scholarly journals The prevalence and anatomical characteristics of the accessory head of the flexor pollicis longus muscle: a meta-analysis

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1255 ◽  
Author(s):  
Joyeeta Roy ◽  
Brandon M. Henry ◽  
Przemysław A. Pękala ◽  
Jens Vikse ◽  
Piravin Kumar Ramakrishnan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Flexor Pollicis Longus ◽  
Anatomical Variant ◽  
Anatomical Characteristics ◽  
Pooled Prevalence ◽  
Longus Muscle ◽  
Anterior Interosseous Nerve ◽  
Language Restriction ◽  
Anterior Interosseous Nerve Syndrome ◽  
The Right

Background and Objectives.The accessory head of the flexor pollicis longus muscle (AHFPL), also known as the Gantzer’s muscle, was first described in 1813. The prevalence rates of an AHFPL significantly vary between studies, and no consensus has been reached on the numerous variations reported in its origin, innervation, and relationships to the Anterior Interosseous Nerve (AIN) and the Median Nerve (MN). The aim of our study was to determine the true prevalence of AHFPL and to study its associated anatomical characteristics.Methods.A search of the major electronic databases PubMed, EMBASE, Scopus, ScienceDirect, and Web of Science was performed to identify all articles reporting data on the prevalence of AHPFL in the population. No date or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. Data on the prevalence of the AHFPL in upper limbs and its anatomical characteristics and relationships including origin, insertion, innervation, and position was extracted and pooled into a meta-analysis using MetaXL version 2.0.Results.A total of 24 cadaveric studies (n= 2,358 upper limb) were included in the meta-analysis. The pooled prevalence of an AHFPL was 44.2% (95% CI [0.347–0.540]). An AHFPL was found more commonly in men than in women (41.1% vs. 24.1%), and was slightly more prevalent on the right side than on the left side (52.8% vs. 45.2%). The most common origin of the AHFPL was from the medial epicondyle of the humerus with a pooled prevalence of 43.6% (95% CI [0.166–0.521]). In most cases, the AHFPL inserted into the flexor pollicis longus muscle (94.6%, 95% CI [0.731–1.0]) and was innervated by the AIN (97.3%, 95% CI [0.924–0.993]).Conclusion.The AHFPL should be considered as more a part of normal anatomy than an anatomical variant. The variability in its anatomical characteristics, and its potential to cause compression of the AIN and MN, must be taken into account by physicians to avoid iatrogenic injury during decompression procedures and to aid in the diagnosis and treatment of Anterior Interosseous Nerve Syndrome.

scholarly journals Bilateral anterior interosseous nerve syndrome with 6-year interval

2018 ◽  
Vol 6 ◽  
pp. 2050313X1877741
Author(s):  
Thomas Tyszkiewicz ◽  
Isam Atroshi
Keyword(s):  
Complete Recovery ◽  
Interphalangeal Joint ◽  
Wrist Arthroscopy ◽  
Flexor Pollicis Longus ◽  
Active Flexion ◽  
Anterior Interosseous Nerve ◽  
History Of ◽  
Anterior Interosseous Nerve Syndrome ◽  
Flexor Pollicis Longus Tendon ◽  
The Right

Flexor pollicis longus paralysis related to idiopathic anterior interosseous nerve syndrome is well known, but few reports exist on bilateral disease. A 24-year-old man with no personal or family history of neurological disease developed isolated total loss of active flexion of the right thumb’s interphalangeal joint after undergoing a wrist arthroscopy. Surgical exploration 5 weeks after onset showed flexor pollicis longus tendon to be intact; anterior interosseous nerve decompression was done with no abnormalities found. Because of persistent paralysis, electromyography was performed showing findings consistent with anterior interosseous nerve syndrome. After 7 months without recovery, the patient underwent tendon transfer. After 6 years, the patient presented with left-sided isolated flexor pollicis longus paralysis and electromyography indicated anterior interosseous nerve syndrome. Examination 9 months after onset showed persistent complete flexor pollicis longus paralysis but by 15 months spontaneous complete recovery had occurred. Anterior interosseous nerve syndrome can occur bilaterally and is likely to resolve completely without intervention but recovery may take longer than a year.

