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Joy P, G A, Bhardwaj K, Rout S. Unilateral Right-Sided Progressive Flexor Digitorum Superficialis Brevis to the Little Finger: A Case Report With Review of Literature. Cureus 2023; 15:e34577. [PMID: 36874313 PMCID: PMC9981545 DOI: 10.7759/cureus.34577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2023] [Indexed: 02/05/2023] Open
Abstract
The flexor digitorum superficialis (FDS), an intermediate flexor of the forearm, can present with variations in the musculature or tendons. Here, we report a very rare anomaly of the FDS-V tendon replaced by a muscle belly in the palm, which was a progressive variation. This variation was found in a 60-year-old female cadaver on the right hand. The anomalous belly took its origin from the center of the volar aspect of the flexor retinaculum and was inserted into the A2 pulley of the middle interphalangeal joint to the little finger. The anomalous muscle was innervated by a branch of the median nerve. Knowledge of such variations will be useful for hand surgeons for meticulous planning of surgeries of the palm. The occurrences of such variations might interfere with the biomechanics of the FDS tendons.
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Affiliation(s)
- Praisy Joy
- Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Arthi G
- Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Krati Bhardwaj
- Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Sipra Rout
- Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Huang C, Jin HJ, Song DB, Zhu Z, Tian H, Li ZH, Qu WR, Li R. Trigger finger at the wrist caused by an intramuscular lipoma within the carpal tunnel: A case report. World J Clin Cases 2021; 9:7564-7571. [PMID: 34616827 PMCID: PMC8464472 DOI: 10.12998/wjcc.v9.i25.7564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/30/2021] [Accepted: 07/19/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Trigger finger at the wrist, which occurs with finger movement, is an uncommon presentation. Few reports describing cases of trigger finger at the wrist have been published. Thus, we present a case of an intramuscular lipoma arising from an anomalous flexor digitorum muscle belly in a 48-year-old female patient causing painful finger triggering at the wrist and carpal tunnel syndrome (CTS).
CASE SUMMARY A 48-year-old woman with complaints of a catching sensation during wrist motion and a progressive tingling sensation on the palmar aspect of the right hand for approximately 2 years was referred to our hospital. Triggering of the index to middle finger was evident with a palpable and audible clunk over the carpal tunnel during passive motion. Tinel’s sign was positive over the carpal tunnel of the right wrist with a positive Phalen’s test. Nerve conduction studies of the median nerve demonstrated a right CTS. Ultrasound examination revealed a 2.5 cm × 2.0 cm subcutaneous hyperechoic mass with no obvious blood flow at the wrist of the right arm. Surgical excision of the tumor and muscle mass led to a resolution of the patient’s symptoms, and any triggering or discomfort disappeared. The patient has had no evidence of recurrence at more than 1 year of follow-up.
CONCLUSION Triggering of the fingers at the wrist is rare. It must be noted that there are many possible causes and types of triggering or clicking around the wrist. Accurate diagnosis is mandatory to avoid inaccurate treatment of patients with trigger wrist. During the diagnosis and treatment of CTS, attention should be paid to the variation of tendon tissue in the carpal tunnel, to avoid only focusing on the release of transverse carpal ligament and ignoring the removal of anomalous muscle belly.
