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Surgical and Radiologic Anatomy

, Volume 41, Issue 11, pp 1315–1318 | Cite as

Accessory flexor carpi ulnaris muscle with associated anterior interosseous artery variation: case report with the definition of a new type and review of concomitant variants

  • Vojtech Kunc
  • Michal Stulpa
  • Georg Feigl
  • David KachlikEmail author
Anatomic Variations
  • 89 Downloads

Abstract

Purpose

Knowledge of accessory flexor carpi ulnaris (AFCU) is not only important for proper orientation in the surgical field but it can be used for tendon transfer as well. AFCU commonly occurs with concomitant variants, and its presence should rise caution in order to prevent iatrogenic injury.

Methods

During a routine dissection for research data collection at the Institute of Anatomy, a AFCU with concomitant variants was observed in a European cadaver fixed with Thiel’s method. A thorough review of the literature concerning all the encountered variants was performed.

Results

AFCU was found in the right upper limb with its insertion on the flexor retinaculum. Palmaris longus muscle was absent in this limb, and an accessory branch of the anterior interosseous artery coursed over the pronator quadratus muscle to anastomose with the ulnar artery 5 cm proximally to the pisiform. On the left hand, a variable lumbrical of the second finger originating from the flexor retinaculum was found, which was not described in the literature before.

Conclusions

AFCU commonly occurs together with concomitant variants, and special attention is needed when performing surgery on such forearm.

Keywords

Accessory flexor carpi ulnaris Anterior interosseous artery Anatomical variability Lumbrical muscle 

Notes

Acknowledgements

We are very thankful to the body donor for his kind donation.

Author’s Contribution

VK was involved in project development, dissection, and manuscript writing/editing. MS contributed to photo documentation, its processing and manuscript writing/editing. GF was involved in dissection supervision and manuscript writing/editing. DK contributed to manuscript writing/editing.

Funding

Funding was provided by Charles University, Prague, Czech Republic (Grant No. PROGRES Q37).

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. 1.
    Alvin M, Alan N, Leone J, Fredieu JR (2011) A unilateral accessory flexor carpi ulnaris muscle observed during cadaveric dissection. Clin Anat 24(8):971–973.  https://doi.org/10.1002/ca.21234 CrossRefPubMedGoogle Scholar
  2. 2.
    Ang GG, Rozen WM, Vally F, Eizenberg N, Grinsell D (2010) Anomalies of the flexor carpi ulnaris: clinical case report and cadaveric study. Clin Anat 23(4):427–430.  https://doi.org/10.1002/ca.20952 CrossRefPubMedGoogle Scholar
  3. 3.
    Arnold G, Zech M (1977) An accessory muscle and additional variants of the forearm. Handchirurgie 9(3):135–136PubMedGoogle Scholar
  4. 4.
    Bhardwaj P, Bhandari L, Sabapathy SR (2013) Supernumerary flexor carpi ulnaris—case report and review. Hand Surg 18(3):393–397.  https://doi.org/10.1142/S0218810413720222 CrossRefPubMedGoogle Scholar
  5. 5.
    Campos D, Nazer MB, Bartholdy LM, Souza PL (2010) Accessory flexor carpi ulnaris muscle: a case report of a rare variation in human. J Morphol Sci 27(1):30–31Google Scholar
  6. 6.
    Chong SJ, Al-Ani S, Pinto C, Peat B (2009) Bilateral flexor carpi radialis brevis and unilateral flexor carpi ulnaris brevis muscle: case report. J Hand Surg Am 34(10):1868–1871.  https://doi.org/10.1016/j.jhsa.2009.08.002 CrossRefPubMedGoogle Scholar
  7. 7.
    Georgiev GP, Jelev L, Ovtscharoff WA (2009) Unusual combination of muscular and arterial variations in the upper extremity: a case report of a variant palmaris longus and an additional tendinous portion of the flexor carpi ulnaris together with a persistent median artery. Anatomy 3:58–61.  https://doi.org/10.2399/ana.09.031 CrossRefGoogle Scholar
  8. 8.
    Lemon M, Belcher HJ (2002) An anomalous flexor carpi ulnaris. J Hand Surg Br 27(2):194–197.  https://doi.org/10.1054/jhsb.2001.0705 CrossRefPubMedGoogle Scholar
  9. 9.
    Lippert H, Pabst R (1985) Arterial variations in man. In: Bergman JF (ed) Bergman’s comprehensive encyclopedia of human anatomic variation, 1st edn. Urban & Schwanzenberg, München, pp 71–77Google Scholar
  10. 10.
    Mehta HJ, Gardner WU (1961) A study of lumbrical muscles in the human hand. Am J Anat 11(109):227–238.  https://doi.org/10.1002/aja.1001090302 CrossRefGoogle Scholar
  11. 11.
    Milena GL, Santiago FR, Santon CC, Barea LC (2001) Forearm soft tissue mass caused by an accessory muscle. Eur Radiol 11(8):1487–1489.  https://doi.org/10.1007/s003300100827 CrossRefGoogle Scholar
  12. 12.
    Mori M (1964) Statistics on the musculature of Japanese. Okajimas Folia Anat Jpn 40:195–300CrossRefGoogle Scholar
  13. 13.
    Poisel S (1974) Ursprung und Verlauf des R. muscularis des Nervus digitalis palmaris communis I (N. medianus). Chir Praxis 18:471–474Google Scholar
  14. 14.
    Quain R (1844) Anatomy of the arteries of the human body and its applications to pathology and operative surgery. Taylor and Walton, London, pp 312–313Google Scholar
  15. 15.
    Schultz RJ, Endler MP, Huddleston HD (1973) Anomalous median nerve and an anomalous muscle belly of the first lumbrical associated with carpal tunnel-syndrome. J Bone Jt Surg Am 55(8):1744–1746CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Anatomy, Second Faculty of MedicineCharles UniversityPragueCzech Republic
  2. 2.Institute of AnatomyMedical University GrazGrazAustria

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