Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and clinical implications of the Gantzer’s muscle

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

The Gantzer’s muscle is considered to be the accessory head of the flexor pollicis longus. The prevalence of the Gantzer’s muscle and its anatomical relations vary in the literature. So, we aimed to study its prevalence and anatomical relations on a broad population on magnetic resonance (MRI) and ultrasound (US) images.

Materials and methods

We investigated a total of 473 upper extremities of 378 people (171 women, 207 men), aged between 18 and 73 years, by MRI and US. We investigated the prevalence and length of the Gantzer’s muscle and its anatomical relationship with the median (MN) and anterior interosseous nerves (AIN).

Results

Of the 473 extremities, 96 had Gantzer’s muscle (20.3%). Overall prevalence of the Gantzer’s muscle was 21.9% (51 in 232) in women and 18.7% (45 in 241) in men. In the population we performed US, Gantzer’s muscle was located 40.0% in only the right limb, 37.1% in only the left limb and 22.9% bilaterally. All the Gantzer’s muscles originated from the coronoid process. Of the 43 Gantzer’s muscles seen in US, thirty-four (79.1%) were attached to flexor pollicis longus and nine (20.9%) were attached to flexor digitorum superficialis. The mean length of the Gantzer’s muscle was 29.7 (range 17.2–44.5) mm. MN was anterior to the Gantzer’s muscle in all extremities except ten. In all extremities, AIN was located posterior to the Gantzer’s muscle.

Conclusion

Although it is seen at a rare rate of 20.3%, Gantzer’s muscle should be considered in MN and AIN compressions due to its close proximity to these nerves.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

References

  1. al-Qattan MM (1996) Gantzer’s muscle. an anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br 21:269–270. https://doi.org/10.1016/s0266-7681(96)80114-8

    Article  PubMed  Google Scholar 

  2. Arıncı K, Elhan A (2020) Anatomi. 7 edn. Güneş Kitabevi, Ankara

  3. Ballesteros DR, Forero PL, Ballesteros LE (2019) Accessory head of the flexor pollicis longus muscle: anatomical study and clinical significance. Folia Morphol 78:394–400. https://doi.org/10.5603/FM.a2018.0091

    Article  CAS  Google Scholar 

  4. Bilecenoglu B, Uz A, Karalezli N (2005) Possible anatomic structures causing entrapment neuropathies of the median nerve: an anatomic study. Acta Orthop Belg 71:169–176

    PubMed  Google Scholar 

  5. Brooks HS (1887) Short muscles of the pollex and hallux of the anthropoid apes, with special reference to the opponens hallucis. J Anat Physiol 22:78–95

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Caetano EB, Sabongi JJ, Vieira LA, Caetano MF, Moraes DV (2015) Gantzer muscle. An anatomical study. Acta Ortop Brasil 23:72–75. https://doi.org/10.1590/1413-78522015230200955

    Article  Google Scholar 

  7. Degreef I, De Smet L (2004) Anterior interosseous nerve paralysis due to Gantzer’s muscle. Acta Orthop Belg 70:482–484

    PubMed  Google Scholar 

  8. Dellon A, Mackinnon S (1987) Musculoaponeurotic variations along the course of the median nerve in the proximal forearm. J Hand Surg Br 12:359–363. https://doi.org/10.1016/0266-7681(87)90189-6

    Article  CAS  PubMed  Google Scholar 

  9. Diogo R, Siomava N, Gitton Y (2019) Development of human limb muscles based on whole-mount immunostaining and the links between ontogeny and evolution. Development. https://doi.org/10.1242/dev.180349

    Article  PubMed  Google Scholar 

  10. Dykes J, Anson BJ (1944) The accessory tendon of the flexor pollicis longus muscle. Anat Rec 90:83–87

    Article  Google Scholar 

  11. El Domiaty MA, Zoair MM, Sheta AA (2008) The prevalence of accessory heads of the flexor pollicis longus and the flexor digitorum profundus muscles in Egyptians and their relations to median and anterior interosseous nerves. Folia Morphol 67:63–71

    Google Scholar 

  12. Gantzer K (1813) Dissertatio anatomica musculorum varietates sistens Quam consensu gratiosi medicorum ordinis. Berolini: Typis Joannis Friderici Starckii

  13. Gray H, Carter H (2020) Gray’s anatomy 42 Edition. The anatomical basis of clinical practice. Elsevier, New York

    Google Scholar 

  14. Gunnal SA, Siddiqui AU, Daimi SR, Farooqui MS, Wabale R (2013) A study on the accessory head of the flexor pollicis longus muscle (Gantzer’s Muscle). J Clin Diagn Res 7:418–421. https://doi.org/10.7860/jcdr/2013/4545.2788

