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Additional muscular slip of the flexor digitorum longus muscle to the fifth toe

Abstract

Despite the fact that there are numerous reports on muscular variations in the sole of the foot, routine dissection in a formaldehyde-fixed cadaver revealed an accessory flexor digiti quinti muscle, which to the best of our knowledge is a very unusual variant. This was in the form of a slender, 38 mm long muscular slip, with a proximal and distal tendon extending from the common flexor digitorum longus tendinous plate out to the distal phalanx of the fifth toe. An associated finding was the absence of the musculotendinous portion of the flexor digitorum brevis to the same toe. A developmental explanation for this variation is presented. Clinical implications with regard to this anatomical condition may result in clawing of the fifth toe.

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References

  1. 1.

    Al-Himdani S, Talbot C, Kurdy N, Pillai A (2013) Accessory muscles around the foot and ankle presenting as chronic undiagnosed pain. An illustrative case report and review of the literature. Foot (Edinb) 23:154–161. https://doi.org/10.1016/j.foot.2013.08.002

    CAS  Article  Google Scholar 

  2. 2.

    Athavale SA, Geetha GN, Swathi (2012) Morphology of flexor digitorum accessorius muscle. Surg Radiol Anat 34:367–372. https://doi.org/10.1007/s00276-011-0909-4

    Article  PubMed  Google Scholar 

  3. 3.

    Bergman RA, Thompson SA, Afifi AK, Saddeh FA (1988) Compendium of human anatomic variation: text, atlas, and world literature. Urban & Schwarzenberg, Baltimore, pp 27, 318

    Google Scholar 

  4. 4.

    Claassen H, Wree A (2003) Isolated flexor muscles of the little toe in the feet of an individual with atrophied or lacking 4th head of the M. extensor digitorum brevis and lacking the 4th tendon of the M. extensor digitorum longus. Ann Anat 185:81–84. https://doi.org/10.1016/S0940-9602(03)80017-1

    Article  PubMed  Google Scholar 

  5. 5.

    Fasel J, Dick W (1984) Akzessorische Muskeln in der Regio retromalleolaris medialis. Z Orthop 122:835–837. https://doi.org/10.1055/s-2008-1045075

    CAS  Article  PubMed  Google Scholar 

  6. 6.

    Humphry GM (1873) Lectures on the varieties in the muscles of man. Br Med J 26:78–80 (PMID: 20747157)

    Article  Google Scholar 

  7. 7.

    Kopuz C, Tetik S, Ozbenli S (1999) A rare anomaly of the abductor digiti minimi muscle of the foot. Cells Tissues Organs 164:174–176. https://doi.org/10.1159/000016655

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Lewis OJ (1962) The comparative morphology of M. flexor accessorius and the associated long flexor tendons. J Anat 96:321–333 (PMID: 14464897)

    CAS  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Lobo SW, Menezes RG, Mamata S, Baral P, Hunnargi SA, Kanchan T, Bodhe AV, Bhat NB (2008) Phylogenetic variation in flexor digitorum brevis: a Nepalese cadaveric study. Nepal Med Coll J 10:230–232 (PMID: 19558059)

    CAS  PubMed  Google Scholar 

  10. 10.

    Nathan H, Gloobe H (1974) Flexor digitorum brevis—anatomical variations. Anat Anz 135:295–301 (PMID: 4413476)

    CAS  PubMed  Google Scholar 

  11. 11.

    Peterson DA, Stinson W, Lairmore JR (1995) The long accessory flexor muscle: an anatomical study. Foot Ankle Int 16:637–640. https://doi.org/10.1177/107110079501601010

    CAS  Article  PubMed  Google Scholar 

  12. 12.

    Saar WE, Bell J (2011) Accessory flexor digitorum longus presenting as tarsal tunnel syndrome: a case report. Foot Ankle Spec 4:379–382. https://doi.org/10.1177/1938640011418496

    Article  PubMed  Google Scholar 

  13. 13.

    Testut L (1911) Traité d’Anatomie Humaine. Tome premier, Ostéologie—Arthrologie—Myologie, sixième édition. Octave Doin et fils, Paris

    Google Scholar 

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Correspondence to Bojan V. Stimec.

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The authors (Stimec BV, Dash J, Assal M, Stern R and Fasel JHD) have no conflicts of interest or financial ties (direct or indirect) to disclose.

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Stimec, B.V., Dash, J., Assal, M. et al. Additional muscular slip of the flexor digitorum longus muscle to the fifth toe. Surg Radiol Anat 40, 533–535 (2018). https://doi.org/10.1007/s00276-018-1991-7

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Keywords

  • Flexor digitorum longus
  • Anatomic variations
  • Muscles
  • Fifth toe