Extensor indicis propriussyndrome secondary to an anomalous extensor indicis propriusmuscle belly. Extensor indicis proprius transfer can be a reliable option for correction of abduction deformity of the small finger, maintaining active abduction and full flexion and extension. The tendons of the EDC and EIP pass beneath the extensor retinaculum within synovial sheaths in the fourth dorsal compartment then diverge as they course distally, where they blend with the sagittal bands over the MCP . J Bone Joint Surg Am. The EMP originated from the distal third of the ulna and its tendon was inserted into the dorsal aponeurosis of the middle finger on both hands. Extensor indicis proprius transfer for rupture of the extensor pollicis longus tendon. [Extensor indicis proprius transfers for extensor pollicis longus ruptures secondary to rheumatoid arthritis]. Ozalp T, Ozdemir O, Coşkunol E, Erkan S, Calli IH. muscle of posterior (extensor) compartment of forearm; origin, dorsal surface of distal ulna and adjacent interosseous membrane; insertion, extensor expansion of index finger; action, independently extends the index finger and assists in extending hand at wrist joint; nerve supply, radial (posterior interosseous). The commonest and certainly the simplest donor tendon to transfer to EPL is the extensor indicis proprius tendon in such cases. It is located in the deep layer of the posterior compartment of the forearm and its tendon passes through the 4 th extensor compartment of the wrist.. Origin: Posterior surface of ulna and interosseous membrane. A First, mini-open carpal tunnle release (CTR) is performed through a 1.5 cm to 2 cm incision (arrow). [7] Refer to extensor digitorum communis for examination. By Georgi Georgiev. Pricing. Extends 2nd digit and helps to extend hand. Spontaneous rupture of extensor pollicis longus tendon: a case report/ ekstansor pollisis longus tendonunun spontan rupturu: vaka sunumu We found muscular variant of extensor indicis proprius (EIP) during a cadaver dissection while teaching medical anatomy students at Addis Ababa University Black lion Specialized and Teaching Hospital, 2018. Extensor indicis proprius (EIP) opponensplasty has been performed mainly in leprosy patients and in patients with combined median/ulnar nerve palsies (2-6). EXAMINATION The key role of the extensor indicis is to enable . (Note: extensor indicis proprius has the most distal muscle belly of the extensors). Extensor indicis proprius opponensplasty. The authors hypothesize that the brain's ability to immediately use extensor indicis proprius for thumb extension stems from the activation of preexisting synergistic cortical finger movement programs. The aberrant muscle is analogous to the extensor indicis with the insertion being the middle finger instead of the index finger. About This Quiz & Worksheet. The extensor indicis (EI) muscle is an accessory extensor of the 2 nd digit. Journal of Bone & Joint Surgery, British Volume, 72(5), 881-883. Rupture of the extensor pollicis longus (EPL) tendon at the wrist has been described after fracture of the distal radius at Lister's tubercle, in synovitis, tenosynovitis, or rheumatoid arthritis. Major Subject Heading (s) Minor Subject Heading (s) PreMedline Identifier: 18343296. YouTube. Pronunciation of the word(s) "Extensor Indicis Proprius".Subscribe to the Channel to stay updated with the latest terms that are added on a regular basis.Tha. The head to the second finger was found arising from extensor carpi radialis brevis, and another head supplied the third finger (Henle). Clinical significance in hand and reconstructive surgery. Results. Extensor indicis proprius muscle and its variants together with the extensor digitorum brevis manus muscle: a common classification. The commonest indication for EIP to EPL transfer is following attrition rupture of the EPL in the 3rd extensor compartment of the wrist associated with a distal radius fracture. Five patients underwent repair by a single surgeon between 2006 and 2012. The most commonly described technique in the literature is the transposition of the extensor indicis proprius (EIP) tendon to the thumb [8,9,10,11,12]. The tendons then diverge on the back of the hand, and are inserted into the middle and distal phalanges of the fingers in the following manner. Extensor indicis proprius muscle and its variants together with the extensor digitorum brevis manus muscle: a common classification. Opponensplasty using the extensor indicis proprius routed subcutaneously around the ulnar side of the forearm and across the palm to the extensor pollicis longus tendons in the region of the thumb metacarpophalangeal joint restored excellent thumb function in fifty-seven of sixty-five forearms: nineteen with low and thirteen with high median-nerve injuries and seventeen with high and fourteen . This video tutorial teaches you the anatomy of the extensor indicis muscle: origin, insertion, innervation and function. more distal muscle belly in comparison to the EDC. Innervation. Distally the tendon of the muscle merged with extensor expansion at metacarpophalangeal joint of third digit deep to the extensor digitorum tendon. However, the insertion on the radial side of the . The extensor indicis proprius and extensor digitorum communis tendon were reapproximated using 2-0 Ethibond sutures in a core Kessler type fashion, with