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1.
Surg Radiol Anat ; 46(10): 1709-1714, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39136747

RESUMEN

PURPOSE: The brachioradialis muscle (BRM) belongs to the lateral group of forearm muscles and contributes to the elbow flexion. Accessory brachioradialis muscle (ABRM) or "brachioradialis accessorius" represents an uncommon BRM variant, not been enough studied. The present study investigates the prevalence of the ABRM, along with its origin, insertion, and innervation. MATERIALS: Eighty-three upper limbs were meticulously dissected at the arm, forearm, and cubital fossa to investigate the ABRM presence. When the variant muscle was identified, morphometric measurements were obtained. RESULTS: The ABRM was identified in two upper limbs (2/83, 2.4%), in a male cadaver, bilaterally. Its origin was located along with the typical BRM, and its insertion was identified into the anterior surface of the radius (proximal third). The ABRM was innervated by the radial nerve, coursing posteriorly (deeply). CONCLUSIONS: In the current study, the variant muscle was observed in 2.4%. Radial nerve compression, at the forearm, is not an uncommon entrapment neuropathy. The relationship between the radial nerve and the ABRM could precipitate radial neuropathy.


Asunto(s)
Variación Anatómica , Cadáver , Antebrazo , Músculo Esquelético , Humanos , Masculino , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología , Músculo Esquelético/inervación , Prevalencia , Antebrazo/inervación , Antebrazo/anomalías , Antebrazo/anatomía & histología , Femenino , Nervio Radial/anatomía & histología , Nervio Radial/anomalías , Anciano , Persona de Mediana Edad , Síndromes de Compresión Nerviosa/diagnóstico , Disección , Anciano de 80 o más Años
2.
Surg Radiol Anat ; 46(9): 1465-1468, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38963432

RESUMEN

PURPOSE: A deep knowledge of the variations of the posterior forearm musculature is crucial for assessing and diagnosing conditions in this region. Extensor indicis (EI) is one of the muscles in this region, which exhibits diverse anatomical variations. This report documents an extremely unusual form of the EI with an accessory head on the dorsum of the hand. METHODS: During routine dissection, an extremely rare presentation of the EI was found in the left forearm of a 94-year-old female cadaver. RESULTS: This unusual EI consisted of two muscle bellies. The traditional belly originated from the distal two-thirds of the ulna. The muscle became tendinous around the carpal area, distal to the extensor retinaculum. The tendon was subsequently joined by an accessory muscle belly originating from the distal radioulnar ligament. The EI tendon inserted onto the dorsal expansion of the index finger, ulnar to that of the extensor digitorum. The posterior interosseous nerve innervated the muscle. CONCLUSION: Herein, we report an extremely rare form of the EI. To our knowledge, EI with an accessory head has only been reported rarely over the past 200 years. Moreover, our report appears to be the first case with photographic details of this anatomical variation. Clinicians should be aware of this variation for proper diagnosis and treatment.


Asunto(s)
Variación Anatómica , Cadáver , Antebrazo , Músculo Esquelético , Humanos , Femenino , Anciano de 80 o más Años , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología , Antebrazo/anomalías , Antebrazo/inervación , Tendones/anomalías , Tendones/anatomía & histología , Disección
3.
Anat Sci Int ; 99(3): 326-330, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38733476

RESUMEN

The extensor digitorum profundus complex underwent degeneration of the ulnar segments during primate adaptation and evolution. This process resulted in the preservation of only the extensor pollicis longus and extensor indicis in some apes, including humans. Consequently, anatomical variations within the digitorum profundus complex in modern humans have been well-documented, with detailed reports on their frequency and patterns in previous studies. Here, we report an unusual arrangement involving two anomalies in the extensor digitorum profundus complex, identified in a 66-year-old Japanese male cadaver. In this cadaver, two accessory muscles differentiated from both the extensor pollicis longus and extensor indicis. Notably, the latter muscle featured a tendon bifurcating towards both the thumb and index fingers, referred to as the extensor pollicis et indicis communis. Under the extensor retinaculum, the tendon of the accessory extensor pollicis longus passed through an independent compartment, whereas that of the extensor pollicis et indicis communis traversed a compartment shared by the extensor indicis and the extensor digitorum communis. Both muscles were innervated by the posterior interosseous nerve. Previous studies have reported that the accessory slip of the extensor pollicis longus and extensor pollicis et indicis communis appear at frequencies of 0.6% and 0.4-1.4%, respectively. However, to the best of our knowledge, a configuration in which both appear simultaneously has not been reported. The data from this case could provide essential insights into the variations in the extensor digitorum profundus complex in humans and non-human primates.


