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Any movement of the thumb and wrist causes the patient pain, inflammation and swelling. The presence of anomalous or variant muscles in the fourth compartment may result in chronic dorsal wrist pain, a condition known as the fourth compartment syndrome. [4] Intersection syndrome can be caused by direct trauma to the second extensor compartment.
The extensor retinaculum (dorsal carpal ligament, or posterior annular ligament) is a thickened portion of the antebrachial fascia that holds the tendons of the extensor muscles in place. [1] It is located on the back of the forearm , just proximal to the hand . [ 2 ]
Symptoms are pain and tenderness at the radial side of the wrist, fullness or thickening over the thumb side of the wrist, painful radial abduction of the thumb, and difficulty gripping with the affected side of the hand. [2] Pain is made worse by movement of the thumb and wrist, and may radiate to the thumb or the forearm. [2]
The abductor digiti minimi is the most variable hypothenar muscle, [4] and might be joined by accessory slips from the tendon of the flexor carpi ulnaris, the flexor retinaculum, the fascia of the distal forearm, or the tendon of the palmaris longus. Occasionally, the muscle is partially inserted onto the fifth metacarpal bone. [5]
The thenar eminence is the mound formed at the base of the thumb on the palm of the hand by the intrinsic group of muscles of the thumb. [1] The skin overlying this region is the area stimulated when trying to elicit a palmomental reflex.
The extensor indicis proprius usually runs and inserts onto the ulnar side of the extensor digitorum communis of the index finger. [4] The fifth compartment is occupied by the extensor digiti minimi, the extensor of the little finger. The extensor carpi ulnaris passes through the sixth compartment to insert to the base of the fifth metacarpal bone.