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Affiliation(s)
- Chao Huang
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
- Department of Orthopaedics, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hong-Juan Jin
- Department of Plastic and Reconstructive Surgery, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - De-Biao Song
- Department of Emergency and Critical Care Medicine, The Second Hospital of Jilin University, Changchun 130012, Jilin Province, China
| | - Zhe Zhu
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Heng Tian
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Ze-Hui Li
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Wen-Rui Qu
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
| | - Rui Li
- Department of Hand Surgery, The Second Hospital of Jilin University, Changchun 130041, Jilin Province, China
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Maniglio M, Chalmers CE, Thürig G, Passaplan C, Müller C, McGarry MH, Lee TQ. The anatomy and function of a bilateral accessory flexor digitorum superficialis muscle: A case report and review of literature. Morphologie 2020; 104:287-292. [PMID: 32622687 DOI: 10.1016/j.morpho.2020.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 06/05/2020] [Accepted: 06/05/2020] [Indexed: 12/01/2022]
Abstract
Anatomical variations of the flexor digitorum superficialis (FDS) include variations of the muscle belly and/or tendon. We present a case of a bilateral accessory FDS muscle and tendon. Dissection was performed in a male specimen (56 years), where an unusual variation was found: a bilateral accessory FDS muscle and tendon. The accessory FDS muscle belly originated at the medial epicondyle, between the tendinous portions of the FDS and flexor carpi radialis, with average dimensions of 70mm in length and 23mm in width. The accessory FDS muscle belly was innervated by the median nerve. After developing a strong tendon, with a length of 51mm (right) and 85mm (left) and width of approximately 9.5mm, the accessory FDS inserted into the dorsal muscle belly of the main FDS. To further analyze the variation, the left accessory FDS muscle and tendon were separated from the adjacent tissues at the elbow and kept attached at the wrist. On a custom jig, 10N were applied sequentially to the main and accessory FDS separately and then together to access their function. Loading of the main FDS muscle resulted in flexion of the fingers with accentuation of the ulnar rays. Loading of the accessory FDS caused flexion of all four long fingers. We described a rare case of an accessory flexor digitorum superficialis, which may assist surgeons with clinical decisions. Surgeons should be aware of variability in forearm anatomy.
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Affiliation(s)
- M Maniglio
- Department of Orthopaedics and Traumatology; HFR Fribourg Cantonal Hospital, University Hospital Fribourg, Chemin des Pensionnats 2-6, 1752 Villars-sur-Glâne, Switzerland; Department of Orthopaedics and Traumatology, Inselspital Bern, University Hospital, Bern, Switzerland.
| | - C E Chalmers
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA; University of California, Irvine, School of Medicine, Irvine, CA, USA
| | - G Thürig
- Department of Orthopaedics and Traumatology; HFR Fribourg Cantonal Hospital, University Hospital Fribourg, Chemin des Pensionnats 2-6, 1752 Villars-sur-Glâne, Switzerland
| | - C Passaplan
- Department of Orthopaedics and Traumatology; HFR Fribourg Cantonal Hospital, University Hospital Fribourg, Chemin des Pensionnats 2-6, 1752 Villars-sur-Glâne, Switzerland
| | - C Müller
- Plastic and Reconstructive Surgery, Berufsgenossenschaftliche Unfallklinik, Ludwigshafen am Rhein, Germany
| | - M H McGarry
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA
| | - T Q Lee
- Orthopaedic Biomechanics Laboratory, Congress Medical Foundation, Pasadena, CA, USA
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4
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Park SH. Anomalous Muscles of the Wrist Encountered During Endoscopic Carpal Tunnel Surgery. J Korean Neurosurg Soc 2019; 62:90-95. [PMID: 30630296 PMCID: PMC6328793 DOI: 10.3340/jkns.2018.0111] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 06/29/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Anomalous muscles of the wrist are infrequently encountered during carpal tunnel surgery. Anatomic variants of the palmaris longus (PL), flexor digitorum superficialis, lumbricalis and abductor digiti minimi (ADM) have been reported but are usually clinically insignificant. Anomalies of the wrist muscles, encountered during endoscopic carpal tunnel surgery have rarely been described. I conducted this study to evaluate muscular anomalies of the volar aspect of the wrist, encountered during endoscopic carpal tunnel surgery. METHODS I studied a consecutive series of 1235 hands in 809 patients with carpal tunnel syndrome who underwent single-portal endoscopic carpal tunnel release (ECTR) from 2002 to 2014. Nine hundred seventy-three hands in 644 patients who had minimal 6-month postoperative follow-up were included in the study. The postoperative surgical outcome was assessed at least 6 months after surgery. RESULTS In eight patients, anomalous muscles were found under the antebrachial fascia at the proximal wrist crease and superficial to the ulnar bursa, passing superficial to the transverse carpal ligament . Those anomalous muscles were presumed to be variants of the PL or accessory ADM muscle, necessitating splitting and retraction to enter the carpal tunnel during the ECTR procedure. Other muscle anomalies were not seen within the carpal tunnel on the endoscopic view. The surgical outcome for all eight wrists was successful at the 6-month postoperative follow-up. CONCLUSION Carpal tunnel surgeons, especially those using an endoscope should be familiar with unusual findings of anomalous muscles of the wrist because early recognition of those muscles can contribute to avoiding unnecessary surgical exploration and unsuccessful surgical outcomes.
