Anomalies of the Flexor Digitorum Superficialis Muscle

Elliot, David; Khandwala, Asit; Kulkarni, M.

doi:10.1054/jhsb.1999.0237

Cited by 50 publications

(64 citation statements)

References 31 publications

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“…Palmar muscle anomalies that have been reported include variant, digastric or accessory bellies of the FDS (Lahey and Aulicino, 1986;Schö n et al, 1992;Elliot et al, 1999;Koizumi et al, 2002;Kobaysahi et al, 2003), and accessory bellies of the FDP (Wahba et al, 1998). Cases of accessory muscle bellies that originate from the FDS tendon and insert distally have also been reported (Still and Kleinert, 1973;Steinberg and Szabo, 1996;Lindley and Kleinert, 2003).…”

Section: Discussionmentioning

confidence: 99%

Coexistence of multiple anomalies in the carpal tunnel

et al. 2005

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We determined the frequency of anomalous structures within the carpal tunnels of 89 cadaveric forearm-hand specimens. We also examined these same specimens for variations in the branching pattern of the median nerve, and analyzed the range in length and width of the lumbricals. Many of the hands contained extra tendinous slips from the long flexors within the tunnel, subligamentous thenar branches of the median nerve, or lumbricals with bipennate origins. Only one hand had an anomalous muscle belly within the tunnel, two had persistent median arteries, two had high division of the median nerve in the distal forearm, and eight had lumbricals with lengths or widths that were greater or less than 2 standard deviations (SD) from the mean. Twenty-nine percent of all hands examined had two to five anomalies/variations per tunnel, whereas another 27% had one anomaly or variation per tunnel. More right hands (17%) than left (11%) contained two to five anomalous/variant structures per carpal tunnel. More right hands (19%) than left (8%) contained only one variant/anomalous structure per carpal tunnel. Anticipation of the frequency and multiplicity of anomalous structures and variations within this region is of importance to clinicians, particularly surgeons.

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Section: Discussionmentioning

confidence: 99%

Coexistence of multiple anomalies in the carpal tunnel

et al. 2005

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“…Interestingly, anomalous FDS muscles have been implicated as rare causes of primary CTS (42,43). FDS anomaly variations have been described by a classification system comprising types I to V (44). Types I to IV involve variations in shape and/or attachment.…”

Section: Discussionmentioning

confidence: 99%

Anomalous flexor digitorum superficialis muscle transposition for vascular coverage of the median nerve in recurrent carpal tunnel syndrome

Neumeister¹

2005

J Plast Surg

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Recurrent carpal tunnel syndrome is uncommon yet troublesome. Significant adhesions and scarring around the median nerve can render it relatively ischemic. A number of vascular flaps have been described to provide vascular coverage in attempts to decrease further cicatricial adhesions and to improve local blood supply around the median nerve. A rare case of an anomalous muscle in the distal forearm used as tissue to provide good vascularized coverage of the median nerve that was severely scarred in its bed is reported. The anomalous muscle was distal to the flexor digitorum superficialis tendon and inserted in the palmar fascia on the ulnar aspect of the hand. Referring branches from the ulnar artery provided vascular supply to the anomalous muscle. The muscle on these vascular pedicles was transposed over the median nerve, providing good, stable, unscarred coverage. The patient had an excellent result with resolution of the carpal tunnel symptoms. The redundant anomalous muscle provided a unique vascularized source for coverage of the median nerve in recurrent carpal tunnel syndrome.

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“…Anomalous flexor muscle bellies are extremely rare in the hand and represent arrests of development, or atavisms, in which anomalous parts retain the form they had in species lower in the evolutionary tree (16). MRI may be helpful in addition to a detailed and thorough history and physical examination.…”

Section: Resultsmentioning

confidence: 99%