Accessory Heads of Forearm Flexors and Flexor Carpi Radialis Brevis: A Cadaveric Study with Clinical Significance (original) (raw)
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" A Study on Accessory Muscle of Flexor Compartment of Forearm "
During routine anatomical dissections, the presence of the accessory muscle in the flexor aspect of the forearm was noted. This accessory muscle presents an intimate relationship with the median nerve. This variation may be clinically important because symptoms of median nerve compression arising from similar variations are often confused with more common causes, such as radiculopathy and carpal tunnel syndrome. The muscular variations of upper limb are common. Methods: During routine dissection classes to undergraduate medical students, we came across additional muscle bellies in the flexor compartment of forearm arising from the under surface of flexor digitorum superficialis(FDS) and inserted to flexor pollicis longus (FPL) separately. Origin, insertion, nerve supply and its relation was noted. Results: presence of accessory muscles(Ganzters muscle) was noted.
Accessory Head of Flexor Digitorum Profundus: A Case Study
International Journal of Anatomy and Research, 2016
In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name, accessory head of flexor digitorum profundus and accessory head of flexor pollicis longus. The less frequently observed was accessory head of flexor digitorum profundus and hence this study was conducted. Materials and Methods: 25 formalin-fixed cadavers (50 upper limbs) were dissected as per the standard methods. Detailed study of origin, insertion of accessory heads of flexor digitorum profundus muscle and various other parameters were recorded. Results: Two out of fifty upper limbs (4%) were observed to have accessory head of flexor digitorum profundus. Origin and insertion of each case was different but all got its innervation through direct branch from Median nerve. Conclusion: Accessory heads of flexor digitorum profundus may cause various syndromes and its knowledge of existence is important for surgeons operating in forearm. KEY WORDS: Accessory head of flexor digitorum profundus, pronator teres, coronoid process of ulna, median nerve, ulnar artery, carpal tunnel syndrome.
Anatomical Study of the Accessory Heads of the Deep Flexor Muscles of the Forearm (Gantzer Muscles)
International Journal of Anatomy and Research, 2016
Background and Objectives: Proper knowledge of muscular variations is essential not only for anatomists but also for surgeons. Forearm flexors are known to exhibit such variations. Such anomalous muscle bellies should be kept in mind while approaching the forearm for FDS tendon transfer and other surgical procedures around it. Materials and Methods: The present study was consisted of 20 upper limbs. The dissections were carried out in all the limbs on the right and left sides. All the muscles were examined for their presence, position, and their attachments, and then the superficial compartment was cut to expose the deep compartment muscles; If any abnormality was found in the muscular pattern, it was recorded in detail and photographed. Result: The incidence of the Gantzer muscle was detected in 9 (45%) of the 20 dissected forearms, three of these cases presented duplicated muscle bellies. It originated from the medial epicondyle in 8(88.9%), and from the coronoid process of ulna in 1(11.1%) of cases. It was inserted in the flexor pollicis lungus in 9(75%) and in the flexor digitorum profundus in 3 (25%). In this study the Gantzer muscle was innervated by the anterior interosseous nerve which crosses posterior to the muscle in all cases. The muscle was 11.022 cm in length and 0.55 cm in width. Conclusion: This study will supplement our knowledge on the possible variations of the muscles in this region, which would be useful for hand surgeons.
Surgical and Radiologic Anatomy, 2023
Purpose Knowledge of the unusual arrangement of the flexor pollicis longus (FPL) muscle is important as the variable tendon may be a rare cause of carpal tunnel syndrome. Methods During a routine dissection at the Department of Anatomy, an unusual formation of the FPL muscle was observed in a formalin embalmed Central European cadaver. Results This report presents a variation of the FPL muscle, where the muscle split and formed a separate accessory head inserting into the first lumbrical muscle. Moreover, a tendinous interconnection was present between the FPL muscle tendon and the tendon of the aberrant muscle head. Conclusion The cases described by previous literature, concerning the Linburg-Comstock variation or the accessory head of the first lumbrical muscle originating from the FPL muscle, are closest to the present case. Such variation has a clinical significance ranging from the functional limitation of the thumb and index finger movement to the potential median nerve compression.
Correspondence. Case report: accessory head of the deep forearm flexors
Journal of Anatomy, 1997
In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name (Wood, 1868; Macalister, 1875) and these have subsequently been reported with variable attachments (Wood, 1868; Macalister, 1875; Turner, 1879; Schäfer & Thane, 1894; Le Double, 1897; Dykes & Anson, 1944; Mangini, 1960; Malhotra et al. 1982; Kida, 1988; Tountas & Bergman, 1993). The accessory heads of the deep flexors of the forearm (Gantzer's muscles) have been described as 2 different small bellies which insert either into FPL or FDP. There are no previous reports which have mentioned the existence of an accessory muscle which inserts into both of the 2 deep flexors of the forearm as in the case presented here.
