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Muscles of the Forearm that Move the Hand and Fingers

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The muscles of the forearm that move the wrist, hand, and digits are numerous and diverse. They can be classified into two groups based on their location and function — the anterior and posterior compartment muscles.
Anterior Compartment
The anterior compartment muscles originate from the humerus. They primarily function as flexors and are also known as flexor muscles. They typically insert on the carpals, metacarpals, and phalanges. The superficial layer includes the flexor carpi radialis,...

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Biomechanical Testing of Murine Tendons

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Published on: October 15, 2019

Forearm Extensor Tendon Fractional Lengthening: An Anatomic Feasibility Study.

Alex Sarosi¹, Diala Burjak², Peter J Taub¹

¹Division of Plastic and Reconstructive Surgery, Mount Sinai Medical Center, New York, NY.

The Journal of Hand Surgery

|October 9, 2025

Summary

Fractional tendon lengthening (FL) is challenging in forearm extensors due to limited muscle-tendon overlap. Most extensor muscles have insufficient areas for safe FL, suggesting alternative methods are needed.

Keywords:

Cadaver extensor muscle feasibility study fractional lengthening tendon

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Area of Science:

Anatomy
Orthopedic Surgery
Biomechanics

Background:

Fractional tendon lengthening (FL) is a common flexor tendon surgical technique.
The feasibility of FL for forearm extensor muscles is not well-established.
Understanding extensor muscle-tendon anatomy is crucial for surgical planning.

Purpose of the Study:

To evaluate the anatomy of forearm extensor muscles.
To analyze the muscle-tendon overlap extent in extensors.
To identify safe zones for performing fractional tendon lengthening (FL).

Main Methods:

Dissection of nine adult cadaver forearms.
Definition and measurement of muscle-tendon overlap zones.
Calculation of the useful zone (UZ) for FL, excluding distal areas.

Main Results:

Significant variability in the useful zone (UZ) was observed across forearm extensor muscles.
Wrist extensors like extensor carpi ulnaris had larger UZs (5.1 cm) compared to extensor carpi radialis brevis (0.6 cm) and longus (0.1 cm).
Finger extensors showed varied UZs, with extensor pollicis longus (5 cm) and extensor digitorum communis (3.6 cm) having larger zones than extensor indicis proprius (1.7 cm).

Conclusions:

The available area for fractional tendon lengthening (FL) in forearm extensors is highly dependent on individual muscle anatomy and varies significantly.
Most forearm extensor muscles possess limited musculotendinous junction areas suitable for free lengthening.
Surgeons should consider alternative tendon lengthening techniques for extensor reconstruction due to anatomical limitations.