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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 ]
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.
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]
Non-surgical treatment methods include anti-inflammatory drugs. The wrist may be immobilized in order to prevent further use and inflammation. When surgery is needed, the flexor retinaculum is either completely severed or lengthened. [5] Surgery to divide the flexor retinaculum is the most common procedure.
Capsular or extensor retinaculum plication. This surgical technique aims to improve DRUJ stability by shortening the joint capsule or the extensor retinaculum. It is mostly used for minor DRUJ instability and is less invasive compared to a complete RUL reconstruction. [14] [15] Shortening of the ulnar bone.
The flexor retinaculum is a strong, fibrous band that attaches to the pisiform and the hamulus of the hamate. The proximal boundary is the distal wrist skin crease, and the distal boundary is approximated by a line known as Kaplan's cardinal line. [14]
Extensor tendons pass through the extensor retinaculum at wrist joint in 6 synovial sheaths, also referred to compartments. [3] The supinator and the anconeus are the two extensor muscles in the posterior compartment of the forearm that do not pass through wrist extensor compartments. [3]
A retinaculum (pl.: retinacula) is a band of thickened deep fascia around tendons that holds them in place. [1] It is not part of any muscle. Its function is mostly to stabilize a tendon. The term retinaculum is Neo-Latin, [2] derived from the Latin verb retinere (to retain). Specific retinacula include: In the wrist: Flexor retinaculum of the hand