The Prevalence of the Extensor Digitorum Communis Tendon and its Insertion Variants: A Systematic Review and Meta-Analysis

摘要

The tendons of the Extensor Digitorum Communis (EDC) are frequently injured in hand trauma. Dislocation and spontaneous rupture can also occur during the course of wrist osteoarthritis and rheumatoid arthritis. The EDC exhibits many variations including splitting of its individual slips to the medial four fingers or their absence. The aim of this systematic review is to assemble evidence about the prevalence of the EDC and its variants on the dorsum of the hand. Twenty-four cadaveric studies met the inclusion criteria, providing data from a total of 2,005 hands. Meta-analysis yielded the following results: (a) for EDC-II (Index), the pooled prevalence estimates (PPEs) were 99.8, 98, 1.8, and 0.2% for the total, single, double, and triple slips, respectively; (b) for EDC-III (Middle), the PPEs were 100, 67.7, 24.2, 6, and 0.42% for the total, single, double, triple, and quadruple slips, respectively; (c) for EDC-IV (Ring), the PPEs were 100, 58.6, 29.1, 7.1, and 1.3% for the total, single, double, triple, and quadruple slips, respectively; (d) for EDC-V (Little), the PPEs were 63.2, 58.5, 10.4, 0.94, and 25% for the total, single, double, triple, and common 4th-5th slips, respectively. There were no significant differences in relation to hand side. Many EDC slip variants demonstrated some interaction with ancestry. A sound knowledge of EDC variants and their prevalences is paramount for assessing and treating hand injuries and disorders. (C) 2014 Wiley Periodicals, Inc.