The EDM tendon in the fifth extensor compartment provides independent little finger extension (like the EI for the index). It typically has two tendon slips at the MCP level. The fifth compartment ECU groove and the EDM compartment are the two ulnar extensor compartments at the wrist. EDM tenosynovitis in the fifth compartment produces ulnar dorsal wrist pain distinct from ECU pathology in the sixth compartment.
Independent little finger MCP extension; the most ulnar dorsal wrist tendon
The EDM is a less frequently used tendon transfer donor but provides the property of independent little finger extension in ring avulsion injuries or intrinsic weakness affecting the little finger specifically. Fifth compartment tenosynovitis from inflammatory arthritis produces ulnar dorsal wrist swelling that may rupture the EDM and EDC tendons — the caput ulnae syndrome of rheumatoid arthritis.
Rheumatoid dorsal tenosynovitis eroding through the EDM and EDC tendons from the ulnar head producing successive ulnar finger extensor tendon ruptures managed with synovectomy and tendon reconstruction.
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