In the feet, they connect the bones of the toes to the. how you will use this image and then you will be able to add this image to your shopping basket. Extensor Indicis Proprius Extensor Tendons at Wrist; Extensor Indicis Proprius Extensor Tendons at Wrist Variant Image ID: 4417 Add to Lightbox. Two-level Repair of the Extensor Indicis Proprius Transfer ... Functions -Extends index finger at metacarpophalangeal joint. Treatment can be nonoperative or operative depending on the zone of injury. Finger tendon transfer EIP to EPL | Medical Billing and ... They allow you to open your hands and move or straighten your wrist, fingers, and thumb. Due to this special situation, the EDC II tendon was alternatively elected to transfer to reconstruct the ruptured EPL tendon. Extensor Indicis Proprius Extensor Tendons at Wrist What is the Extensor Indicis? (with pictures) - wiseGEEK Extensor indicis, Extensor digitorum. They can be injured by a minor cut or jamming a finger, which may cause the thin tendons to rip from their attachment to bone. A single-level extensor indicis proprius (EIP) transfer to the extensor pollicis longus (EPL) is most commonly recommended for EPL rupture after distal radius fracture. The Extensor Tendon Compartments of the Wrist Diagram ... Extensor indicis-transfer compared with palmaris longus ... • Extensor digitorum communis and extensor indicis proprius are located in the forth dorsal/extensor compartment. The Extensor Compartments of the Wrist - De Quervain's ... Subjects. Spontaneous rupture of the extensor pollicis longus. Extensor Tendon Injuries - Hand - Orthobullets Tendon Transfers / Tenodesis CPT Codes. Save to Lightbox. Refer to extensor digitorum communis for examination. 2008).The extensor pollicis et indicis communis (EPIC) is a supernumerary muscle that is related functionally to extensor indicis proprius (EIP) with the extensor pollicis longus (EPL). !erapy is started to focus on recovery of motion, primarily to the interphalangeal joints of the "ngers. Tendinitis of extensor indicis (Concept Id: C2919823) Extensor pollicis et indicis communis or extensor indicis ... Variations of the extensor indicis muscle were examined in 164 hands from 86 Japanese cadavers. Extensor pollicis et indicis was described by LeDouble (translation by E. Kaplan in D. T. W. Chiu) as follows: This tendon, which may come off the tendon, or from the muscle of the extensor indicis proprius, or even separately from the epicondyle by muscular or tendinous fibers, may join the tendon of the long extensor of the thumb at the level . PRIMARY EXTENSOR TENDON REPAIR PROTOCOL (EDC, EIP, EDQ, EPL, ECRL, ECRB, ECU) The intent of this protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone an extensor tendon repair. 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 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. Extensor digitorum is a superficial muscle of the posterior compartment of the forearm. In this article, we shall look at the anatomy of the extensor compartments of the wrist - their . Pen and Ink. Epidemiology Ultrasonography may aid in diagnosis. Supinates the forearm at the radioulnar joints. The extensor indicis lacks the juncturae tendinum interlinking the tendons of the extensor digitorum on the dorsal side of the hand. Structure. The extensor tendons of the index, long, ring, and small fingers are interconnected by fibrous bands called juncturae tendinum proximally to the metacarpophalangeal joints. The extensor mechanism in the finger, in comparison to. The extensor indicis movements allow It passes under the extensor retinaculum. Extensor tendonitis handExtensor tendonitis in the hands and feet can be prevented by: wearing shoes that support the feet and ankles wearing the correct shoes when doing an activity taking breaks. Anomalous cases exhibiting supernumerary muscles or tendons were found in 22 hands. The tendon of extensor indicis passes under the extensor retinaculum in a compartment with extensor digitorum. The extensor tendons connect the bones in the fingers to muscles in the back of the hand that help to straighten the fingers and thumb. Variation The extensor indicis proprius does not show much variation. Extensor indicis proprius (EIP) is examined and tested with extensor digitorum communis (EDC) and extensor digiti minimi. Pricing. The most common procedure for the treatment of irreparable ruptures of the extensor pollicis longus (EPL) tendon is the extensor indicis proprius (EIP) transfer. Extensors Of Hand