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Despite its functional and clinical importance, little is known about its internal structure. Investigation of the ultrastructure of the human extensor carpi ulnaris (ECU) tendon was undertaken using plane polarized light microscopy and microcomputer tomography with 3D reconstruction. The study demonstrates that the tendon comprises fibre bundles (fascicles) approximately 0.1 mm in diameter that are arranged in a gradual spiral. The spiralling fibres make an angle of 8\u00ba to the longitudinal axis of the tendon. The spiral structure of the human ECU tendon has important biomechanical implications, allowing fascicular sliding during forearm rotation. 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