Accessory Heads of Forearm Flexors and Flexor Carpi Radialis Brevis: A Cadaveric Study With Clinical Significance

Abstract

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 observed in five (3.2%) limbs, and accessory head for the flexor digitorum superficialis (ahFDS) in two limbs (1.2%,). Two accessory bellies in the same hand with common or separate origin were found in 5 limbs (3.2%). An anatomical variant flexor carpi radialis brevis (FCRB), which is not very common, was found in one limb. Conclusion: Accessory bellies of the muscles in the forearm are known for compression neuropathies like anterior interosseous nerve syndrome (AINS). Available accessory muscles like FCRB could be used for tendon transfers in patients with arthritis of thumb. Awareness of such variations helps in diagnosis of neuropathies, to avoid complications during surgeries and most importantly accessory muscles could be used for tendon graft/ transfer to to transform disability into functional hands.

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

“…Fifty-eight studies in the current review have been undertaken to explore the prevalence of Gantzer’s muscle ( Fig. 1 ) [ 3 , 4 , 8 - 55 ]. These studies examined 5,903 upper limbs for ahFPL variant ( Table 1 ).…”

“…In the current meta-analysis, the prevalence of Gantzer's muscle was 65% in 5,903 upper limbs, which is inconsistent with the results of the prior meta-analysis. The pooled prevalences of ahFPL and ahFDP variants were 48% and 17%, re-EI Domiaty et al 2008 [8] Loth 1912 [53] Mohammed 2018 [9] African Afroze et al 2020 [18] aI-Qattan 1996 [15] Bagoji a et al 2017 [16] Bajpe et al 2015 [17] Bangarayya et al 2018 [20] Bilecenoglu 2005 [21] Burute & Vatsalaswamy 2017 [22] Chakravarthi et al 2014 [24] Desai et al 2017 [ spectively. The pooled prevalence that varied in the cumulative analysis was 4% (48% to 52%).…”

Muscle Activation During Forehand and Backhand Drives in the Sport Discipline of Tennis

“…The following analysis applies to any grip used: Eastern, Continental, Semi-continental. To tighten the fingers and palm on the racket the activation of the following is necessary: flexor digitorum superficialis, palmaris longus, flexor carpi ulnaris, flexor pollicis longus and flexor digitorum profundus (Burute & Vatsalaswamy, 2017;Hodde, Ioannou, & Altenmuller, 2019).…”