Anatomy and Cell Biology

  • 제55권1호
  • /
  • Pages.3-13
  • /
  • 2022
  • /
  • 2093-3665(pISSN)
  • /
  • 2093-3673(eISSN)
대한해부학회 (Korean Association of Anatomists)
권호 표지
DOI QR코드

DOI QR Code

The prevalence and distribution of the variants of Gantzer's muscle: a meta-analysis of cadaveric studies

  • Adil Asghar (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Rakesh Kumar Jha (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Apurba Patra (Department of Anatomy, All India Institute of Medical Sciences Bathinda) ;
  • Binita Chaudhary (Department of Anatomy, All India Institute of Medical Sciences Patna) ;
  • Brijendra Singh (Department of Anatomy, All India Institute of Medical Sciences Rishikesh)
  • 투고 : 2021.07.09
  • 심사 : 2021.09.17
  • 발행 : 2022.03.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

The Gantzer's muscle is often present in the flexor compartment of the forearm. It lies underneath flexor digitorum superficialis and compresses the anterior interosseous nerve. Furthermore, this muscle frequently bestows an accessory muscle of flexor pollicis longus or flexor digitorum profundus, or sometimes together. The current meta-analysis aims to compute the prevalence of subtypes of Gantzer's muscle. Major electronic databases (PubMed, Scopus, Google Scholar, etc.) were searched for title and abstract. After removing the duplicate citations, the titles/abstracts were shortlisted with the help of inclusion and exclusion criteria. The shortlisted titles/abstracts were downloaded or collected from the library. The data of all subtypes of Gantzer's muscle were pooled from shortlisted published manuscripts for meta-analysis. The pooled estimate of other anatomical characteristics was also observed. A total of 59 cadaveric studies of sample size 5,903 were evaluated for pooled prevalence of flexor pollicis longus (accessory head). Similarly, the authors evaluated 14 studies of 1,627 upper limbs for flexor digitorum profundus (accessory head). The unit of analysis was per 100 upper limbs. The Pooled prevalence of accessory muscle of flexor pollicis longus and flexor digitorum profundus were 48% (95% CI, 44%-52%) and 17% (95% CI, 13%-21%), respectively. The Gantzer's muscle is present in 2/3rd of the upper limbs. Accessory head of flexor pollicis longus is almost three times more common than the accessory head of flexor digitorum profundus. A classification of Gantzer's muscle is needed to reduce the ignorance of these variants.

