A novel accessory muscle in the flexor compartment of anterior forearm inserting into the tenosynovium of the flexor pollicis longus (original) (raw)
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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.
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.
" 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.
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.
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.
2017
Address for Correspondence: Dr. Pushpa Burute, Associate Professor, Department of Anatomy, BKL Walawalkar Rural Medical College, Sawarde, DistRatnagiri, Maharashtra, India 415606 E-Mail: pushpaburute60@gmail.com Introduction: Muscular variations in the form of accessory muscles are common and observed during cadaveric dissections, surgeries or investigative radiological procedures. Knowledge of such variations in upper limb is useful for hand surgeons and neurosurgeons. Materials and Methods: Total 156 (80 of right side and 76 of left side) upper limbs of unknown sex were dissected for presence of accessory muscles in the flexor compartment of the forearm. Observed accessory bellies and anatomical variant muscles were studied for its origin and insertion, size and shape and its important relations. Observations: Accessory head for the flexor pollicis longus (ahFPL) was the most common variation found in 56 (36%) limbs. Accessory head for the flexor digitorum profundus (ahFDP) was ob...
The Concomitant Presence of Two Anomalous Muscles in the Forearm
HAND, 2007
This article describes the concomitant presence of two anomalous forearm muscles in a 20-year-old man, discovered accidentally during an operation for a forearm injury. The first one was similar to a reverse palmaris longus muscle except for its direction to the Guyon's canal. The second one originated from the radial antebrachial fascia, superficial to all other forearm muscles in the lower half of the forearm, then diverged medially and extended into the Guyon's canal and was innervated by the ulnar nerve. The patient had no symptoms related to overcrowding of the Guyon's canal before the injury. A hand surgeon should be well informed about the anatomic variations of the hand to be comfortable during surgical practice.
Abnormal muscle in the anterior compartment of the forearm: a case report
Cases Journal, 2009
During routine dissection for the undergraduate medical students, we encountered an unusual, additional muscle in the anterior compartment of the forearm. This muscle took origin from the anterior surface of the radius in common with the flexor digitorum superficialis muscle. It had a tendon of origin and a tendon of insertion. Its fleshy radial belly and the tendon of insertion, crossed superficial to the median nerve. The muscle was inserted partly to the flexor retinaculum and partly to the undersurface of palmar aponeurosis. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for hand surgeons as it could possibly compress the median nerve because of its close relationship to it.
Unique Anomalous Muscle in the ExtensorCompartment of Forearm
EC Clinical and Experimental Anatomy, 2020
Extensor compartment of the forearm has superficial and deep group of muscles. All the muscles of this compartment arise from the lateral epicondyle and insert either on metacarpals or phalanges. During routine cadaveric dissection, we found an anomalous muscle with its tendon in the center of dorsum of palm. When traced, it was originating from the carpal bones and inserting at the dorsum of the base of proximal phalanx of middle finger. It was supplied by the posterior interosseous nerve. The numerical variations in the tendinous slips of some muscles of extensor compartment is not uncommon. Anomalous muscles in extensor compartment like Extensor digitorum brevis manus, extensor indices proprius and extensor medii proprius are reported in the literature. But this variant muscle in our case is not having any similarity with any of those variations reported in literature. It can be called as Variant Extensor digitorum manus.The knowledge of such rare variant muscle is important for surgeons for tendon transfer, tenosynovectomies, grafting and tendon repair surgeries to prevent inadvertent injuries. 13. Srijit Das., et al. "Additional tendons of the extensor digitorum muscle in the hand-an anatomical study with clinical significance".
Superficial group of muscles of posterior compartment of the forearm: an anatomical study
To understand the normal anatomical variations in the muscles of the posterior compartment. Material and Methods: A total of 50 upper limbs from 25 phenol embalmed adult human cadavers were studied. The supercial and deep fascia were dissected carefully and reected along skin incision. The origin, insertion, and other variations in the muscle bellies and tendons of the supercial extensor muscles were studied after careful dissection. Results: Brachioradialis had origin extending up to the insertion of deltoid in 3 specimens and had insertion on the radius as two-slips in 4 limbs. The muscle bellies of ECRL and ECRB were fused in 2 limbs. The ECRL also had double and triple tendinous insertions. An accessory muscle, Extensor Carpi Radialis Intermedius, was noted in 2 limbs. The EDC tendon to little nger tendon was bifurcated in 20 limbs, had an intertendinous connection in 12 limbs. An accessory tendinous extension from lower part of ECU tendon was present in 5 limbs. Conclusion: Extensor muscles of the forearm have undergone a dramatic change during the period of evolution; however, these are not uniform and there are number of anatomical variations which are of signicance during the repair of extensor tendon injury or during tendon transfer surgeries.