Anatomy and Cell Biology

Korean Association of Anatomists (대한해부학회)
권호 표지
DOI QR코드

DOI QR Code

An accessory muscle of flexor digitorum profundus with bipennate first lumbrical: a unique variation of clinical significance

  • Received : 2022.07.18
  • Accepted : 2022.10.01
  • Published : 2023.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

During the deep dissection of the front of the forearm, an anomalous accessory muscle in relation to the flexor digitorum profundus (FDP) muscle was observed in the right forearm. The accessory muscle consisted of a spindle-shaped muscle belly with a long tendon underneath the flexor pollicis longus muscle. When followed distally, the accessory muscle tendon was found lateral to the FDP tendon for the index finger and entered the palm deep to the flexor retinaculum. In the palm, we encountered the first lumbrical muscle as a bipennate muscle taking origin from the adjacent sides of the middle of the tendons of FDP and accessory muscle tendon. After giving origin to first lumbrical muscle, the accessory muscle got merged with the tendon of FDP for index finger. Understanding this kind of variation is required for radiologists and hand surgeons for diagnostic purposes and while performing corrective surgical procedures.

Keywords

Acknowledgement

We would like to express our gratitude to the families of all those who selflessly donated their relatives' bodies for medical research and education.Also we would like to acknowledge the efforts of anatomy laboratory attenders for regular maintenance of cadavers and the laboratory.

References

  1. 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.  https://doi.org/10.5115/acb.2011.44.2.160
  2. Biant LC. Elbow and the forearm. In: Standring S, editors. Gray's anatomy. 41st ed. Philadelphia: Elsevier; 2016. p. 837-861. 
  3. Kumar S, Verma R, Mehra RD. An anomalous origin of accessory head of flexor digitorum profundus in forearm: a rare variant. J Anat Soc India 2016;65(Suppl 1):S73-5.  https://doi.org/10.1016/j.jasi.2016.04.001
  4. Wahba MY, Singh GD, Lozanoff S. An anomalous accessory flexor digiti minimi profundus muscle: a case study. Clin Anat 1998;11:55-9.  https://doi.org/10.1002/(SICI)1098-2353(1998)11:1<55::AID-CA9>3.0.CO;2-R
  5. 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.  https://doi.org/10.1046/j.1469-7580.1997.19130451.x
  6. Mangini U. Flexor pollicis lungus muscle. Its morphology and clinical significance. J Bone Joint Surg Am 1960;42-A:467-70.  https://doi.org/10.2106/00004623-196042030-00010
  7. Wood J. XVII. Variations in human myology observed during the winter session of 1867-68 at King's College, London. Proc R Soc Lond 1868;16:483-525.  https://doi.org/10.1098/rspl.1867.0110
  8. 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. 
  9. Macalister A. Additional observations on muscular anomalies in human anatomy. (Third series) with a catalogue of the principal muscular variations hitherto published. Trans R Ir Acad 1875;25:1-134. 
  10. Le Double AF. Treatise on the variations of the muscular system of man and their significance from the point of view of zoological anthropology. Paris: Schleicher freres; 1897. 
  11. Parsons FG. The muscles of mammals, with special relation to human myology: a course of lectures delivered at the Royal College of Surgeons of England. J Anat Physiol 1898;32(Pt 4):721-52. 
  12. Bhavya BS, Myageri M, Smitha M. Accessory head of flexor digitorum profundus: a case study. Int J Anat Res 2016;4:2931-5.  https://doi.org/10.16965/ijar.2016.376
  13. 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. 
  14. Testut L. Muscle abnormalities in humans. Paris: Masson; 1884. p.454-89. 
  15. Nayak SR, Ramanathan L, Prabhu LV, Raju S. Additional flexor muscles of the forearm: case report and clinical significance. Singapore Med J 2007;48:e231-3.