    Article  Google Scholar 

  15. Jones M, Abrahams PH, Sañudo JR, Campillo M (1997) Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer’s muscles). J Anat 191(Pt 3):451–455. https://doi.org/10.1046/j.1469-7580.1997.19130451.x

    Article  PubMed  PubMed Central  Google Scholar 

  16. Kara A, Elvan O, Yildiz S, Ozturk H (2012) Accessory head of flexor pollicis longus muscle in fetuses and adult cadavers and its relation to anterior interosseous nerve. Clin Anat 25:601–608. https://doi.org/10.1002/ca.21296

    Article  PubMed  Google Scholar 

  17. Mangini U (1960) Flexor pollicis lungus muscle. Its morphology and clinical significance. J Bone Joint Surg Am 42:467–470

    Article  Google Scholar 

  18. Pai MM, Nayak SR, Krishnamurthy A, Vadgaonkar R, Prabhu LV, Ranade AV, Janardhan JP, Rai R (2008) The accessory heads of flexor pollicis longus and flexor digitorum profundus: Incidence and morphology. Clin Anat 21:252–258. https://doi.org/10.1002/ca.20612

    Article  PubMed  Google Scholar 

  19. Rengachary S (2000) Entrapment neuropathies. In: Wilkins RH, SS R (eds) Neurosurgery, vol 2. 2nd edn. McGraw-Hill Education, London

  20. Roshni B, Tarakeshwari R, Shubha R (2015) Gantzer muscles A study on 50 cadaveric upper limbs. Natl J Clin Anat 4:179

    Article  Google Scholar 

  21. Roy J, Henry BM, Pekala PA, Vikse J, Ramakrishnan PK, Walocha JA, Tomaszewski KA (2015) The prevalence and anatomical characteristics of the accessory head of the flexor pollicis longus muscle: a meta-analysis. PeerJ 3:e1255. https://doi.org/10.7717/peerj.1255

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sembian U, Srimathi T, Muhil M, Nalina Kumari SD, Subramanian T (2012) A study of the accessory muscles in the flexor compartment of the forearm. J Clin Diagn Res 6:564–567

    Google Scholar 

  23. Susman RL (1979) Comparative and functional morphology of hominoid fingers. Am J Phys Anthropol 50:215–236. https://doi.org/10.1002/ajpa.1330500211

    Article  CAS  PubMed  Google Scholar 

  24. Susman RL (1998) Hand function and tool behavior in early hominids. J Hum Evol 35:23–46. https://doi.org/10.1006/jhev.1998.0220

    Article  CAS  PubMed  Google Scholar 

  25. Uyaroglu FG, Kayalioglu G, Erturk M (2006) Incidence and morphology of the accessory head of the flexor pollicis longus muscle (Gantzer`s muscle) in a Turkish population. Neurosciences 11:171–174

    PubMed  Google Scholar 

  26. Zielinska N, Szewczyk B, Tubbs RS, Olewnik L (2021) Coexistence of two accessory flexor pollicis longus heads or coexistence of two-headed flexor pollicis longus with an unrecognized anatomical structure? Surg Radiol Anat 43:763–769. https://doi.org/10.1007/s00276-021-02721-w

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors thank to Hiranur Kıranşal for the illustrations.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. Department of Anatomy, Faculty of Medicine, Ankara Yildirim Beyazit University, Bilkent, Ankara, Turkey

    Bilge İpek Torun

  2. Department of Radiology, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey

    Mehtap Balaban

Authors
  1. Bilge İpek Torun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehtap Balaban
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BIT: Project development, data analysis, drafting the article, revising it critically for important intellectual content, final approval of the version to be published, agree to be accountable for all aspects of the work if questions arise related to its accuracy or integrity. MB: Data collection, data analysis, drafting the article, revising it critically for important intellectual content, final approval of the version to be published, agree to be accountable for all aspects of the work if questions arise related to its accuracy or integrity.

Corresponding author

Correspondence to Bilge İpek Torun.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interest.

Compliance with ethical standards

Ethical approval was taken from the Ethical Committee of our university. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval was obtained from the Institutional Ethics Committee. Informed consent was not required for the MR study, in accordance with retrospective review policies. Informed consent was obtained from the volunteers who underwent US.

Consent for publication

Since the article does not contain any identifying information about the participants, informed consent is not required for its publication.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Torun, B.İ., Balaban, M. Prevalence and clinical implications of the Gantzer’s muscle. Surg Radiol Anat 44, 1297–1303 (2022). https://doi.org/10.1007/s00276-022-03006-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-022-03006-6

Keywords

Search

Navigation