Asunto(s)
Cadáver , Músculo Esquelético , Tendones , Humanos , Masculino , Anciano , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología , Tendones/anomalías , Tendones/anatomía & histología , Dedos/anomalías , Dedos/anatomía & histología , Variación Anatómica , Pulgar/anomalías
4.
Prague Med Rep ; 125(2): 163-171, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38761050

RESUMEN

Anatomical variations of the forearm flexor muscles are occasionally encountered. Though usually observed incidentally during autopsies or imaging studies, they may at times cause concern due to associated clinical symptoms. This report presents a case of unilateral accessory flexor carpi ulnaris (AFCU) muscle observed in a human male cadaver aged 78 years. During routine cadaveric dissection, an anomalous AFCU muscle was observed in the left forearm of a human male cadaver aged 78 years. Standard institutional guidelines pertaining to the use of human cadaver for teaching and research were followed. A thorough literature review about the flexor carpi ulnaris (FCU) through the PubMed, Embase and Google scholar databases was undertaken, using the keywords - accessory flexor carpi ulnaris muscle, aberrant flexor carpi ulnaris muscle and anatomical variation of flexor carpi ulnaris muscle. Relevant gross anatomical findings were recorded and photographed. AFCU was identified on the medial aspect of the distal third of the left forearm. The AFCU was found originating from the ante-brachial fascia and the fascia covering the FCU on the left forearm, forming a small separate belly deep to the main muscle. It terminated as a thin tendon running alongside the hypothenar muscles and attached distally to the base of the proximal phalanx of the little finger. The AFCU was found to be innervated by a branch of the ulnar nerve. Awareness about the rare AFCU muscle is clinically important as a possible cause of ulnar nerve compression but also as a possible graft in reconstruction surgeries.


Asunto(s)
Cadáver , Antebrazo , Músculo Esquelético , Humanos , Masculino , Anciano , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología , Antebrazo/anomalías , Antebrazo/anatomía & histología
5.
Surg Radiol Anat ; 46(6): 771-776, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38637415

RESUMEN

Awareness of unique path of the superficial branch of the radial nerve and its unusual sensory distribution can help avoid potential diagnostic confusion. We present a unique case encountered during a routine dissection of a Central European male cadaver. An unusual course of the superficial branch of the radial nerve was found in the right forearm, where the superficial branch of the radial nerve originated from the radial nerve distally, within the supinator canal, emerged between the extensor digitorum and abductor pollicis longus muscles and supplied the second and a radial half of the third digit, featuring communications with the lateral antebrachial cutaneous nerve and the dorsal branch of the ulnar nerve. Due to dorsal emerging of the superficial branch of the radial nerve the dorsal aspect of the thumb was innervated by the lateral antebrachial cutaneous nerve. To our best knowledge such variation of the superficial branch of the radial nerve has never been reported before. This variation dramatically changes aetiology and manifestation of possible entrapment syndromes which clinicians should be aware of.


Asunto(s)
Variación Anatómica , Cadáver , Dedos , Antebrazo , Músculo Esquelético , Nervio Radial , Humanos , Nervio Radial/anatomía & histología , Nervio Radial/anomalías , Masculino , Músculo Esquelético/inervación , Músculo Esquelético/anomalías , Dedos/inervación , Antebrazo/inervación , Antebrazo/anomalías , Disección
6.
J Anat ; 245(2): 217-230, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-38624036

