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Extensor indicis proprius muscle and its variants together with the extensor digitorum brevis manus muscle: a common classification. Clinical significance in hand and reconstructive surgery

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Abstract

Purpose

The extensor indicis proprius (EIP) is a muscle of the forearm that originates from the posterior surface of the ulna and the adjacent interosseous membrane and attaches to the index finger. Many anatomical variations of this muscle have been reported in the literature. The extensor digitorum brevis manus (EDBM) is a variant muscle found on the back of the wrist and hand. These muscle variants should be considered in the context of clinical syndromes and reconstructive hand surgery. The aim of the present study was to describe in detail the normal and variant anatomy of these muscles and propose new systematic classifications.

Materials and methods

Formol–carbol-fixed Europid upper limbs (n = 176) were examined in the Department of Anatomy, Histology and Embryology at the Medical University of Sofia for variations of the EIP and occurrences of the EDBM.

Results

We found normal anatomy in 147 (84%) of the specimens examined and we measured the length and width of the muscle belly and tendon of the EIP. Variations of the EIP in the other 29 upper limbs (16%) included replacement of the EIP by an EIB, coexistence of the EIP and EIB, presence of accessory tendons, and additional muscles.

Conclusions

Knowledge of anatomical variations of forearm muscles is important because they can cause clinical syndromes or have implications for reconstructive surgery, most often as tendon transfers in response to functional loss of other forearm muscles.

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Acknowledgements

The authors would like to express their most sincere gratitude and to pay their respects to all the men and women who donated their bodies for the purpose of scientific research. We would also like to thank Mr. Martin Tsekov for his contribution in preparing the figures and schemes in this manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University Hospital Queen Giovanna-ISUL, Medical University of Sofia, 8 Bialo more str., 1527, Sofia, Bulgaria

    Georgi P. Georgiev

  2. Seattle Science Foundation and Department of Anatomy, St. George’s University, True Blue, Grenada

    R. Shane Tubbs

  3. Department of Anatomy, Histology and Embryology, Medical University of Sofia, Sofia, Bulgaria

    Alexandar Iliev, Georgi Kotov & Boycho Landzhov

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  1. Georgi P. Georgiev
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  2. R. Shane Tubbs
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  3. Alexandar Iliev
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  4. Georgi Kotov
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  5. Boycho Landzhov
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Contributions

GPG performed the data collection, data analysis, manuscript writing; RST editing the article; AI, GK, BL helped in preparing the manuscript. All authors approved the final version of the article to be published.

Corresponding author

Correspondence to Georgi P. Georgiev.

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The authors declare that they have no conflicts of interest concerning this article.

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Georgiev, G.P., Tubbs, R.S., Iliev, A. et al. Extensor indicis proprius muscle and its variants together with the extensor digitorum brevis manus muscle: a common classification. Clinical significance in hand and reconstructive surgery. Surg Radiol Anat 40, 271–280 (2018). https://doi.org/10.1007/s00276-018-1981-9

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  • DOI: https://doi.org/10.1007/s00276-018-1981-9

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