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Affiliation(s)
- Se-Hyuck Park
- Department of Neurosurgery, Gangdong Sacred Heart Hospital, Hallym University Collge of Medicine, Seoul, Korea
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5
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Choo HJ, Lee SJ, Park YM, Kim DW. Distally extended muscle belly of the flexor digitorum within the carpal tunnel: is it a risk factor for carpal tunnel syndrome? Acta Radiol 2017; 58:1269-1275. [PMID: 28173726 DOI: 10.1177/0284185117690422] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background The distally extended muscle belly of the flexor digitorum (MB-FD) within the carpal tunnel has been suggested as a plausible cause for carpal tunnel syndrome (CTS) based on cadaveric studies. Purpose To evaluate whether MB-FD within the carpal tunnel is a risk factor for CTS by comparing asymptomatic volunteers and patients with CTS. Material and Methods Presence, length, and cross-sectional area of MB-FD within the carpal tunnel were evaluated in 63 wrists of 32 asymptomatic volunteers and 52 wrists of 33 patients with CTS using ultrasonography. Length of MB-FD within the carpal tunnel was measured as the distance between the distal end of MB-FD and the palmar margin of the distal radius longitudinally. On a transverse scan, the cross-sectional area of MB-FD at the proximal limit of the carpal tunnel was measured. Results MB-FD in the carpal tunnel was found in 39 (62%) asymptomatic volunteers and 35 (67%) patients with CTS ( P = 0.549). There was a female preponderancy of MB-FD within the carpal tunnel in asymptomatic volunteers ( P = 0.044), but not in patients. Length and cross-sectional area of MB-FD within the carpal tunnel were significantly greater in male-CTS patients than in male volunteers ( P = 0.022 and 0.012, respectively). These qualities were risk factors for CTS in men, though not in women. Conclusion The presence of distally extended MB-FD within the carpal tunnel was not a risk factor for CTS. In men, a longer and thicker MB-FD within the carpal tunnel increased the risk for CTS.
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Affiliation(s)
- Hye Jung Choo
- Department of Radiology, College of Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Sun Joo Lee
- Department of Radiology, College of Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Young-Mi Park
- Department of Radiology, College of Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Dong Wook Kim
- Department of Radiology, College of Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
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Bhat W, Davis CR, Akali A, Kay SP, Roberts AM. Painful, palpable and pathological: anomalous flexor digitorum superficialis brevis in the palm, comparative anatomical context, and an updated classification of anomalies of the flexor digitorum superficialis. J Hand Surg Eur Vol 2014; 39:101-6. [PMID: 23435488 DOI: 10.1177/1753193413478349] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Anomalies of the flexor digitorum superficialis are rare and can present a diagnostic dilemma. Patients present with a painful or palpable mass, or symptoms of carpal tunnel syndrome. This review article summarizes previously reported anomalies of the flexor digitorum superficialis, reports a further case, and proposes a new classification.