scholarly journals Two muscular variations in the elbow associated with the anterior interosseous nerve

2021 ◽  
Author(s):  
Łukasz Olewnik ◽  
Bartłomiej Szewczyk ◽  
Nicol Zielinska ◽  
Dariusz Grzelecki ◽  
Michał Polguj
Keyword(s):  
Biceps Brachii ◽  
Clinical Importance ◽  
Ulnar Artery ◽  
Flexor Pollicis Longus ◽  
Main Band ◽  
Anatomical Dissection ◽  
Pronator Teres ◽  
Anterior Interosseous Nerve ◽  
Male Cadaver ◽  
The Right

AbstractThe coexistence of different muscular-neurovascular variations is of significant clinical importance. A male cadaver, 76 years old at death, was subjected to routine anatomical dissection; the procedure was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The right forearm and hand were dissected using standard techniques according to a strictly specified protocol. The presence accessory head of the flexor pollicis longus may potentially compress the anterior interosseous nerve. The present case report describes a rare variant of the ulnar head of the pronator teres, characterized by two independent bands (i.e., two proximal attachments). The main band originates from the coronoid process and the second originates from the tendon of the biceps brachii. This type of attachment could potentially affect the compression of the ulnar artery running between the two bands. Additionally, the accessory head of the flexor pollicis longus was observed, which started on the medial epicondyle; its coexistence with a high division median nerve creates a potential pressure site on the anterior interesosseous nerve.

Solitary Paralysis of the Flexor Pollicis Longus Muscle after Minimally Invasive Elbow Procedures: Anatomical and Clinical Study of the Anterior Interosseous Nerve

2011 ◽  
Vol 127 (3) ◽  
pp. 1229-1236 ◽  
Author(s):  
Juergen H. Dolderer ◽  
Eva-Christina Prandl ◽  
Andreas Kehrer ◽  
Alfred Beham ◽  
Hans-Eberhard Schaller ◽  
...  
Keyword(s):  
Clinical Study ◽  
Minimally Invasive ◽  
Flexor Pollicis Longus ◽  
Longus Muscle ◽  
Anterior Interosseous Nerve

Accessory head of flexor pollicis longus muscle in fetuses and adult cadavers and its relation to anterior interosseous nerve

2011 ◽  
Vol 25 (5) ◽  
pp. 601-608 ◽  
Author(s):  
Alev Kara ◽  
Ozlem Elvan ◽  
Selda Yildiz ◽  
Hakan Ozturk
Keyword(s):  
Flexor Pollicis Longus ◽  
Longus Muscle ◽  
Anterior Interosseous Nerve

Attritional Flexor Tendon Rupture due to a Scaphoid Non Union Imitating an Anterior Interosseous Nerve Syndrome: A Case Report

1985 ◽  
Vol 10 (1) ◽  
pp. 62-64 ◽  
Author(s):  
M. MÁHRING ◽  
CAMPBELL SEMPLE ◽  
I. C. M. GRAY
Keyword(s):  
Index Finger ◽  
Scaphoid Fracture ◽  
Acute Onset ◽  
X Rays ◽  
Loss Of Function ◽  
Flexor Pollicis Longus ◽  
Non Union ◽  
Anterior Interosseous Nerve ◽  
Flexor Tendon Rupture ◽  
Anterior Interosseous Nerve Syndrome

A case is presented of acute loss of function of flexor pollicis longus and profundus tendon to the index finger. Although the aetiology was obscure, the acute onset suggested a mechanical cause rather than a nerve compression disorder such as anterior interosseous nerve palsy. X-rays showed an ununited scaphoid fracture related to an injury many years previously. Surgical exploration revealed attritional rupture of flexor pollicis longus and partial division of profundus tendon to index finger by a spicule of ununited scaphoid which had eroded through the volar capsule. Removal of the spicule and tenodesis of flexor pollicis longus gave a good long term result.

scholarly journals A report on the accessory head of Flexor Pollicis Longus and Variations of Forearm Musculature