RESUMEN

Radial dysplasia (RD) is a congenital upper limb birth defect that presents with changes to the upper limb anatomy, including a shortened or absent radius, bowed ulna, thumb malformations, a radially deviated hand and a range of muscle and tendon malformations, including absent or abnormally shaped muscle bundles. Current treatments to address wrist instability caused by a shortened or absent radius frequently require an initial soft tissue distraction intervention followed by a wrist stabilisation procedure. Following these surgical interventions, however, recurrence of the wrist deviation remains a common, long-term problem following treatment. The impact of the abnormal soft connective tissue (muscle and tendon) anatomy on the clinical presentation of RD and the complications following surgery are not understood. To address this, we have examined the muscle, fascia and the fascial irregular connective tissue (ICT) fibroblasts found within soft connective tissues, from RD patients. We show that ICT fibroblasts isolated from RD patients are functionally abnormal when compared to the same cells isolated from control patients and secrete a relatively disordered extracellular matrix (ECM). Furthermore, we show that ICT fibroblast dysfunction is a unifying feature found in RD patients, even when the RD clinical presentation is caused by distinct genetic syndromes.


Asunto(s)
Tejido Conectivo , Fibroblastos , Músculo Esquelético , Humanos , Fibroblastos/patología , Tejido Conectivo/patología , Músculo Esquelético/anomalías , Músculo Esquelético/patología , Masculino , Femenino , Radio (Anatomía)/anomalías , Radio (Anatomía)/patología
8.
Morphologie ; 108(362): 100776, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-38555754

RESUMEN

PURPOSE: The biceps brachii muscle (BBM) is a large and thick muscle on the ventral portion of the upper arm. The scientific literature reports the existence of extra heads. OBJECTIVE: The present work investigated the frequency of occurrence of BBM accessory head(s) in four different Anatomy Laboratories at universities in Northeast Brazil. MATERIAL AND METHODS: Once the upper limbs with an anatomical variation of the BBM heads were identified, the accessory head was evaluated for morphometric characterization (the length, width, and thickness). RESULTS: The sample consisted of 249 upper limbs and the outcomes were 26 members with BBM accessory heads (10.44% of the total sample). Among the 26 members studied was found a single accessory head in 22 (84.62%), two accessory heads in 3 (11.54%), and three accessory heads in 1 (3.85%). BBMs with one, two, and three accessory heads were found, with different origins. The average length, width, and thickness of these accessory heads were 169.39mm, 10.25mm, and 3.39mm, respectively. CONCLUSION: The frequency of BBM accessory heads in a population of northeastern Brazil in this cadaveric study was 10.44%.


Asunto(s)
Variación Anatómica , Cadáver , Músculo Esquelético , Humanos , Músculo Esquelético/anatomía & histología , Músculo Esquelético/anomalías , Brasil , Masculino , Brazo/anatomía & histología , Femenino , Anciano , Persona de Mediana Edad
9.
J Anat ; 245(1): 197-198, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38444373

RESUMEN

We read with great interest the article by Weninger et al. (2023) on the presence of the axillary arch (AA) (of Langer) found during anatomical dissections-"Axillary arch (of Langer): A large-scale dissection and simulation study based on unembalmed cadavers of body donors." The authors performed their study using 400 axillae from 200 unembalmed cadavers; they identified this variant muscle in 27 axillae of 18 cadavers. Weninger et al. (2023) described the muscular AA in 15 cases; AA was composed of connective tissue in six cases, and AA comprised muscular and connective tissue in six cadavers. Moreover, these authors indicated that after passive abduction and lateral rotation of the arm, 17 arches (63%) came into contact with the neurovascular axillary bundle, which is of clinical importance. In our opinion, this is the most precise and detailed AA muscle study in the literature, illustrated with excellent photographs and schemes. Such studies expand the existing data in the literature and are of real help to clinicians. However, we want to present our modest comments about the title of the article and would like to pose the question, "What is the axillary arch (of Langer)?" Weninger et al. (2023) stated that connective or muscular tissue crossing the axilla is termed the AA (of Langer). This structure splits from the latissimus dorsi muscle, crosses the axilla, and joins the anterior part of the upper limb. The first detailed description of this variation was published in 1846 by Karl Langer Ritter von Edenberg (Langer, 1846). Nowadays, a significant number of articles term all muscular and fibromuscular connections between the latissimus dorsi muscle and the anterior part of the upper limb as "Langers AA" (Markou et al., 2023; Sang et al., 2019; Scrimgeour et al., 2020; Taterra et al., 2019). What Langer described in his work "Zur anatomie des musculus latissimus dorsi" was a fibrous thickening of the medial edge of the axillary fascia between the borders of the pectoralis major and the latissimus dorsi muscles, a structure he termed "Achselbogen." In a sequel of this article, Langer investigated muscular fibers inserting at or encircling the connective tissue "Achselbogen" (Langer, 1846). Therefore, in our opinion, in the study of Weninger et al. (2023), the term AA (of Langer) should only be used to describe the cases presenting solely with a connective tissue "arch" or these comprised of both, muscular and connective tissue. Weninger et al. (2023) noted that muscle fibers could not be excluded in these cases. Of course, to answer this question accurately, a histological study of these cases would be necessary.