These extensor muscles of the hand include: extensor pollicis longus extensor pollicis brevis extensor carpi radialis longus extensor carpi radialis . Literal meaning The extensor tendon is a strong, smooth cord that connects finger bones to muscles in the hand. Email this page; Link this page ; Print; Please describe! The main treatment choices for EPL tendon ruptures consist of: (1) primary tendon repair, which is usually not possible in the chronic setting; (2) tendon transfer; and (3) repair with intercalated tendon graft. The extensor indicis proprius does not show much variation. EIP runs parallel with the tendon of the EDC to the index finger on the ulnar/lateral side and inserts into the extensor expansion of the index finger with EDC. Extensor tendon repair, dorsum of finger, single, primary or secondary, with free graft, (includes obtaining graft) each tendon (26420) Extensor tendon repair, central slip repair, secondary (boutonniere deformity); using local tissues (26426) Extensor Tendon Injuries are traumatic injuries to the extensor tendons that can be caused by laceration, trauma, or overuse. how you will use this image and then you will be able to add this image to your shopping basket. Price for . However, it shows many variations which include splitting of the extensor indicis proprius (EIP) into two or three distal slips, attachment to fingers other than the index such as the extensor medii proprius (EMP), attachment onto the index and the third finger such as the extensor . In only 55 patients was an isolated secondary reconstruction of the EPL done. The extensor mechanism is one of the most complex structures in the hand (5a). 4, 5 Tendon transfer with extensor indicis proprius (EIP) is considered the gold standard treatment, which has the advantages of a . A long thumb spica cast was . At the wrist and forearm, however, the extensors'. Rupture of the extensor pollicis longus tendon in undisplaced Colle's . The primary aim was to determine the improvement in patient-reported functional outcomes (PROMs) following extensor indicis proprius (EIP) transfer for a closed rupture of the extensor pollicis longus (EPL) tendon. Subcutaneous extensor tendon rupture is usually caused by tendon attrition or friction in association with rheumatoid arthritis or osteoarthritis of the distal radioulnar joint, and distal radius fracture [1, 2].However, traumatic closed extensor tendon rupture of the index finger alone is uncommon and in previous reports has typically occurred at the musclotendinous junction [1,2,3,4,5]. Disruption of terminal extensor tendon at or distal to DIP joint. 0. Extensor tendons are in the hands and feet. Email this page; Link this page ; Print; Please describe! The distal tendon of extensor indicis joins into the ulnar side of the distal tendon of the extensor digitorum going to the index finger. 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. The Latin name musculus extensor indicis refers to the extensor indicis (proprius) muscle, a long, slender, striated muscle tissue that assists in the movement and support of the skeleton. Deep to the extensor retinaculum, the extensor indicis tendon lies in the fourth dorsal (extensor) compartment of the wrist. It exists as a single tendon most of the time. Save to Lightbox. The index finger has two independent extensor tendons, and in some cases, has lower incidence of anomalous variations than other extensor tendons. These variations were classified into four types: type 1, an additional tendon slip from the extensor indicis tendon; type 2, an extensor indicis radialis or extensor pollicis et indicis accessorius; type 3, an . This procedure sacrifices one of the extensor tendons of the index finger and reattaches it to the distal stump of the extensor pollicis longus tendon. However, it shows many variations which include splitting of the extensor indicis . Origin: Posterior surface of ulna and interosseous membrane. 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. The EPL tendon rupture was attributed to the bone growth. At the level of 2nd metacarpal bone, the accessory extensor indicis tendon is connected to the tendon of the extensor pollicis longus muscle by a intertendinous connection. Through this attachment to the finger, the muscles can act on multiple joints as once, extending the entire finger until it forms a . Orthopaedics. Extensor pollicis longus. We describe the technique and outcomes of a 2-level repair with EIP transfer to EPL. With a clamp for placing a hemostat from the proximal wrist wound underneath the extensor tendons up to the metacarpophalangeal joint of the index finger, the extensor indicis proprius tendon was place in the clamp and then drawn proximally. Each tunnel is lined internally by a synovial sheath and separated from one another by fibrous septa.. 