Folia Morphologica, 2021
A common variant of accessory muscles in the anterior forearm is the Gantzer's muscle (GM). GM arises as a muscle belly from flexor digitorum superficialis (FDS) or ulnar coronoid process to merge distally with the flexor pollicis longus (FPL) muscle. In the present case report, we describe a novel accessory muscle in the flexor compartment of the forearm. The proximal attachment was tendinous and came from three sources: FDS muscle, ulnar coronoid process, and the medial aspect of the proximal radius. The distal tendon of the novel accessory muscle ran parallel to FPL, passed through the carpal tunnel, and entered the palmar aspect of the hand. In the hand, the tendon thinned out and blended with the tenosynovium of the FPL, contributing to the sheath around the FPL tendon. This accessory muscle of the FPL is comparable to the frequently documented Gantzer muscle (GM); however, the present case exhibited fundamental nuances that distinguish it from the previously described iterations of the GM in the following ways: 1) The novel accessory muscle is tendinous from its proximal origin and throughout the 2 upper one-third of the forearm, and one component of its origin arose from the medial aspect of the radius. Gantzer muscles with an origin on the radius have not been previously reported. 2) In the middle one-third, the tendinous proximal attachment transitioned to a muscle belly that passed through the carpal tunnel and entered the hand. 3) In the hand, the novel tendon widened, thinned, and merged with the tenosynovium of the FPL. Accessory muscles are a common finding in the anterior forearm during cadaveric dissection. In patients, they can be the cause of neuropathies due to compression of the anterior interosseous nerve. Awareness of variations is also important for clinicians who examine the forearm and hand, as well as hand and surgeons.
Journal of Anatomy, 1997
In 1813 Gantzer described 2 accessory muscles in the human forearm which bear his name (Wood, 1868; Macalister, 1875; Testut, 1884; Le Double, 1897). The more frequent of the 2 accessory muscles or ‘accessorius ad pollicem’ was found to arise from the coronoid process of the ulna, coursing distally to attach into the flexor pollicis longus muscle (flexor pollicis longus accessory head, FPLah). The less frequently observed or ‘accessorius ad flexorem profundum digitorum’ was again found to arise from the coronoid process and course to join into the flexor digitorum profundus (flexor digitorum profundus accessory head, FDPah). Since their initial description, they have been examined in further detail by a number of authors (Wood, 1868; Macalister, 1875; Le Double, 1897; Dykes & Anson, 1944; Mangini, 1960; Malhotra et al. 1982; Dellon & McKinnon, 1987; Kida, 1988). These studies, most of them focusing on the FPLah, all show different results of prevalence, origin, insertion, relations ...
Accessory flexor carpi ulnaris muscle: a case report of a rare variation in human
This study describes a rare case of the accessory muscle originated from the flexor carpi ulnaris muscle. An unusual variation of the flexor muscle was observed during the male cadaver dissection. The presence of an anatomical variation muscle was verified in the forearm on the left side of a 59 year old corpse settled in formol 10%. Morphological variability and clinical significance are reviewed.
Accessory muscle in the forearm: a clinical and embryological approach
Anatomy & Cell Biology, 2011
Muscular variations of the fl exor compartment of forearm are usual and can result in multiple clinical conditions limiting the functions of forearm and hand. Th e variations of the muscles, especially accessory muscles may simulate soft tissue tumors and can result in nerve compressions. During a routine dissection of the anterior region of the forearm and hand, an unusual muscle was observed on the left side of a 65-year-old male cadaver. Th e anomalous muscle belly arose from the medial epicondyle approxiamately 1 cm posterolateral to origin of normal fl exor carpi ulnaris muscle (FCU), and from proximal part of the fl exor digitorum superfi cialis muscle. It inserted to the triquetral, hamate bones and fl exor retinaculum. Passive traction on the tendon of accessory muscle resulted in fl exion of radiocarpal junction. Th e FCU which had one head, inserted to the pisiform bone hook of hamate and palmar aponeurosis. Its contiguous muscles displayed normal morphology. Knowledge of the existence of muscle anomalies as well as the location of compression is useful in determining the pathology and appropriate treatment for compressive neuropathies. In this study, a rare accessory muscle has been described.