키워드

참고문헌

  1. Zdilla MJ, Pacurari P, Celuck TJ, Andrews RC, Lambert HW. A Gantzer muscle arising from the brachialis and flexor digitorum superficialis: embryological considerations and implications for median nerve entrapment. Anat Sci Int 2019;94:150-3.
  2. Gantzer KFL. [Dissertation on the anatomical variations of the muscular structure: with the consent of the highly esteemed medical class chaired by Charles Asmund Rudolph]. Berolini: Typis Joannis Friderici Starckii; 1813. Latin.
  3. Jones M, Abrahams PH, Sanudo JR, Campillo M. Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer's muscles). J Anat 1997;191(Pt 3):451-5.
  4. Yang K, Jung SJ, Lee H, Choi IJ, Lee JH. Topographical relations between the Gantzer's muscle and neurovascular structures. Surg Radiol Anat 2017;39:843-8.
  5. Gyambibi A, Lemelin P. Comparative and quantitative myology of the forearm and hand of prosimian primates. Anat Rec (Hoboken) 2013;296:1196-206.
  6. Roy J, Henry BM, Pekala PA, Vikse J, Ramakrishnan PK, Walocha JA, Tomaszewski KA. The prevalence and anatomical characteristics of the accessory head of the flexor pollicis longus muscle: a meta-analysis. PeerJ 2015;3:e1255.
  7. Henry BM, Tomaszewski KA, Ramakrishnan PK, Roy J, Vikse J, Loukas M, Tubbs RS, Walocha JA. Development of the anatomical quality assessment (AQUA) tool for the quality assessment of anatomical studies included in meta-analyses and systematic reviews. Clin Anat 2017;30:6-13.
  8. El Domiaty MA, Zoair MM, Sheta AA. The prevalence of accessory heads of the flexor pollicis longus and the flexor digitorum profundus muscles in Egyptians and their relations to median and anterior interosseous nerves. Folia Morphol (Warsz) 2008;67:63-71.
  9. Mohammed WHE. Prevalence and morphology of Gantzer's muscle: a cadaveric based study [theses]. Omdurman: Omdurman Islamic University; 2018.
  10. Mangini U. Flexor pollicis lungus muscle. Its morphology and clinical significance. J Bone Joint Surg Am 1960;42:467-70.
  11. Oliveira KM, Breder CB, Ponte EF, Cordeiro AF, Oliveira MFS, Gomes WAPR, Goncalves MF, Goncalves GR, Grecco LH, Meggiolaro EDA, Silva JGBPCP, Lopez CAC. The accessory heads of the muscles flexor pollicis longus and flexor digitorum profundus (Gantzer muscle) - an anatomical study in Brazilian cadavers. Morphologie 2021 Mar 17 [Epub]. https://doi.org/10.1016/j.morpho.2021.02.010.
  12. Pai MM, Nayak SR, Krishnamurthy A, Vadgaonkar R, Prabhu LV, Ranade AV, Janardhan JP, Rai R. The accessory heads of flexor pollicis longus and flexor digitorum profundus: incidence and morphology. Clin Anat 2008;21:252-8.
  13. Philip SE, Dakshayani KR. A morphological study of a rare variant of Gantzer's muscle. Int J Anat Res 2018;6:4811-4.
  14. Wood J. XVII. Variations in human myology observed during the winter session of 1867-68 at King's College, London. Proc Royal Soc London 1868;16:483-525.
  15. al-Qattan MM. Gantzer's muscle. An anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br 1996;21:269-70.
  16. Bagoji IB, Doshi MA, Hadimani GA, Bannur BM, Patil BG, Patil BS, Das KK. Incidence and morphology of the accessory head of the flexor pollicis longus muscle (Gantzer's muscle) in South Indian population. J Anat Soc India 2017;66(Suppl 1):S50.
  17. Bajpe R, Tarakeshwari R, Shubha R. Gantzer muscles; a study on 50 cadaveric upper limbs. Nat J Clin Anat 2015;4:179-85.
  18. Afroze MKH, Umesh SN, Sangeeta M, Varalakshmi KL, Tiwari S. An anatomical and morphological study on accessory head of flexor pollicis longus (Gantzer's muscles) and its clinical emphasis. Int J Anat Res 2020;8:7568-71.
  19. Ballesteros DR, Forero PL, Ballesteros LE. Accessory head of the flexor pollicis longus muscle: anatomical study and clinical significance. Folia Morphol (Warsz) 2019;78:394-400.
  20. Bangarayya V, Narayana P, Pillai T, Priyanka K. A study on accessory muscle of flexor compartment of forearm. IOSR J Dent Med Sci 2018;17:18-21.
  21. Bilecenoglu B, Uz A, Karalezli N. Possible anatomic structures causing entrapment neuropathies of the median nerve: an anatomic study. Acta Orthop Belg 2005;71:169-76.
  22. Burute P, Vatsalaswamy P. Accessory heads of forearm flexors and flexor carpi radialis brevis: a cadaveric study with clinical significance. Int J Anat Res 2017;5:3698-703.
  23. Caetano EB, Sabongi JJ, Vieira LA, Caetano MF, Moraes DV. Gantzer muscle. An anatomical study. Acta Ortop Bras 2015;23:72-5.
  24. Chakravarthi KK, Ks S, Venumadhav N, Sharma A, Kumar N. Anatomical variations of brachial artery - its morphology, embryogenesis and clinical implications. J Clin Diagn Res 2014;8:AC17-20.
  25. Dellon AL, Mackinnon SE. Musculoaponeurotic variations along the course of the median nerve in the proximal forearm. J Hand Surg Br 1987;12:359-63.
  26. Desai RR, Desai AR, Ambali MP. Incidence of accessory head of flexor pollicis longus (only in males) and its clinical significance. Nat J Integr Res Med 2017;8:88-91.
  27. Dolderer JH, Prandl EC, Kehrer A, Beham A, Schaller HE, Briggs C, Kelly JL. Solitary paralysis of the flexor pollicis longus muscle after minimally invasive elbow procedures: anatomical and clinical study of the anterior interosseous nerve. Plast Reconstr Surg 2011;127:1229-36.
  28. Dykes J, Anson BJ. The accessory tendon of the flexor pollicis longus muscle. Anat Rec 1944;90:83-7.