Asunto(s)
Axila , Cadáver , Músculo Esquelético , Humanos , Axila/anatomía & histología , Axila/anomalías , Músculo Esquelético/anatomía & histología , Músculo Esquelético/anomalías , Disección
10.
Ann Plast Surg ; 92(5): 557-563, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38547123

RESUMEN

OBJECTIVES: Some patients develop ulnar nerve compression due to rare anatomical variations or malformations. The aims of this review are to provide a comprehensive overview of anatomical structures and variations that can cause ulnar nerve compression and to evaluate treatment options. METHODS: Case reports and case series about rare cases of unusual ulnar nerve compression published from January 2000 until April 2022 were obtained from databases Embase, MEDLINE, and Web of Science. A total of 48 studies describing 64 patients were included in our study. RESULTS: The following structures have proven to cause ulnar nerve compression: anconeus epitrochlearis, accessory abductor digiti minimi, vascular anomalies, palmaris longus, fibrous bands, and flexor carpi ulnaris. All cases except one have had a surgical release of the ulnar nerve resulting in diminished symptoms or complete recovery at follow-up. CONCLUSIONS: In addition to considering common compression points, it is important to be aware that proximal compression symptoms, such as pain and a positive Tinel sign at the medial elbow, may be attributed to a hypertrophic AE or vascular anomaly. Distal compression symptoms encompass swelling, along with pain and a positive Tinel sign at the distal forearm. Various structures contributing to distal compression include an accessory abductor digiti minimi muscle, an accessory or anomalous palmaris longus muscle, or an accessory or hypertrophic flexor carpi ulnaris muscle. The occurrence of fibrous bands exhibits variability, manifesting in diverse locations across the arm.Level of Evidence: IV.


Asunto(s)
Síndromes de Compresión del Nervio Cubital , Humanos , Síndromes de Compresión del Nervio Cubital/etiología , Síndromes de Compresión del Nervio Cubital/cirugía , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología , Descompresión Quirúrgica/métodos
11.
Int. j. morphol ; 42(1): 17-20, feb. 2024. ilus
Artículo en Inglés | LILACS | ID: biblio-1528819

RESUMEN

SUMMARY: Variations in the triceps brachii muscle are uncommon, and especially limited reports exist on the accessory heads of tendinous origin that attach near the upper medial part of the humerus. During anatomical training at Nagasaki University School of Medicine, the accessory head of the triceps brachii muscle was observed on the right upper arm of a 72-year-old Japanese female. It arose tendinously from the medial side of the upper humerus, then formed a muscle belly and joined the distal side of the long head. This accessory head had independent nerve innervation, and the innervating nerve branched from a bundle of the radial nerve, which divided the nerve innervating the long head and the posterior brachial cutaneous nerve. The origin of the innervation of the accessory head was the basis for determining that this muscle head was an accessory muscle to the long head of the triceps brachii muscle. Embryologically, we discuss that part of the origin of the long head of the triceps brachii muscle was separated early in development by the axillary nerve and the posterior brachial circumflex artery, and it slipped into the surgical neck of the humerus and became fixed there. The accessory head crossed the radial nerve and deep brachial artery. When clinicians encounter compression of the radial nerve or profunda brachii artery, they should consider the presence of accessory muscles as a possible cause.