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Affiliation(s)
- W Bhat
- 1Department of Plastic and Reconstructive Surgery, Leeds General Infirmary, Leeds
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Tan J, Kim CH, Lee HJ, Chen J, Chen QZ, Jeon IH. A new examination method for anatomical variations of the flexor digitorum superficialis in the little finger. Clin Orthop Surg 2013; 5:138-44. [PMID: 23730479 PMCID: PMC3664674 DOI: 10.4055/cios.2013.5.2.138] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2012] [Accepted: 12/06/2012] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Current examination methods to assess the anatomical variations of flexor digitorum superficialis (FDS) tendon in the little finger necessitate a strong external force applied by the examiner and cause false negatives. A new examination method was designed to detect the variations more accurately. METHODS We examined the little fingers of 220 adult hands (110 subjects) by 2 methods: the expanded examination method advocated by Tan et al., and a new examination method. Variations of the FDS in the little finger were examined by both methods and categorized separately as having independent FDS function, FDS connection to the tendons of the ring finger or of the multiple adjacent fingers, and functional substitution of the flexor digitorum profundus (FDP) with or without tendinous connection to the ring or multiple adjacent fingers. By our new method, we could further divide the FDS connection or FDP substitution with connection to the ring finger into 2 subtypes: loose and close connections. Data were reported as case numbers and percent. Date on symmetry were statistically analyzed by matched case-control studies. RESULTS Among 220 hands, 113 hands (51.4%) had independent FDS function by the new examination method, which was lower than the incidence (55.5%) detected with the existing expanded examination method. In the hands with connections between FDS tendons of the little and the ring fingers, 32 hands (14.5%) demonstrated loose and 37 (16.8%) close connections. Three hands (1.4%) had loose and 19 (8.6%) had close FDP substitution with tendinous connection to the ring finger. Among 110 hands without independent FDS function, variants of 42 hands (38.2%) were asymmetric. There was no statistical significance in symmetry of variations. CONCLUSIONS This new examination method offers other assessment variations of FDS tendon in the little finger. We recommend using this test to assess the variations and function of the FDS of the little finger.
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Affiliation(s)
- Jun Tan
- Department of Hand Surgery, Hand Surgery Research Center, Affiliated Hospital of Nantong University, Nantong, China
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8
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Stephens N, Marques E, Livingston C. Anomalous flexor digitorum superficialis muscle belly presenting as a mass within the palm. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2011; 15:44-6. [PMID: 19554131 DOI: 10.1177/229255030701500103] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Anomalies of the flexor digitorum superficialis muscle are extremely uncommon and usually present as a painful mass or pseudotumour within the palm. Diagnosis may be difficult because many other soft tissue tumours (lipomas, ganglions, giant cell tumours and hamartomas) may present similarly. Magnetic resonance imaging helps to define the extent and characteristics of this anomalous muscle belly and to distinguish it from a soft tissue sarcoma, whereas plain radiographs are of little value. Three types of flexor digitorum superficialis muscle anomalies have been described, and treatment consists of subtotal or total surgical debulking of the mass if symptoms persist or if the diagnosis is in question. Most patients have complete resolution and full recovery. To date, 20 cases have been reported in the literature, usually involving the right small finger. In the present paper, the case of an anomalous flexor digitorum superficialis muscle in a 17-year-old male patient's left index finger is reported. Symptoms were relieved following surgical debulking and hand-based occupational therapy.
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Affiliation(s)
- Nicholas Stephens
- Division of Plastic and Reconstructive Surgery, University of Texas - Houston Health Science Center, Houston, Texas, USA
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9
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Tan JS, Oh L, Louis DS. Variations of the flexor digitorum superficialis as determined by an expanded clinical examination. J Hand Surg Am 2009; 34:900-6. [PMID: 19410995 DOI: 10.1016/j.jhsa.2009.01.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Revised: 12/29/2008] [Accepted: 01/05/2009] [Indexed: 02/02/2023]
Abstract
PURPOSE Current examination techniques do not detect the wide clinical variability of the flexor digitorum superficialis (FDS). Modification of current examination techniques may be necessary to detect anomalies and lead to more accurate diagnosis. We examined 500 subjects using an expansion of current techniques to elicit the range of variations in FDS function discernable on clinical examination. METHODS FDS function was evaluated by asking subjects to flex the finger of interest while all other fingers were held fully extended at the metacarpophalangeal and interphalangeal joints. Isolated flexion at the proximal interphalangeal (PIP) joint indicated independent FDS function. Obligatory flexion at the distal interphalangeal (DIP) joint indicated flexor digitorum profundus (FDP) activity. Because FDS activity could not be evaluated if concurrent FDP activity was present, these fingers were designated as having FDP substitution. Difficulty isolating PIP joint flexion suggested connections to adjacent FDS or FDP, prompting the examiner to serially release adjacent fingers while observing for improvement in PIP or DIP range of motion. RESULTS Independent FDS function was most consistently present in the ring and middle fingers, less so in the index finger, and least in the small finger. Variations included FDP substitution or connections to flexor tendons in 1 or 2 adjacent fingers with or without evidence of FDP substitution. Absent FDS function cannot be presumed in any subject based solely on clinical examination of a single digit. CONCLUSIONS Current examination techniques are inadequate to discern among the multiple variations of FDS function. An expanded examination technique is recommended for accurate diagnosis of FDS function following flexor tendon injury.
