Anatomical variations in the first extensor compartment: a cadaver study

Abstract

Our findings may help to improve the awareness of the anatomical variations in the first extensor compartment.

The Anatomy of the Tendon of Abductor Pollicis Longus and its Morphological Variations: An Anatomical Approach Emphasizing the Clinical Relevance

“…There can be supernumerary tendons or tendons with different points of insertion, contrary to descriptions in the classical literature (Testut et al, 1979;Bergman et al, 1984;O'Rahilly, 1986;Orts, 1987;Williams, 1995;Rouviere et al, 2005). These observations are supported by current evidence, which implies that the percentage of APL muscle variants can range from 33 % to 100 % (Lacey et al, 1951;Coleman et al, 1953;Baba, 1954;Jackson et al, 1986;Brunelli et al, 1991;Khoury et al, 1991;van Oudenaarde, 1991;Yuksel et al, 1992;Zancolli and Cozzi, 1992;Fabrizio et al, 1996;Dos Remédios et al, 2005;Shiraishi et al, 2005;Kulthanan et al, 2007;Paul et al, 2007;Mehta et al, 2009;Bravo et al, 2010;Roy et al, 2012;El-Beshbishy et al, 2013;Thwin et al, 2014;Tewari et al, 2015;Lee et al, 2017;Palatty et al, 2018;Xu et al, 2018;Karauda et al, 2020;Deivasigamani et al, 2021;Gnanasekaran et al, 2021). These data show that the presence of accessory or supernumerary APL tendons in human anatomy is not unusual and is rather common.…”

“…Only Brunelli et al (1991) and van Oudenaarde (1991) reported their use, the latter in only 22 of their 84 samples. These two factors hinder proper comparison since intratendinous dissection could account for the supernumerary tendons recognised in the studies reviewed (Lacey et al, 1951;Coleman et al, 1953;Baba, 1954;Jackson et al, 1986;Brunelli et al, 1991;Khoury et al, 1991;van Oudenaarde, 1991;Yuksel et al, 1992;Fabrizio et al, 1996;Dos Remédios et al, 2005;Shiraishi et al, 2005;Kulthanan et al, 2007;Paul et al, 2007;Mehta et al, 2009;Bravo et al, 2010;Roy et al, 2012;El-Beshbishy et al, 2013;Thwin et al, 2014;Tewari et al, 2015;Lee et al, 2017;Palatty et al, 2018;Xu et al, 2018;Karauda et al, 2020;Deivasigamani et al, 2021;Gnanasekaran et al, 2021). Nonetheless, if the data were to be compared with the present study, the ranges observed would be similar with a mean maximum of five tendons and a two tendon APL being the most frequent pattern.…”

“…An extensive bibliographical review revealed that accessory APL tendons insert on the trapezium, first metacarpal, APB muscle, OP muscle, flexor pollicis brevis muscle, thenar fascia, volar carpal ligament and TMC joint. However, many of these articles failed to note the presence of double or triple insertions of single tendons, possibly because there was no clear differentiation between tendinous slips and tendons (Lacey et al, 1951;Baba, 1954;Brunelli et al, 1991;Khoury et al, 1991;van Oudenaarde, 1991;Yuksel et al, 1992;Fabrizio et al, 1996;Dos Remédios et al, 2005;Shiraishi et al, 2005;Kulthanan et al, 2007;Paul et al, 2007;Mehta et al, 2009;Bravo et al, 2010;El-Beshbishy et al, 2013;Thwin et al, 2014;Tewari et al, 2015;Lee et al, 2017;Palatty et al, 2018;Xu et al, 2018;Karauda et al, 2020;Gnanasekaran et al, 2021). When the difference was reported, the sites of insertion were identical to those described in the Results section (Coleman et al, 1953;Jackson et al, 1986;Roy et al, 2012;Deivasigamani et al, 2021).…”

“…However, during the last seventy years, several studies (Lacey et al, 1951;Coleman et al, 1953;Baba, 1954;Jackson et al, 1986;Brunelli et al, 1991;Khoury et al, 1991;van Oudenaarde, 1991;Yuksel et al, 1992;Fabrizio et al, 1996;Dos Remédios et al, 2005;Shiraishi et al, 2005;Kulthanan et al, 2007;Paul et al, 2007;Mehta et al, 2009;Bravo et al, 2010;Roy et al, 2012;El-Beshbishy et al, 2013;Thwin et al, 2014;Tewari et al, 2015;Lee et al, 2017;Palatty et al, 2018;Xu et al, 2018;Karauda et al, 2020;Deivasigamani et al, 2021;Gnanasekaran et al, 2021) have shown that the APL tendon is much more variable than reports from the classical literature suggests, reaching proportions of 74.41 % and 85 % according to Roy et al (2012) and Bravo et al (2010) respectively. The anatomical diversity ranges from supernumerary tendons to variations of the point of insertion or tendons that divide themselves into various tendinous slips.…”

Prevalence of Septated First Dorsal Compartment Among Iranian Patients with De Quervain Tenosynovitis

“…The number of APL and EPB tendons is also associated with an increased risk of developing the disease (2). Moreover, these differences affect the success rate of different treatments (11,12). Understanding the anatomical variations of this compartment is essential for effective treatment.…”