  29. Gunnal S, Siddiqui A, Daimi S, Farooqui M, Wabale R. A study on the accessory head of the flexor pollicis longus muscle (Gantzer's muscle). J Clin Diagn Res 2013;7:418-21.
  30. Hemmady MV, Subramanya AV, Mehta IM. Occasional head of flexor pollicis longus muscle: a study of its morphology and clinical significance. J Postgrad Med 1993;39:14-6.
  31. Herrold CB, Cook RL, Burkett JT, Hobeika NA, Zdilla MJ, Lambert HW. The Gantzer muscle: an expanded study of this variant forearm muscle. FASEB J 2020;34:1-1.
  32. Kara A, Elvan O, Yildiz S, Ozturk H. Accessory head of flexor pollicis longus muscle in fetuses and adult cadavers and its relation to anterior interosseous nerve. Clin Anat 2012;25:601-8.
  33. Khade B, Chaudhari G, Yadav N, Mangalgiri A. Anatomical study of accessory head of flexor pollicis longus and its clinical significance. Natl J Clin Anat 2020;9:151-4.
  34. Kida M. [The morphology of Gantzer's muscle, with special reference to the morphogenesis of the flexor digitorum superficialis]. Kaibogaku Zasshi 1988;63:539-46. Japanese.
  35. Kumari A, Kumar S, Akhtar MJ, Ratnesh R, Kumar V. Morphological study of accessory heads of deep flexor muscle of forearm. J Med Sci Clin Res 2017;5:24172-6.
  36. Le Double AF, Berry RJA. [Treatise on variations of the muscular system of man: and their significance from the point of view of zoological anthropology]. Paris: Schleicher frères; 1897. French.
  37. Mahakkanukrauh P, Surin P, Ongkana N, Sethadavit M, Vaidhayakarn P. Prevalence of accessory head of flexor pollicis longus muscle and its relation to anterior interosseous nerve in Thai population. Clin Anat 2004;17:631-5.
  38. Malhotra VK, Sing NP, Tewari SP. The accessory head of the flexor pollicis longus muscle and its nerve supply. Anat Anz 1982;151:503-5.
  39. Matsunaga K, Matsuzaki A, Miyauchi R. Relationship of Gantzer's muscle (accessory head of flexor pollicis longus) with median and anterior interosseous nerves. Orthop Traumatol 2000;49:845-9.
  40. Mustafa AYAE, Alkushi AG, Alasmari WAM, Ali Sakran AME, Elamin AM. Anatomical study of theaccessory heads of the deep flexor muscles of theforearm (Gantzer muscles). Int J Anat Res 2016;4:2984-7.
  41. Mori M. Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn 1964;40:195-300.
  42. Ravi Prasanna KH, Das AK, Kulkarni AL. Study of morphology of Gantzer muscle in forearm and its clinical significance. Sch Int J Anat Physiol 2019;2:261-4.
  43. Riveros A, Olave E, Sousa-Rodrigues C. Anatomical study of the accessory head of the flexor pollicis longus muscle and its relationship to the anterior interosseous nerve in Brazilian individuals. Int J Morphol 2015;33:31-5.
  44. Sato S. Statistical studies on the anomalous muscles of the Kyushu-Japanese. 4. The muscles of the upper limb. Kurume Med J 1969;16:69-81.
  45. Sharma M, Chabbra U, Kaushal S, Patnaik VVG, Prashar R. Accessory head of flexor pollicis longus muscle. J Exerc Sci Physiother 2008;4:15-8.
  46. Shayo J, Pokhojaev A, Medlej B. The Gantzer's muscle: an anatomical and US study [Internet]. Princeton, NJ: Labome. Org-Research; 2015 [cited 2021 May 27]. Available from: http://www.labome.org/research/The-Gantzer-s-muscle-an-anatomical-and-US-study.html.
  47. Shirali S, Hanson M, Branovacki G, Gonzalez M. The flexor pollicis longus and its relation to the anterior and posterior interosseous nerves. J Hand Surg Br 1998;23:170-2.
  48. Tamang BK, Sinha P, Sarda RK, Shilal P, Murlimanju BV. Incidence and morphology of accessory head of Flexor pollicis longus muscle--an anatomical study. J Evol Med Dent Sci 2013;2:6800.
  49. Tubbs RS, Custis JW, Salter EG, Wellons JC 3rd, Blount JP, Oakes WJ. Quantitation of and superficial surgical landmarks for the anterior interosseous nerve. J Neurosurg 2006;104:787-91.
  50. Uyaroglu FG, Kayalioglu G, Erturk M. Incidence and morphology of the accessory head of the flexor pollicis longus muscle (Gantzer's muscle) in a Turkish population. Neurosciences (Riyadh) 2006;11:171-4.
  51. Oh CS, Chung IH, Koh KS. Anatomical study of the accessory head of the flexor pollicis longus and the anterior interosseous nerve in Asians. Clin Anat 2000;13:434-8.
  52. Yu JM, Yoon SP, Kim J. Accessory head of flexor pollicis longus in Jeju islander cadavers. J Med Life Sci 2018;15:16-8.
  53. Tomizawa I. Arthropological studies on variation of the muscles of upper extremity of the Ainu. Sapporo Med J 1986;55:101-23.
  54. Wagenseil F. [Investigations into the musculature of the Chinese]. Z Fur Morphol Anthropol 1936;36:39-150. German.
  55. Dubois de Mont-Marin G, Laulan J, Le Nen D, Bacle G. Topographic anatomy of structures liable to compress the median nerve at the elbow and proximal forearm. Orthop Traumatol Surg Res 2021;107:102813.
  56. Ciftcioglu E, Kopuz C, Corumlu U, Demir MT. Accessory muscle in the forearm: a clinical and embryological approach. Anat Cell Biol 2011;44:160-3.
  57. Tabib W, Aboufarah F, Asselineau A. [Compression of the anterior interosseous nerve by Gantzer's muscle]. Chir Main 2001;20:241-6. French.
  58. Degreef I, De Smet L. Anterior interosseous nerve paralysis due to Gantzer's muscle. Acta Orthop Belg 2004;70:482-4.
  59. Nakano KK, Lundergran C, Okihiro MM. Anterior interosseous nerve syndromes. Diagnostic methods and alternative treatments. Arch Neurol 1977;34:477-80.
  60. Rodner CM, Tinsley BA, O'Malley MP. Pronator syndrome and anterior interosseous nerve syndrome. J Am Acad Orthop Surg 2013;21:268-75.