Las variaciones en el músculo tríceps braquial son poco comunes y existen informes especialmente limitados sobre las cabezas accesorias de origen tendinoso que se insertan cerca de la parte medial superior del húmero. Durante un entrenamiento anatómico en la Facultad de Medicina de la Universidad de Nagasaki, se observó la cabeza accesoria del músculo tríceps braquial en la parte superior del brazo derecho de una mujer japonesa de 72 años. Se originaba tendinosamente desde el lado medial de la parte superior del húmero, luego formaba un vientre muscular y se unía al lado distal de la cabeza larga. Esta cabeza accesoria tenía inervación nerviosa independiente, cuyo nervio se ramificaba a partir de un ramo del nervio radial, que dividía el nervio que inervaba la cabeza larga y el nervio cutáneo braquial posterior. El origen de la inervación de la cabeza accesoria fue la base para determinar que esta cabeza muscular era un músculo accesorio de la cabeza larga del músculo tríceps braquial. Embriológicamente, discutimos que parte del origen de la cabeza larga del músculo tríceps braquial se separó temprananamente en el desarrollo por el nervio axilar y la arteria circunfleja braquial posterior, y se deslizó hacia el cuello quirúrgico del húmero y quedó fijado allí. La cabeza accesoria cruzaba el nervio radial y la arteria braquial profunda. Cuando los médicos encuentran compresión del nervio radial o de la arteria braquial profunda, deben considerar la presencia de mús- culos accesorios como una posible causa.


Asunto(s)
Humanos , Femenino , Anciano , Músculo Esquelético/anatomía & histología , Músculo Esquelético/anomalías , Variación Anatómica , Nervio Radial , Cadáver
12.
J Hand Surg Eur Vol ; 49(7): 917-919, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38103046

RESUMEN

An anomalous flexor carpi radialis brevis (FCRB) muscle was present in four of nine patients undergoing surgery for Madelung's deformity. This disproportionately frequent finding suggests an embryologic dysgenesis of forearm formation rather than a developmental tethering of Vicker's ligament.Level of evidence: IV (case series).


Asunto(s)
Músculo Esquelético , Humanos , Masculino , Femenino , Músculo Esquelético/anomalías , Músculo Esquelético/cirugía , Antebrazo/anomalías , Antebrazo/cirugía , Niño , Adulto , Adolescente , Sinostosis/cirugía , Sinostosis/diagnóstico por imagen , Polidactilia/cirugía , Trastornos del Crecimiento , Osteocondrodisplasias
13.
Ann Afr Med ; 22(3): 359-364, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37417026

RESUMEN

Background: Biceps brachii is an elongated two-headed fusiform muscle of the anterior compartment of the arm which crosses the shoulder as well as the elbow joint. It assists in flexion of the shoulder joint and elbow joint and powerful supinator of the forearm. It also assists in the abduction of the shoulder joint. Accessory heads of biceps brachii muscle not only give additional strength to the joints, at the same time, they may also simulate soft-tissue tumors that can result in neurovascular compression. Aims and Objectives: Accordingly, the aim of this study was designed to evaluate the prevalence of accessory heads of biceps brachii muscle in human cadavers. Materials and Methods: This study was conducted on 107 formalin embalmed human cadavers (male 62 and 45 female), and dissections were performed in accordance with the institutional ethical standards and the Indian Anatomy Act. Results: Out of 107 cadavers, three-headed biceps brachii was noted in 18 cadavers (16.82%) associated with the unusual course of musculocutaneous nerve. Rare and unusual unilateral five-headed biceps brachii was noted in one male cadaver (0.93%). All accessory heads noted in this study were supplied by the separate branches of musculocutaneous nerve except the humeral head of five-headed biceps, which was supplied by the radial nerve. Conclusion: Awareness of these anatomical variations, knowledge is necessary for radiologists, anesthetists, physiotherapists, and orthopedic surgeons to avoid complications during various radiodiagnostic procedures or surgeries of flexor deformities of the upper arm and forearm.