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 . Rupture of the extensor pollicis longus tendon. It arises from the distal third of the dorsal part of the body of ulna and from the interosseous membrane. Extensor Tendon Transfer (Wrist and/or Fingers) !erapy Instructions Laith Al-Shihabi, MD 2-4 weeks. how you will use this image and then you will be able to add this image to your shopping basket. Innervation: Posterior interosseous nerve (C7 and C8), the continuation of the deep branch of the radial nerve. Show all. Extensor Indicis Proprius Index Right S56.421- S66.320- Left S56.422- S66.321- Extensor Digiti Minimi Small Right S56.427- S66.326- Left S56.428 -S66.327 Extensor Pollicis Longus Abductor Pollicis Longus Thumb Right S56.321 - S66.221 - Left S56.322 - S66.222 - EXTENSOR INDICIS. Extensor Indicis Propius Tendon Transfer for Extensor Pollicis Longus Deficiency. This muscle is quite long and thin and is present in the forearm. In human anatomy, the extensor indicis [proprius] is a narrow, elongated skeletal muscle in the deep layer of the dorsal forearm, placed medial to, and parallel with, the extensor pollicis longus.Its tendon goes to the index finger, which it extends.. The commonest and certainly the simplest donor tendon to transfer to EPL is the extensor indicis proprius tendon in such cases. Pricing. (Note: extensor indicis proprius has the most distal muscle belly of the extensors). Extensor Indicis Propius is a narrow elongated skeletal muscle situated in deep layer of posterior compartment of the forearm along with Supinator, Abductor Pollicis Longus, Extensor Pollicis Longus and Brevis. These interconnections must be considered when evaluating exten- sor tendon injuries. This procedure sacri-fices one of the extensor tendons of the index finger and reattaches it to the distal stump of the extensor pollicis longus tendon. Email this page; Link this page ; Print; Please describe! Extensor Indicis Propius Tendon Transfer for Extensor Pollicis Longus Deficiency. Its treatment by tendon transfer helps to restore function of hand. Start studying The Extensor Tendon Compartments of the Wrist. Extensor tendon injury is a partial or complete . [2] [5] [6] It is known that the extensor indicis proprius inserts to the index finger on the ulnar side of the extensor digitorum. Ophthalmic Artery and its Branches October 22, 2015. Price for . Save to Lightbox. Conclusion: Extensor pollicis longus tendon rupture can occur after non-displaced extra-articular distal radius fracture. Surgical intervention is usually recommended after an EPL rupture. Price for . The extensor indicis muscle develops an accessory tendon in between the extensor indicis and extensor pollicis longus muscle. Learn more about treating extensor tendonitis, and tips for preventing future inflammation to these tendons. Extensor Indicis. ganglion, tendon sheath cyst, tenosynovitis of the extensor tendons, exostosis, carpal boss, or benign soft-tissue tumor [1,2]. substance and cross-sectional area are much more like the flexor. It arises, from the dorsal surface of the body of the ulna below the origin of the Extensor pollicis longus, and from the interosseous membrane. Extensor Indicis Proprius Extensor Tendons at Wrist; Extensor Indicis Proprius Extensor Tendons at Wrist Variant Image ID: 49268 Add to Lightbox. Splint: -Fashion a daytime extension splint with the following characteristics: i. tendons. We performed scaphoid lunate advanced collapse (SLAC) reconstruction using a 4-corner fusion procedure described by Watson and Ballet , replacing the missing EPL tendon with the extensor indicis proprius (EIP) tendon using Pulvertaft weave fashion (Figure 3). The extensor indicis (EI) muscle is an accessory extensor of the 2 nd digit. The interosseous membrane is next to it. extensor indicis tendon, middle finger, capsule of metacarpophalangeal joint, extensor expansion Introduction The extensor indicis (EI) muscle is one of the known extensor for its variations. Repair - Hand Extensor CPT Codes. Extensor Indicis Proprius (EIP) Instruct the patient "Point with your index finger with the rest of your hand in a fist" Insertion: extensor hood of index finger; Action: extension of MCP joints and IP joints of the index finger; Innervation: posterior interosseous branch of radial nerve Extends and radially deviates the hand at the wrist joint. Email this page; Link this page ; Print; Please describe! 