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Affiliation(s)
- Jane S Tan
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA.
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10
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Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory Muscles: Anatomy, Symptoms, and Radiologic Evaluation. Radiographics 2008; 28:481-99. [DOI: 10.1148/rg.282075064] [Citation(s) in RCA: 156] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Elliot D, Khandwala AR, Kulkarni M. Anomalies of the flexor digitorum superficialis muscle. JOURNAL OF HAND SURGERY (EDINBURGH, SCOTLAND) 1999; 24:570-4. [PMID: 10597934 DOI: 10.1054/jhsb.1999.0237] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Three anomalies of the human flexor digitorum superficialis are presented. The normal development of this muscle from the amphibian to the human is discussed and the described anomalies of the muscle in humans classified.
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Affiliation(s)
- D Elliot
- Hand Surgery Department, St Andrew's Centre for Plastic Surgery, Broomfield Hospital, Chelmsford, Essex, UK
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12
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Kostakoğlu N, Borman H, Keçik A. Anomalous flexor digitorum superficialis muscle belly: an unusual case of mass in the palm. BRITISH JOURNAL OF PLASTIC SURGERY 1997; 50:654-6. [PMID: 9613412 DOI: 10.1016/s0007-1226(97)90515-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A case of anomalous superficialis muscle belly in the palm is presented. Nineteen such cases have been reported until now. Our case differs in that the anomalous muscle originated from the flexor digitorum superficialis tendon to the index finger by way of an accessory tendon.
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Affiliation(s)
- N Kostakoğlu
- Department of Plastic and Reconstructive Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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13
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Honing ML, Ritt MJ, Bos KE. An anomalous flexor digitorum superficialis to the index finger. Surg Radiol Anat 1995; 17:339-41. [PMID: 8896155 DOI: 10.1007/bf01795194] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
An anomalous, digastric flexor digitorum superficialis in addition to a normal flexor digitorum superficialis to the index finger, is reported. To our knowledge, this is an anatomic variation never described before. The anomalous muscle belly presented as a progressive pseudotumor of the palm and needed exploration to provide the final diagnosis.
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Affiliation(s)
- M L Honing
- Academisch Medisch Centrum (AMC), Amsterdam, The Netherlands
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14
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Grant SD, Due TM. Anomalous flexor digitorum superficialis presenting as a painful palmar mass: a case report. Clin Anat 1995; 8:432-3. [PMID: 8713167 DOI: 10.1002/ca.980080613] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This case study presents an anomalous flexor digitorum superficialis indicis. The patient presented with a painful palmar mass. Physical exam and exploratory surgery were used to describe this anomaly. The anomalous muscle was intrinsic to the hand.
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Affiliation(s)
- S D Grant
- Chandler Medical Center, University of Kentucky College of Medicine, Lexington 40508, USA
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Abstract
A rupture occurred in the substance of an apparently normal flexor digitorum profundus tendon of a left small finger. It was associated with a previously undescribed anomalous flexor digitorum superficialis of the brevis type to the same finger. Clinical reports of 20 anomalous flexor digitorum superficialis muscles were found in the literature; all but one were on the right side or bilateral and occurred predominantly in females. Three cases were of the brevis type and all involved the index finger. Although the precise reason for rupture is not known we have speculated that the anomalous superficialis may have given rise to a deficient vinculum longus to the profundus predisposing it to failure.
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Affiliation(s)
- S A Lillmars
- Department of Orthopaedics, Geisinger Medical Center, Danville, Pa. 17822
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Abstract
Derived from postmortem dissections, early descriptions of a muscle belly in the palm that served the index finger in the manner of the flexor digitorum superficialis were published by MacAlister (1868), Graper (1917), and Mainland (1927). In the English literature, we have found reports on only 15 clinical cases that involved the palm. Based on available information regarding sex, 12 patients were female and one was male. The anomaly involved the right hand in all cases and was bilateral in four of the female patients. We report two additional cases, of which one is considered the first bilateral case in a man with symptoms on the left side.
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