The ECRB tendon runs in the second extensor compartment deep to ECRL, inserting onto the dorsal base of the third metacarpal. At the wrist the ECRB is the deeper, more ulnar radial wrist extensor and the primary driver of power grip wrist extension.
The ECRB is the muscle-tendon unit primarily degenerated in lateral epicondylitis (tennis elbow) at its humeral origin, but its wrist-level tendon pathology also contributes to dorsal wrist pain in heavy manual work. At the wrist level ECRB inserts centrally on the third metacarpal base, balanced between radial and ulnar deviation. ECRB transfer is used in finger extension restoration for radial nerve palsy.
Degenerative tendon changes in the ECRB at the second extensor compartment producing dorsal wrist pain with resisted wrist extension in neutral deviation, contributing to chronic wrist pain in manual workers.
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