2017 ◽  
Vol 34 (02) ◽  
pp. 098-106
Author(s):  
S. Hafez
Keyword(s):  
Surgical Intervention ◽  
Anatomical Variation ◽  
Soft Tissue Tumors ◽  
Flexor Digitorum Superficialis ◽  
Flexor Pollicis Longus ◽  
Cadaver Dissection ◽  
Anterior Interosseous Nerve ◽  
The Right ◽  
Flexor Digitorum ◽  
Accessory Muscles

Abstract Introduction: Gantzer's muscle has drawn attention from several authors owing to the possibility of interosseous nerve compression. This is a report of an accessory head of flexor pollicis longus (FPL, a variant of Gantzer's muscle) and a review of the variations of all muscles of the forearm. Materials and Methods: An accessory head of FPL was discovered in both the right and left antebrachial regions during a cadaver dissection. The muscle was dissected and photographed. Results: The anatomical variation I report is a slender conical muscle joining the FPL. Its origin merged with fibers of the flexor digitorum superficialis. It inserted into the upper part of the middle third of the forearm by joining the medial tendinous part of the FPL; this join was by means of a short cylindrical tendon. The reported muscle was innervated by the anterior interosseous nerve, which was seen to be present posterolateral to the muscle in both forearms. Conclusion: The described muscle might cause pressure problems to the underlying structures especially the anterior interosseous nerve. Variations must be considered during surgical intervention to avoid unintentional damage to healthy tendons. In addition, accessory tendons can potentially be useful in the repair or replacement of damaged tendons through surgical transfer or transplantation. Variations of muscles, especially accessory muscles, may mimic the behavior of soft tissue tumors and can result in nerve compressions. This collection of variations of the forearm musculature will be useful to surgeons in practice as well as students in dissection labs.

scholarly journals The origin of the medial circumflex femoral artery: a meta-analysis and proposal of a new classification system

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1726 ◽  
Author(s):  
Krzysztof A. Tomaszewski ◽  
Brandon M. Henry ◽  
Jens Vikse ◽  
Joyeeta Roy ◽  
Przemysław A. Pękala ◽  
...  
Keyword(s):  
Femoral Head ◽  
Femoral Artery ◽  
Classification System ◽  
Meta Analysis ◽  
Lower Limbs ◽  
Circumflex Femoral Artery ◽  
Pooled Prevalence ◽  
Medial Circumflex Femoral Artery ◽  
Branching Patterns ◽  
Language Restriction

Background and Objectives.The medial circumflex femoral artery (MCFA) is a common branch of the deep femoral artery (DFA) responsible for supplying the femoral head and the greater trochanteric fossa. The prevalence rates of MCFA origin, its branching patterns and its distance to the mid-inguinal point (MIP) vary significantly throughout the literature. The aim of this study was to determine the true prevalence of these characteristics and to study their associated anatomical and clinical relevance.Methods.A search of the major electronic databases Pubmed, EMBASE, Scopus, ScienceDirect, Web of Science, SciELO, BIOSIS, and CNKI was performed to identify all articles reporting data on the origin of the MCFA, its branching patterns and its distance to the MIP. No data or language restriction was set. Additionally, an extensive search of the references of all relevant articles was performed. All data on origin, branching and distance to MIP was extracted and pooled into a meta-analysis using MetaXL v2.0.Results.A total of 38 (36 cadaveric and 2 imaging) studies (n= 4,351 lower limbs) were included into the meta-analysis. The pooled prevalence of the MCFA originating from the DFA was 64.6% (95% CI [58.0–71.5]), while the pooled prevalence of the MCFA originating from the CFA was 32.2% (95% CI [25.9–39.1]). The CFA-derived MCFA was found to originate as a single branch in 81.1% (95% CI [70.1–91.7]) of cases with a mean pooled distance of 50.14 mm (95% CI [42.50–57.78]) from the MIP.Conclusion.The MCFA’s variability must be taken into account by surgeons, especially during orthopedic interventions in the region of the hip to prevent iatrogenic injury to the circulation of the femoral head. Based on our analysis, we present a new proposed classification system for origin of the MCFA.

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