Identification of a flexor digitorum accessorius longus muscle with unique distal attachments

Holzmann, Matthew; Almudallal, Noor; Rohlck, Kelsey E.; Singh, Rohit; Lee, Sung-Ho; Fredieu, John R.

doi:10.1016/j.foot.2009.03.002

Cited by 11 publications

(6 citation statements)

References 17 publications

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“…Accessory flexor digitorum longus has been reported to be found more commonly in males than females [ 14 ]. In some instances, AFDL may be a two-headed muscle [ 26 , 27 ], although the muscle identified in this case report consisted of only one head. The presence of AFDL is believed to be associated with tarsal tunnel syndrome [ 15 , 26 , 28 – 30 ], club foot [ 31 ], and flexor hallucis syndrome [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bale

Herrin

2017

Case Reports in Medicine

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Muscle variants are routinely encountered in the dissection laboratory and in clinical practice and therefore anatomists and clinicians need to be aware of their existence. Here we describe two different accessory muscles identified while performing educational dissection of a 51-year-old male cadaver. Tensor fasciae suralis, a rare muscle variant, was identified bilaterally and accessory flexor digitorum longus, a more common muscle variant, was present unilaterally. Tensor fasciae suralis and accessory flexor digitorum longus are clinically relevant muscle variants. To our knowledge, the coexistence of tensor fasciae suralis and accessory flexor digitorum longus in the same individual has not been reported in either cadaveric or imaging studies.

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Section: Discussionmentioning

confidence: 99%

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bale

Herrin

2017

Case Reports in Medicine

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“…In addition, the literature suggests that there may be an association between FDL development and the presence of flexor digitorum accessorius longus (Driver and Denison, 1914). This muscle is noted in 15–16.2% of the population, from both clinical and cadaveric studies, arising from the posterior aspect of the tibia, the interosseous membrane and the fascia investing FDL and inserts into the tendinous slips of FDL (Holzmann et al, 2009). It is possibly a vestige of a phylogenetically deteriorating muscle that has had its function superseded by quadratus plantae.…”

Section: Discussionmentioning

confidence: 99%

Absence of the flexor digitorum longus tendon: An MRI study

et al. 2012

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Flexor digitorum longus (FDL) is the primary flexor of the lateral four toes. It is a reliable source of tendon for transfer surgery. We present a case whereby a patient who required a reconstruction for adult acquired flatfoot deformity using FDL as a dynamic structure for transfer was found to have an absent FDL tendon at the time of operation, necessitating the use of flexor hallucis longus (FHL) instead. This unusual finding prompted us to investigate the frequency of absence of the FDL tendon. We reviewed our hospital MRI database of foot and ankle images specifically looking for patients with absence of this tendon. After randomization, 756 images were reviewed independently by two surgeons and a consultant musculoskeletal radiologist. No instances of an absent FDL tendon were identified. In conclusion, the frequency of absence of the FDL tendon is less than 1 in 750. Surgeons who require FDL for tendon transfer surgery need not image the foot preoperatively to anticipate the need for the use of FHL as an alternative.

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“…Moreover, one patient presented subluxation of the tendons of the peroneal muscles. The presence of an accessory flexor digitorum longus muscle was described in 18 studies of different characteristics [71][72][73][74][75][76][77][78][79][80][81][82][83][84][85][86][87][88]. In most cases, its presence was associated with tarsal tunnel syndrome, which is triggered by the compression of the tibial nerve within the tarsal tunnel, as this accessory muscle compresses the nerve.…”

Section: Clinical Considerationsmentioning

confidence: 99%

The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis

Valenzuela-Fuenzalida,

Inostroza-Wegner,

Osorio-Muñoz

et al. 2024

Diagnostics

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Objective: The aim of this study was to describe the main anatomical variants and morphofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to October 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14–0.23), with a heterogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03–0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01–0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be attentive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications.

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Identification of a flexor digitorum accessorius longus muscle with unique distal attachments

Cited by 11 publications

References 17 publications

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Bilateral Tensor Fasciae Suralis Muscles in a Cadaver with Unilateral Accessory Flexor Digitorum Longus Muscle

Absence of the flexor digitorum longus tendon: An MRI study

The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis

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