Incidence of Accessory Head Of Flexor Pollicis Longus (Only In Males) and Its Clinical Significance

Incidence Of Accessory Head Of Flexor Pollicis Longus (Only In Males) And Its Clinical Significance

Authors

  • R R Desai
  • A R Desai
  • M P Ambali

Keywords:

Flexor pollicis longus, accessory head of flexor pollicis longus, median nerve, anterior interosseous nerve and ulnar artery

Abstract

Background & objectives: Accessory muscle slips may arise from coronoid process of ulna or medial epicondyle of humerus and it joins to flexor pollicis longus muscle. This accessory muscle slip is known as accessory head of flexor pollicis longus or Gantzer’s muscle. It runs downward and obliquely to join the flexor pollicis longus. While coursing it may compress median, ulnar and anterior interosseous nerves and produce neurological conditions. Aim of our study was to observe incidence of accessory head of flexor pollicis longus in adult. Method: We studied 60 upper limbs (rt: 30; lt: 30) of adult male Indian cadavers. Each forearm was dissected carefully to see the presence of accessory heads of the flexor pollicis longus and its relations with nearby structures. Results: Accessory head of flexor pollicis longus was observed in 35 upper limbs out of 60 (58.33%). It was present in 31.66 % (19) in right side and 26.66% (16) in left side upper limbs. We observed that, the median nerve ran over the accessory head of flexor pollicis longus while the anterior interosseous nerve ran posteriorly. Conclusions: Incidence of accessory head of flexor pollicis longus was high and its relation to the median nerve, anterior interosseous nerve and ulnar artery is important. Therefore, precise knowledge about this muscle is essential which will help the clinician, surgeon and radiologist to determine the exact cause of entrapment. [R Desai NJIRM 2017; 8(1): 88-91]

References

1. Mangini U. Flexor pollicis longus muscle-its morphology and clinical significance. The Journal of Bone and Joint Surgery, 1960, 42, 467-70.
2. Kosuri Kalyan Chakravarthi. Unusual Unilateral Muscular Variations of the Flexor Compartment of Forearm and Hand- A Case Report. Int J Med Health Sci. 2012; 1: 93-8.
3. Kaplan EB. Anatomia funcional y quirurgia de la mano. Buenos Aires: Artécnica; 1961. p. 197-250.
4. Hemmady MV, Subramanya AV, Mehta IM. Occasional head of flexor pollicis longus muscle: astudy of its morphology and clinical significance. J Postgrad Med. 1993; 39(1):14-6.
5. Dellon AL, Mackinnon SE. Musculoaponeurotic variations along the course of the median nerve in the proximal forearm. J Hand Surg Br. 1987; 12(3):359-63.
6. Al-Qattan MM. Gantzer's muscle. An anatomical study of the accessory head of the flexor pollicis longus muscle. J Hand Surg Br. 1996; 21(2):269-70.
7. Pai MM, Nayak SR, Krishnamurthy A, Vadgaonkar R, Prabhu LV, Ranade AV et al. The accessory heads of flexor pollicis longus and flexor digitorum profundus: Incidence and morphology. Clin Anat 2008; 21:252–58.
8. 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. Eid N, Otsuki Y. A case of double Gantzer's muscle and its possible role in nerve entrapment. Clin Anat 2009; 22:881-82.
9. El Domiaty MA, Zoair MM, Sheta AA. 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 Morph. 2008; 67(1):63–71.
10. Kara A, Elvan O, Yildiz S, Ozturk H. Accessory head of flexor pollicis longus muscle in fetuses and adult cadavers and its relation to anterior interosseous nerve. Clinical Anatomy.2012; 25(5):601–608.
11. Soubhagya R Nayak, Suranjali Sharma, Hasi Dasgupta, Kalyan Bhattacharya. Presence of Triple Gantzer's Muscle - A Rare Anatomical Variation. NUJHS 2013, 3, 69-71.
12. Campos D, Nazer MB, Bartholdy LM. Anatomical variation of the accessory muscle of the forearm (Gantzer’s muscles) and his relationship with the median nerve: a case report in human. Braz J Morphol Sci 2009, 26, 39-41.
13. Oh CS, Chung IH, Koh KS. Anatomical study of the accessory head of the flexor pollicis longus and the anterior interosseous nerve in Asians. Clin Anat. 2000; 13(6):434-8.
14. Dykes J, Anson BJ. The accessory tendon of the flexor pollicis longus muscle. Anat Rec. 1944; 90:83-9.
15. Malhotra VK, Sing NP, Tewari SP. The accessory head of the flexor pollicis longus muscle and its nerve supply. Anat Anz. 1982; 151(5):503-5.
16. Jones M, Abrahams PH, Sañudo JR, Campillo M. Incidence and morphology of muscles). J Anat. 1997; 191(Pt 3):451-5.
17. Shirali S, Hanson M, Branovacki G, Gonzalez M. The flexor pollicis longus and its relation to the anterior and posterior interosseous nerves. J Hand Surg Br.1998; 23(2):170-2.
18. Tamang BK, Sinha P, Sarda RK, Shailo P, Murtimanju BV. Incidence and morphology of acessory head of flexor pollicis longus muscle. An anatomical study. J Evol Med Dental Sci. 2013; 2(36):6800-6.
19. Jadhav S D, Zambare B R. Accessory head of flexor pollicis longus muscle and its clinical significance. International Journal of Current Research 2015; 7(5): 16540-16543.
20. Tabib W, Aboufarah F, Assilineau A. Compression du nerf interosseux antérieur par le muscle de Gantzer. Chir Main 2001; 20: 241-246.
21. Levangie PK, Norkin CC. Joint Structure and Function: A Comprehensive Analysis. 4th Ed., Philadelpia, F. A. Davis Company 2006:120-21.
22. Shanmuga Sundaram Mani, Vishnumaya G, Madhan Kumar SJ. Accessory head of flexor pollicis longus and its significance in anterior interosseus nerve neuropathies and precision handling. International Journal of Anatomical Variations. 2010; 3: 46-8.
23. Kosuri Kalyan Chakravarthi. Anatomical Variations of Brachioradialis Muscle In Relation to Radial Nerve. a cadaveric study. International Journal of Chemical and Life Sciences 2013, 02 (4), 1156-8.

Downloads

Published

2018-01-31

How to Cite

Desai, R. R., Desai, A. R., & Ambali, M. P. (2018). Incidence of Accessory Head Of Flexor Pollicis Longus (Only In Males) and Its Clinical Significance: Incidence Of Accessory Head Of Flexor Pollicis Longus (Only In Males) And Its Clinical Significance. National Journal of Integrated Research in Medicine, 8(1), 88–91. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/1177

Issue

Section

Original Articles