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Extensor Carpi Radialis Longus Tendon

tendo musculi extensoris carpi radialis longi

The ECRL inserts on the second metacarpal base dorsal surface, making it a wrist extensor and radial deviator. It is an important donor tendon for transfers in radial nerve palsy reconstruction, providing the force for finger extension reconstruction alongside the PT-to-ECRB transfer for wrist extension. Unlike ECRB which inserts on the third metacarpal for pure extension, ECRL's second metacarpal insertion adds radial deviation.

Region: Hand & Wrist

Biomechanics

Function & Actions

Wrist extension and radial deviation — the more radial of the two wrist extensors; synergist with FCU during radial deviation

Clinical Relevance

Clinical Notes

In radial nerve palsy, PT-to-ECRB (pronator teres to ECRB) restores wrist extension, and ECRL is redirected as a donor for finger extension reconstruction. Riordan's transfer uses ECRL for EDC extension restoration in low radial nerve palsy. The ECRL is palpable at the dorsal radial wrist lateral to the EPL during resisted wrist extension and radial deviation.

Pathology

Common Injuries & Conditions

Tendon Transfer in Radial Palsy

ECRL used as donor tendon for finger extension reconstruction in radial nerve palsy alongside PT-to-ECRB transfer for wrist extension.