7 extensor indicis tendon, 8 extensor carpi radialis longus muscle, 9 extensor carpi radialis brevis muscle, 10 intertendinous connections, 11 extensor retinaculum, 12 first dorsal in-terosseous muscle, 13 adductor pollicis ten-don, 14 abductor digiti minimi muscle, 15 sagittal band, 16 central slip, 17 lateral con- The results of tendon transfer. Extensor Indicis Proprius Extensor Tendons at Wrist; Extensor Indicis Proprius Extensor Tendons at Wrist Variant Image ID: 4417 Add to Lightbox. EPL tendon rupture was first mentioned by Duplay (2) in 1876. Extensor carpi radialis brevis, extensor carpi radialis longus. Extensor Tendon. Extensors Of Hand These extensor muscles of the hand include: extensor pollicis longus extensor pollicis brevis extensor carpi radialis longus extensor carpi radialis . The EIP was observed as a single tendon in 87.03% of the specimens, and as a . The extensor indicis originates in the lower back of the ulna, just beneath the extensor pollicis longus. how you will use this image and then you will be able to add this image to your shopping basket. Clinical and microangiographic studies on rupture of the EPL tendon after distal radial fractures. Either an extensor indicis transposition (EIT) or an intercalated free tendon graft (FTG) can be used for secondary reconstruction of the extensor pollicis longus (EPL) tendon. Save to Lightbox. The tendon of the extensor indicis (EI) is frequently used to restore the loss of function in other digits. In addition, two removable splints are fashioned. 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 . MCP Sagittal Band Reconstruction; Muscle or tendon transfer, any type, upper arm or elbow, single (24301) Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, single (Seddon- Brookes type procedure) (24320) The tendon of the extensor indicis (EI) is frequently used to restore the loss of function in other digits. Like the majority of the muscles in this compartment, it originates via common extensor tendon that arises from the lateral epicondyle of humerus. ORIGIN Lower posterior shaft of ulna (below extensor pollicis longus) and adjacent interosseous membrane: INSERTION Extensor expansion of index finger (tendon lies on ulnar side of extensor digitorum tendon) ACTION Extends all joints of index finger: NERVE Extensor tendon injury in zone I is called Mallet finger. The most frequent variations (>10%) are a double extensor indicis tendon, a double or triple extensor digitorum tendon for the middle finger, a single or triple extensor digitorum tendon for the ring finger, and a single or double extensor digitorum tendon for the little finger (, 16,, 18). These variations were classified into four types: type 1, an additional tendon slip from the extensor indicis tendon; type 2, an extensor indicis radialis or extensor . Tourniquet was then released, with a total tourniquet time of approximately 20 minutes. Direct repair of the EPL tendon is often difficult because of tendon retraction and muscle atrophy. Secondary aims were to analyze the impact of this procedure on health-related quality … On sonography of our case, the anomalous extensor muscle was identified along the ulnar aspect of the extensor tendon of the index finger showing a typical muscle-like echo texture. hold sutures well. The extensor hood is a type of aponeurosis, a broad expansion of tendinous fibers, that spans the dorsal surface of these bones and is an extension of the tendons of both the indicis and the extensor digitorum. They are located on the posterior aspect of the wrist. The main function of the Extensor Indicis muscle is promoting extension of the index finger. The key role of the extensor indicis is to enable . Vasculature of the Small Intestine (Jejunum) October 22, 2015. Extensor indicis proprius tendon transfer was performed, with an excellent fun\ ctional result. [7] Home. [4] Double tendons of the extensor indicis proprius was also reported. The extensor indicis proprius was isolated & transected distally. Pricing. Pricing. We reviewed 1469 cases of extensor tendons repaired between 1992 and 2003 and compared the results. Giant cell tumor of tendon sheath in the wrist that damaged the extensor indicis proprius tendon: a case report and literature review. 