treated with fixation of larger fragments or excision and reattachment for smaller avulsions.
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