The ECRL tendon passes through the second extensor compartment alongside the ECRB, inserting onto the dorsal base of the second metacarpal. At the wrist level the ECRL is the more radial and superficial of the two radial wrist extensors.
The ECRL is the primary wrist extensor used in precision grip and keyboard work, making it a common site of repetitive strain. It can be distinguished from ECRB by resisted wrist extension with radial deviation (ECRL) versus neutral deviation (ECRB). The ECRL is the primary wrist extensor transfer for wrist drop rehabilitation. Its proximal muscle belly origin from the lateral supracondylar ridge makes it the brachioradialis companion.
Degenerative tendinopathy of the ECRL at its wrist level producing dorsoradial wrist pain with grip and wrist extension, managed by eccentric loading and wrist brace in radial deviation.
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