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FCR tendon !

The flexor carpi radialis tendon runs on the thumb side of the front of the wrist; it bends the wrist and guides surgeons to the radius.

Official name: Flexor carpi radialis tendon

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What it is

A cord-like tendon on the thumb side of the front of the wrist.

What it does

Bends the wrist; surgeons use it as a landmark to reach the radius.

Key facts

Attaches
In its own tunnel through the groove of the trapezium, outside the carpal tunnel proper, to the base of the 2nd (and 3rd) metacarpal
Function
Wrist flexion and radial deviation; the radial pulse is felt just lateral to it at the wrist; approach to distal radius fractures runs along it
Tight in
Wrist extension with ulnar deviation

Relations

Course
The tendon forms in mid-forearm, runs down in front of the radius and passes through a groove in the trapezium in its own tunnel to the base of the second metacarpal
Lateral
Radial artery with its veins, then the brachioradialis tendon
Medial
Palmar cutaneous branch and, a little deeper, the median nerve; then the palmaris longus tendon
Deep
FPL tendon and the pronator quadratus over the distal radius
Superficial
Antebrachial fascia and skin

How to find it

With the wrist flexed and tilted toward the thumb against resistance, it is the most prominent tendon on the radial side of the front of the wrist; the radial pulse is felt just on its radial side.

Examination

  • Resisted wrist flexion with radial deviation: pain over the tendon near the trapezium suggests FCR tendinitis

On imaging

Ultrasound shows fluid around it in tenosynovitis and its relation to a trapezial spur; MRI shows tendinosis where it passes the trapezium.

Clinical notes

  • Used as a graft or interposition material in basal thumb joint arthroplasty
  • A donor for tendon transfer in radial nerve palsy, to restore finger extension
  • Arthritis of the scaphotrapeziotrapezoid joint can fray it in its tunnel

Test yourself

Think of the answer, then tap the question to see it.

Where does the FCR tendon run and insert?

In its own tunnel through the groove of the trapezium, outside the carpal tunnel proper, to the base of the 2nd (and 3rd) metacarpal.

Which surgical approach to the distal radius uses the FCR tendon?

The volar (modified Henry) approach, through the floor of its sheath, with the radial artery kept radially.

Which nerve branch runs just ulnar to the FCR tendon at the wrist?

The palmar cutaneous branch of the median nerve, at risk in incisions there.

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Educational information, not medical advice. For any symptom, see a health professional.

Its names

Official Latin (TA2)
tendo musculi flexoris radialis carpi TA2 2481
Official Spanish (DeCS)
Tendón del músculo flexor radial del carpo
English (TA2)
Flexor carpi radialis tendon

Sources: Terminologia Anatomica (TA2); Anatomy, Shoulder and Upper Limb, Forearm Muscles; Anatomy, Shoulder and Upper Limb, Forearm Compartments.

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Representative model, for educational purposes only.

FCR tendon highlighted on the Durgical 3D model