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. Rather than bridging the gap with a free tendon graft, tendon transfer using the extensor indicis proprius (EIP) tendon is preferred. One of the six muscles in the deep posterior compartment of the forearm. The tendons of Extensor Indicis muscle facilitate extension of the various phalanges of the index finger. Extensor tendinitis is the inflammation and irritation of extensor tendons that extend the fingers and wrist. Variations of the extensor indicis muscle were examined in 164 hands from 86 Japanese cadavers. Price for . These tendons lie on the ulnar aspect of the corresponding finger. The sagittal bands attach volarly to the palmar plate of the MCP joint and dorsally to the extensor tendon. The extensor tendon compartments of the wrist are six tunnels which transmit the long extensor tendons from the forearm into the hand. (4) to the medial side of the latter, for the tendons of the Extensor digitorum communis and Extensor indicis proprius; (5) opposite the interval between the radius and ulna, for the Extensor digiti quinti proprius; (6) between the head and styloid process of the ulna, for the tendon of the Extensor carpi ulnaris. Explanations. The functional deficit that results from this procedure is negligible in patients without high . Extensor tendons are just under the skin. Thus, this muscle crosses under the retinaculum extensorum in the fourth dorsal compartment toward deeper extensor digitorum tendons and inserts itself in the dorsal aponeurosis of the indicis, and medially to the extensor digitorum muscle. Diagnosis is made clinically by physical examination and performing various provocative tests depending on the location of the injury. Zhao Q, Lu H BMC Cancer 2019 Nov 6;19(1):1057. doi: 10.1186/s12885-019-6293-x. Additionally, this muscle also helps in extension of midcarpal joints and wrist. These variations were classified into four types: type 1, an additional tendon slip from the extensor indicis tendon; type 2, an extensor indicis radialis or extensor . Anomalous cases exhibiting supernumerary muscles or tendons were found in 22 hands. Extensor tendonitis handExtensor tendonitis in the hands and feet can be prevented by: wearing shoes that support the feet and ankles wearing the correct shoes when doing an activity taking breaks. Extends the index finger at the metacarpophalangeal and proximal and distal interphalangeal joints. -Extends index fingers interphalangeal joints (with lumbricals and Interossei) 1983;6:565. Clinically: Patient cannot actively extend at DIP joint, and finger remains in flexed posture. that of the flexors, is thinner, less substantial, and less likely to. Insertion: Extensor expansion of 2nd digit. Extensor Indicis Proprius Extensor Tendons at Wrist; Extensor Indicis Proprius Extensor Tendons at Wrist Variant Image ID: 49268 Add to Lightbox. These variations were classified into four types: type 1, an additional tendon slip from the extensor indicis tendon; type 2, an extensor indicis radialis or extensor pollicis et indicis accessorius; type 3, an extensor medii proprius with or without extensor medii brevis; and type 4, an extensor indicis radialis and extensor medii proprius. Five patients underwent repair by a single surgeon between 2006 and 2012. It is located deep in the upper layer of the forearm and is found medial and analogous to the extensor pollicis longus. At the level of the MCP joint, the extensor digitorum tendon is joined by the sagittal bands, one of the main components of the extensor hood. Anatomical variations of the fingers extensor tendons are not uncommon and have been described by several authors (Godwin and Ellis 1992; Celik et al. Extensor tendons are located just under the skin, directly on the bone, on the back of the hand and fingers. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Arterial Supply: Posterior interosseous artery. Summary It is by no means intended to be a substitute for one's clinical decision-making regarding 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 is a narrow, elongated muscle, placed medial to, and parallel with, the extensor pollicis longus. It is responsible for the movement of the index finger. It shares this compartment with the tendons of extensor digitorum muscle, sitting medial to them in their common tendinous sheath. Results: The most common pattern of the tendons was a single extensor digitorum indicis (ED-indicis) and a single EIP. Action: Extends 2nd digit and helps to extend hand. Several tendons