Résumé Contexte: Le biceps brachial est un muscle allongé fusiforme à deux têtes de la loge antérieure du bras qui traverse l'épaule ainsi que l'articulation du coude. Il aide à la flexion de l'articulation de l'épaule et du coude et supinateur puissant de l'avant-bras. Il aide également à l'abduction de l'articulation de l'épaule. Les têtes accessoires du muscle biceps brachial donnent non seulement une force supplémentaire aux articulations, en même temps, ils peuvent également simuler des tumeurs des tissus mous pouvant entraîner une compression neurovasculaire. Buts et objectifs: En conséquence, le but de ce étude a été conçue pour évaluer la prévalence des têtes accessoires du muscle biceps brachial chez les cadavres humains. Matériels et méthodes: ce étude a été menée sur 107 cadavres humains embaumés au formol (hommes 62 et 45 femmes), et des dissections ont été réalisées dans conformément aux normes éthiques institutionnelles et à la loi sur l'anatomie indienne. Résultats: Sur 107 cadavres, biceps brachial à trois têtes a été notée sur 18 cadavres (16,82 %) associée à l'évolution inhabituelle du nerf musculo-cutané. Unilatérale rare et inhabituelle Un biceps brachial à cinq têtes a été noté sur un cadavre masculin (0,93 %). Toutes les têtes accessoires notées dans cette étude ont été fournies par le branches du nerf musculo-cutané à l'exception de la tête humérale du biceps à cinq têtes, qui était alimentée par le nerf radial. Conclusion: Conscience de ces variations anatomiques, une connaissance est nécessaire aux radiologues, anesthésistes, kinésithérapeutes, et chirurgiens orthopédistes pour éviter les complications lors de diverses procédures de radiodiagnostic ou de chirurgies des déformations des fléchisseurs de la partie supérieure bras et avant-bras. Mots-clés: Asymétrie, tumeurs dermoïdes, hypertrophie et lipome, névralgie mandibulaire.


Asunto(s)
Brazo , Músculo Esquelético , Femenino , Humanos , Masculino , Brazo/anatomía & histología , Cadáver , Desarrollo Embrionario , Músculo Esquelético/anomalías , Músculo Esquelético/anatomía & histología
14.
J Med Genet ; 60(9): 866-873, 2023 09.
Artículo en Inglés | MEDLINE | ID: mdl-36977548

RESUMEN

BACKGROUND: Titin truncating variants (TTNtvs) have been associated with several forms of myopathies and/or cardiomyopathies. In homozygosity or in compound heterozygosity, they cause a wide spectrum of recessive phenotypes with a congenital or childhood onset. Most recessive phenotypes showing a congenital or childhood onset have been described in subjects carrying biallelic TTNtv in specific exons. Often karyotype or chromosomal microarray analyses are the only tests performed when prenatal anomalies are identified. Thereby, many cases caused by TTN defects might be missed in the diagnostic evaluations. In this study, we aimed to dissect the most severe end of the titinopathies spectrum. METHODS: We performed a retrospective study analysing an international cohort of 93 published and 10 unpublished cases carrying biallelic TTNtv. RESULTS: We identified recurrent clinical features showing a significant correlation with the genotype, including fetal akinesia (up to 62%), arthrogryposis (up to 85%), facial dysmorphisms (up to 73%), joint (up to 17%), bone (up to 22%) and heart anomalies (up to 27%) resembling complex, syndromic phenotypes. CONCLUSION: We suggest TTN to be carefully evaluated in any diagnostic process involving patients with these prenatal signs. This step will be essential to improve diagnostic performance, expand our knowledge and optimise prenatal genetic counselling.


Asunto(s)
Aborto Habitual , Conectina , Músculo Esquelético , Miocardio , Femenino , Humanos , Embarazo , Aborto Habitual/genética , Conectina/genética , Estudios Retrospectivos , Músculo Esquelético/anomalías
15.
Am J Phys Med Rehabil ; 102(9): e117-e119, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-36811548

RESUMEN

ABSTRACT: The flexor digitorum accessorius longus is an anomalous muscle with a reported prevalence of 1.6%-12.2% in cadaveric studies. Flexor digitorum accessorius longus courses through the tarsal tunnel and has been reported as an etiology of tarsal tunnel syndrome in previous case reports. The flexor digitorum accessorius longus is intimately related to the neurovascular bundle and may impinge on the lateral plantar nerves. However, very few cases of lateral plantar nerve compression by the flexor digitorum accessorius longus have been reported. Herein, we report a case of lateral plantar nerve compression caused by the flexor digitorum accessorius longus muscle in a 51-year-old man who complained of insidious pain at the lateral sole and hypoesthesia at the left third-fifth toe and lateral sole, and the pain improved after treatment of botulinum toxin injection into the flexor digitorum accessorius longus muscle.


