Pronator Radii Tcrcs 271 



Dupuytren's contraction. Sometimes, as the result of pressure, 

 and especially in gouty men, the bands of the palmar fascia descending 

 to the ring and little 

 fingers become perma- 

 nently shortened, so that 

 those fingers are rigidly 

 bent into the palm, the 

 flexor tendons and the 

 joints being unaffected. 

 Subcutaneous division of 

 the contracted bands sets 

 the fingers free, but relapse 

 is apt to occur. The ad- 

 jacent woodcut, from Fergusson, shows that the skin also may be im- 

 plicated in the contraction. 



The supinator longus arises from the upper two-thirds of the ex- 

 ternal condylar ridge of the humerus, and is inserted into the base of 

 the styloid process of the radius. Its chief action is to flex the fore- 

 arm ; as regards supination, all that it can do is to evert the pronated 

 fore-arm until the thumb points upwards. Its nerve-supply is from 

 the musculo-spiral. 



Relations. Just above its insertion it is overlaid by the tendons of 

 the extensors ossis and primi. It overlaps the brachialis anticus ; the 

 origin of the radial extensors of the wrist ; and the insertions of the 

 supinator brevis and pronator teres. Along its inner aspect are the 

 musculo-spiral and radial nerves, the anterior part of the superior pro- 

 funda, and the radial artery and its recurrent branch. In the upper 

 half of the fore-arm its fleshy, anterior border has to be everted in order 

 to expose the radial artery. 



The pronator radii teres arises from the region of the internal 

 condyle of the humerus, and, by a small deep head, from the adjacent 

 part of the coronoid process of the ulna ; between these heads the 

 median nerve enters the fore-arm. The insertion is into the middle of 

 the outer surface of the radius. It is supplied by the median nerve. 



Relations. Superficial to it at its insertion are the supinator longus 

 and the radial nerve and artery. Its origin overlaps the brachialis 

 anticus, the anterior ulnar recurrent artery intervening. It rests on the 

 origin of the flexor sublimis digitorum. Along its ulnar border slopes 

 the flexor carpi radialis ; its outer border limits the triangle at the bend 

 of the elbow, and, therefore, is close to the inner side of the brachial 

 artery and its division into the radial and ulnar. The ulnar artery 

 passes beneath it, being separated there from the median nerve by the 

 deep head of the muscle. 



The flexor carpi radialis arises from the inner condyle ; it ends 

 in a long tendon which passes through a separate compartment in 

 the anterior annular ligament, and through the groove in the trapezium, 