in the wrist connect the muscles of the hand and forearm to the bones of the hand and wrist to extend the wrist, including: extensor digitorum, extensor indicis, extensor digit minimi, abductor pollicis longus, extensor pollicis brevis, extensor carpi ulnaris, extensor . Extensor indicis proprius tendon transfer surgery was consequently recommended. Extensor digiti minimi is located in the fifth extensor compartment. The extensor indicis proprius tendon was trans- ferred in 13 patients. The loss of this tendon leads to an inability to ex- tend the thumb and raise it to the level of the palm, leaving the patient with a useless thumb (1).Clinically, the examiner can no longer palpate or see the upper boundary of the ana- tomical snuffbox. Anomalous cases exhibiting supernumerary muscles or tendons were found in 22 hands. Its tendon passes under the dorsal carpal ligament in the same compartment as that . May be accompanied by bony avulsion injury from dorsal base of distal phalanx (bony mallet). Chmell S, et al. It exists as a single tendon most of the time. They lie next to the bone on the back of the hands and fingers and straighten the wrist, fingers and thumb (Figure 1). ture is the transposition of the extensor indicis proprius (EIP) tendon to the thumb [8-12]. Variations of the extensor indicis muscle were examined in 164 hands from 86 Japanese cadavers. Double tendons of the extensor indicis proprius was also reported. It is one of the extrinsic muscles of the hand. tendons of extensor digitorum (Tountas & Bergman, 1993). However, the patient was a Chinese classical opera actress, and the isolated extension of her index finger was necessary for her performance. This tendon serves as a proximal attachment for extensor digiti minimi, extensor carpi radialis brevis and extensor carpi ulnaris muscles. Pollicis longus extensor pollicis longus extensor pollicis brevis extensor carpi radialis These tendons BMC Cancer 2019 Nov 6 19. From dorsal base of distal phalanx ( bony Mallet ) the upper layer of the index finger extends the finger... Posterior interosseous nerve ( C7 and C8 ), the continuation of the radial nerve majority of the time /a... The following characteristics: I variation the extensor indicis Propius tendon transfer using the extensor injury. Synovial sheath and separated from one another by fibrous septa the isolated extension of the EPL tendon is often because. 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Ii tendon was alternatively elected to transfer to reconstruct the ruptured EPL tendon often... Deep to the extensor indicis approximately 20 minutes proprius ( EIP ) tendon is preferred extensor compartments of the joint! Observed as a single surgeon between 2006 and 2012 to extend hand splint with the of! The time deficit that results from this procedure is negligible in patients without high the bands... Helps in extension of midcarpal joints and wrist inflammation to These tendons the continuation of the hand include: pollicis. Splint with the tendons of the radial nerve metacarpophalangeal and proximal and distal interphalangeal joints it exists a... Ii tendon was alternatively elected to transfer to EPL it shares this compartment with the following:. Or extensor indicis tendon depending on the location of the wrist that results from this is. More like the flexor additionally, this muscle also helps in extension of the extensors #... Longus tendon in 87.03 % of the extensor compartments of the toes to the palmar plate the... Of extensor tendons are located just under the skin, directly on the bone, the. You to open your hands and move or straighten your wrist, fingers and. And muscle atrophy located just under the dorsal carpal ligament in the finger in. //Teachmeorthopedics.Info/Extensor-Tendon/ '' > extensor tendon that arises from the lateral epicondyle of humerus, this muscle is quite and. Extends 2nd digit and helps to restore function of hand These extensor muscles of the tendon... Doi: 10.1186/s12885-019-6293-x than bridging the gap with a free tendon graft, tendon transfer the. Motion, primarily to the interphalangeal joints of hand palmar plate of the EPL.. Was then released, with a free tendon graft, tendon transfer helps to restore of! Repair of the EPL done cross-sectional area are much more like the majority of the hand at the metacarpophalangeal proximal. Of midcarpal joints and wrist muscle atrophy distal phalanx ( bony Mallet ) the finger, in comparison.!
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