Asunto(s)
Toxinas Botulínicas , Síndrome del Túnel Tarsiano , Masculino , Humanos , Persona de Mediana Edad , Músculo Esquelético/anomalías , Pie , Síndrome del Túnel Tarsiano/tratamiento farmacológico , Síndrome del Túnel Tarsiano/etiología , Dolor/complicaciones , Toxinas Botulínicas/uso terapéutico
16.
JBJS Case Connect ; 13(1)2023 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-36812354

RESUMEN

CASE: During dissection of the upper limb of a cadaver in preparation for a first-year anatomy course, an extensor indicis proprius (EIP) variant was discovered with its muscle belly extending distal to the extensor retinaculum and beyond what has been previously described in the literature. CONCLUSION: EIP is commonly used as a tendon transfer for extensor pollicis longus rupture. Few anatomic variants of EIP have been reported in the literature, but such variants should be considered because of their consequences to the success of tendon transfer and potential implications for diagnosis of an otherwise unexplained mass of the wrist.


Asunto(s)
Músculo Esquelético , Traumatismos de los Tendones , Humanos , Músculo Esquelético/anomalías , Transferencia Tendinosa , Muñeca , Articulación de la Muñeca
17.
Int. j. morphol ; 41(1): 22-24, feb. 2023. ilus
Artículo en Inglés | LILACS | ID: biblio-1430511

RESUMEN

SUMMARY: The axilla is the main communication channel connecting the upper limbs, the neck and chest. Stabilization of the internal structure is essential for upper limb and shoulder mobility. In this case, we observed and recorded the characteristics of the variation of the radial nerve as well as the intercalated ectopic muscle from latissimus dorsi muscle. The position relationship between both, was also particularly noted by us. In view of the presence of the variation we reported, related clinical research, surgery and disease diagnosis are expected to take this case into account.


La axila es el principal canal de comunicación que conecta los miembros superiores, el cuello y el tórax. La estabilización de la estructura interna es fundamental para la movilidad del miembro superior y del hombro. En este caso observamos y registramos las características de la variación del nervio radial así como del músculo ectópico intercalado del músculo latísimo del dorso. La relación de posición entre ambas también fue significativa en este estudio. En vista de la presencia de la variación que informamos, se espera que la investigación clínica relacionada con la cirugía y el diagnóstico de la enfermedad tengan en cuenta este caso.


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Nervio Radial/anatomía & histología , Plexo Braquial/anatomía & histología , Músculo Esquelético/anomalías , Variación Anatómica , Axila/inervación , Cadáver , Coristoma
18.
World Neurosurg ; 170: e402-e415, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36379360

RESUMEN

BACKGROUND: Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the median nerve throughout the carpal tunnel. It is the most common entrapment neuropathy, with an estimated prevalence of 4%-7%. Surgical management is more effective in moderate to severe and severe CTS. CTS recurs in approximately 20% of patients, and up to 12% of these patients require reoperation. Knowledge of normal anatomy and variations would improve the success rate of the index surgery. Atypical causes of CTS were reported, including ganglion cysts, synovial hypertrophy, lipomas, bone fracture, bone fragments, tumor of soft tissues or bones, neurofibromas, neuromas, vascular malformations, and accessory muscles. Accessory muscles are commonly detected in upper limbs. However, their concomitant presentation with CTS has rarely been reported. We aimed to present different accessory muscles diagnosed during CTS surgery through a systematic review of the literature with our exemplary case. METHODS: A systematic review/meta-analysis was performed concomitant with a case presentation. RESULTS: Accessory muscles associated with CTS were as follows: palmaris longus, 28.6%; lumbrical muscles, 19.3%; palmaris profundus, 17.8%; flexor digitorum superficialis, 16.1%; transverse carpal muscle, 5%; flexor digitorum indicis, 4.2%; flexor superficialis indicis, 4.2%; flexor sublimis, 0.8%; accessory superficialis longus, 0.8%; flexor pollicis longus, 0.8%; abductor digiti minimi, 0.8%; abductor digiti quinti, 0.8%; and flexor digitorum superficialis brevis, 0.8%. Accessory muscles were mostly noticed during CTS surgery (88.2%). CONCLUSIONS: Knowledge of possible variations within the carpal tunnel would improve the surgeon's capability during CTS surgery.


