Abstract：Objective To describe the anatomical characteristics of the brachioradialis (BR) tendon insertion and explore the role of the insertion on the formation of radial styloid process fragment.Methods Fourteen fresh adult cadaver arms were selected from March to September in 2015. The general anatomical structure of the BR tendon and the location, shape of the BR insertion were observed, its length, width, area and the distance from insertion to the tip of styloid process were measured. Twenty-nine patients with distal radius fractures concurrent radial styloid process fragment were reviewed from July 2014 to April 2016. The anteroposterior radiographs of the wrists were retrospectively analyzed. The radius styloid process fragments were classified into 2 types: solitary and fragmented. The length of the styloid process and the length of the articular surface of the metaphyseal bone were measured. The fracture pattern was compared with the location of the BR insertion based on the cadaver measurements. The Results of the measured fragments were analyzed using statistical software of SPSS 17.0.Results The BR tendon had a firm attachment to the deep antebrachial fascia, and the aponeurosis of pronator quadratus and 2nd dorsal compartment. This fibrous connection was very stout. The distal end of BR tendon firmly inserted onto radial styloid process. The shape of insertion was like a water-drop, with the tip pointing to the proximal. The insertion was (18.80±3.67)mm long, (11.23±2.06)mm wide, and the area was (141.53±4.55)mm2. It was (26.59±3.76)mm away from the proximal end of the insertion to the tip of radius. In radiological study, there were 11 cases of the solitary type, the length of the styloid process fragment was (24.42±4.30) mm. There were 18 cases of the fragmented type, the total length of the styloid process fragment, metaphyseal fragment and articular surface fragment were (28.08±4.93) mm, (16.32±3.87) mm and (11.76±3.46) mm, respectively. Compared with specimen anatomical measurements, there was no significant difference between the length of the styloid process fragment and the distance between the proximal end of the insertion and the tip of radius styloid in solitary and fragmented types (t=1.345, 1.334, all P values＞0.05). In fragmented type, there was no significant difference between the length of metaphyseal fragment and the length of the BR insertion (t=1.839, P＞0.05).Conclusions The BR tendon is firmly attached to the radius styloid process, which is the anatomical basis of the metaphyseal fragment in distal radius fracture.
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