a bolstering horizontal mattress suture, giving a total of 4 core strand repair to each tendon. We report a unique case of an anomalous extensor indicis proprius causing a painful snapping wrist. Extensor indicis exercises. Double tendons of the extensor indicis proprius was also reported. Variation in the extensor muscles of the hand is common. The extensor indicis originates in the lower back of the ulna, just beneath the extensor pollicis longus. Intraoperative examination revealed a disproportionately large muscle belly under the extensor retinaculum causing subluxation of the ring and small extensor tendons creating a painful . EDM (extensor digiti minimi): attaches to extensor expansion of little finger; Sixth compartment. Innervation: Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve. origin: posterior surface of the ulna (distal to extensor pollicis longus) Spontaneous attritional extensor tendon ruptures of the index finger due to carpal bone lesions are uncommon. Radial Motor Nerve Conduction Study, recording Extensor Indicis Proprius, stimulating Proximal to Spiral Groove This photograph illustrates the technique for performing a radial motor nerve conduction study, recording form the extensor indicis proprius (EIP) muscle. the sheaths lining these compartments extends from above the dorsal carpal ligament; those for the tendons of abductor pollicis longus, extensor brevis pollicis, extensores carpi radialis, and extensor carpi ulnaris stop immediately proximal to the bases of the metacarpal bones, while the sheaths for extensor communis digitorum, extensor indicis … Steven F. Viegas, A New Modification of Extensor Indicis Proprius Transfer to Extensor Pollicis Longus Using a Retinacular Pulley, Techniques in Hand and Upper Extremity Surgery, 10.1097/00130911-200312000-00004, 7, 4, (147-150), (2003). Extensor indicis proprius (EIP) is examined and tested with extensor digitorum communis (EDC) and extensor digiti minimi. The most common procedure for the treatment of irreparable ruptures of the extensor pollicis longus (EPL) tendon is the extensor indicis proprius (EIP) transfer. ABSTRACT. • Extensor digitorum communis and extensor indicis proprius are located in the forth dorsal/extensor compartment, Extensor digiti minimi is located in the fifth extensor compartment. Some fibers also stem from the adjacent interosseous membrane. Type of study/level of evidence [2] [5] [6] It is known that the extensor indicis proprius inserts to the index finger on the ulnar side of the extensor digitorum. Extensor expansion of 2nd digit. Traumatic and non-traumatic tendon lesions are common at the wrist and hand. Graft union to the bony base of the hypoplastic thumb was achieved in all the cases, and differing amounts of . The prevalence of the extensor indicis tendon and its variants: a systematic review and meta-analysis Kaissar Yammine . The EPL can rupture from attritional wear after distal… The extensor tendons of the fingers are the extensor digitorum communis (EDC), the extensor indicis proprius (EIP), and the EDQ. The lesion shows iso-indensity on T1 image (1a),while it shows hyperintense signal on T1WI with fat suppression(1b,1c) and T2WI with fat suppression(1d).On T2WI with . Acta Orthop Traumatol Turc, 41(1):48-52, 01 Jan 2007 Cited by: 4 articles | PMID: 17483636 Dong Hyun Lee *, Jae Hee Lee *, Ran Sook Woo, Dae Yong Song, Tai Kyung Baik, Hong Il Yoo. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV. The extensor indicis proprius muscle (EIPM) is considered a key muscle in the assessment of the level of the neurologic lesion causing any motor or sensory medio-cubital impairment of the hand. The extensor conimunis tendon to the little finger was used as the second transfer in the reoperated case, and in I patient the extensor carpi radialis longus tendon was transferred, because the indicis proprius tendon was too thin. The extensor indicis proprius and extensor digiti quinti, which run ulnar to their respective extensor digitorum com-munis (EDC) tendons and allow independent extension of the index and small fingers, must also be considered in an evaluation. It exists as a single tendon most of the time. This quiz/worksheet tool is designed to test what you know about all aspects of the extensor indicis proprius. While dissecting of right hand of unknown age male cadaver, proper tendons attaching to the indicis finger are present and anomalous muscle . The extensor indicis proprius does not show much variation. Department of Anatomy and Neurosciences, Eulji University School of Medicine, Daejeon, Korea. Extensor indicis is a narrow muscle that originates mainly from the ulna, arising from the posterior two-thirds of its distal surface, distal to extensor pollicis longus muscle. Extensor indicis proprius syndrome : A case report Author PATEL, M. R; MORADIA, V. J; BASSINI, L; LEI, B Departments of Orthopedics and Plastic Surgery, Methodist Hospital, Health Science Center, State University of New York, Brooklyn, NY, United States Division of Orthopedic Surgery, Department of Hand Surgery, Maimonides Medical Center, Brooklyn, NY, United States Staten Island University . 1) showed a mass in her left dorsal wrist, arising from the extensor indicis proprius tendon, and a partial tear in the left wrist triangular fibrocartilage disc. 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