Asunto(s)
Síndrome del Túnel Carpiano , Síndromes de Compresión Nerviosa , Humanos , Síndrome del Túnel Carpiano/cirugía , Recurrencia Local de Neoplasia , Músculo Esquelético/cirugía , Músculo Esquelético/anomalías , Mano , Ligamentos Articulares/cirugía
19.
Anat Sci Int ; 98(1): 99-106, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-35798911

RESUMEN

In the present study, four types of variations of the flexor carpi radialis with accessory muscular bundles were classified depending on the origin of the accessory muscular bundle and relationships with the bicipital aponeurosis, biceps brachii, pronator teres, and coracobrachialis. Six types of insertions of the tendon of the flexor carpi radialis were also divided according to their inserted positions on the carpal and metacarpal bones. An accessory muscular bundle of the flexor carpi radialis was found in 4 (1 female and 3 males) of 68 cadavers (5.88%), with five examples in 136 arms (3.68%). It was bilateral in one cadaver and unilateral (two on the right and one on the left) in three. The insertion of the flexor carpi radialis tendon was not only on the proximal surface of the base of the second metacarpal bone but also on the third metacarpal bone, the tubercle of the trapezium, and the scaphoid. These findings and classifications are important in anatomical education, and have important significances in clinical diagnosis and therapies.


Asunto(s)
Antebrazo , Músculo Esquelético , Masculino , Femenino , Humanos , Músculo Esquelético/anomalías , Antebrazo/anatomía & histología , Tendones/anatomía & histología , Muñeca , Brazo , Cadáver
20.
Ann Afr Med ; 22(4): 557-559, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38358162

RESUMEN

An interesting case of unusual unilateral variant of palmaris longus (PL) tendon of forearm was noticed by us. We found two bellies of PL as well as their different insertions. These observations will help in understanding morphological variations of this muscle and its clinical implications. PL is a fusiform muscle in the superficial flexor group of muscles of forearm. It originates from medial epicondyle of humerus by common flexor tendon. We found PL having one origin, i.e., from medial epicondyle from common tendinous origin of flexor muscles and then it divided to form two bellies having two long tendons distally. Understanding of presence or absence or anomalies of PL is not only important for medical professionals but also for evolutionary biologists. Awareness of anatomy and variations of flexor tendons is important for health care practitioners for the correct diagnosis and management of pain, disease, and trauma of forearm and hand.


Résumé Nous avons remarqué un cas intéressant de variante unilatérale inhabituelle du tendon du long palmaire (PL) de l'avant-bras. Nous avons retrouvé deux ventres de PL ainsi que leurs différentes insertions. Ces observations aideront à comprendre les variations morphologiques de ce muscle et ses implications cliniques. Le PL est un muscle fusiforme du groupe des muscles fléchisseurs superficiels de l'avant-bras. Il provient de l'épicondyle médial de l'humérus par le tendon fléchisseur commun. Nous avons trouvé que le PL avait une origine, c'est-à-dire de l'épicondyle médial provenant de l'origine tendineuse commune des muscles fléchisseurs, puis il s'est divisé pour former deux ventres ayant deux longs tendons distalement. Comprendre la présence, l'absence ou les anomalies de PL est non seulement important pour les professionnels de la santé mais également pour les biologistes évolutionnistes. La connaissance de l'anatomie et des variations des tendons fléchisseurs est importante pour les praticiens de la santé afin de diagnostiquer et de gérer correctement la douleur, la maladie et les traumatismes de l'avant-bras et de la main. Mots-clés: Palmaris longus, greffe tendineuse, variation, contracture ischémique de Volkmann.


Asunto(s)
Antebrazo , Músculo Esquelético , Humanos , Antebrazo/anatomía & histología , Músculo Esquelético/anomalías , Tendones/diagnóstico por imagen , Tendones/anomalías , Mano
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