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Anomalous muscles in carpal tunnel associated with neurovascular variations: Case report and brief review
Department of Anatomy and Cell Biology, Division of Life Sciences, Osaka Medical College, Osaka, Japan
Department of Anatomy and Cell Biology, Division of Life Sciences, Osaka Medical College, Osaka, Japan
Department of Anatomy and Cell Biology, Division of Life Sciences, Osaka Medical College, Osaka, Japan
- 1 Department of Anatomy and Cell Biology, Division of Life Sciences, Osaka Medical College, Osaka, Japan
Forensic Medicine and Anatomy Research·Volume 02, Issue 1·Pages 8–10·Published 24 January 2014·DOI10.4236/fmar.2014.21003
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Abstract
Anomalous muscles in carpal tunnel (CT) may cause carpal tunnel syndrome (CTS), and may be also associated with neurovascular abnormalities, altering the diagnosis and surgical interventions for CTS. The authors report a case of bilateral Gantzer’s muscles (GMs) inserted into the tendons of flexor digitorum profundus within the CTs in an old male cadaver. The left GM was associated with enlarged lumbrical muscles in the CT and bifid median nerve (MN) communicating with ulnar nerve in the hand. The right GM was associated with perforation of MN branches in the hand by superficial palmar arch. This unreported coexistence of anomalous GMs and the associated neurovascular variations may have clinical relevance to etiology, diagnosis and treatment of CTS.
KeywordsCarpal TunnelGantzer’s MuscleMedian NerveNerve Compression Syndromes
- Bland, J.D. (2007) Carpal tunnel syndrome. BMJ, 335, 343-346. http://dx.doi.org/10.1136/bmj.39282.623553.AD
- Luchetti, R. and Amando, P.C. (2007) Carpal tunnel syndrome. Springer-Verlag, Berlin, Heidelberg. http://dx.doi.org/10.1007/978-3-540-49008-1
- Demircay, E., Civelek, E., Cansever, T., Kabatas, S. and Yilmaz, C. (2011) Anatomic variations of the median nerve in the carpal tunnel: A brief review of the literature. Turkish Neurosurgery, 21, 388-396.
- Jones, D.P. (2006) Bilateral palmaris profundus in association with bifid median nerve as a cause of failed carpal tunnel release. Journal of Hand Surgery (American Volume), 31, 741-743. http://dx.doi.org/10.1016/j.jhsa.2006.02.017
- Mhoon, J.T., Juel, V.C. and Hobson-Webb, L.D. (2012) Median nerve ultrasound as a screening tool in carpal tunnel syndrome: Correlation of cross-sectional area measures with electrodiagnostic abnormality. Muscle Nerve, 46, 871-878. http://dx.doi.org/10.1002/mus.23426
- Potu, B.K., Gorantla, V.R., Rao, M.S., Bhat, K.M., Vollala, V.R., Pulakunta, T. and Nayak, S.R. (2008) Anomalous origin of the lumbrical muscles: A study on South Indian cadavers. Morphologie, 92, 87-89. http://dx.doi.org/10.1016/j.morpho.2008.04.006
- Eid, N. and Otsuki, Y. (2009) A case of double Gantzer’s muscle and its possible role in nerve entrapment. Clinical Anatomy, 22, 881-882. http://dx.doi.org/10.1002/ca.20862
- Eid, N., Ito, Y., Shibata, M.A. and Otsuki, Y. (2011) Persistent median artery: Cadaveric study and review of the literature. Clinical Anatomy, 24, 627-633. http://dx.doi.org/10.1002/ca.21127
- El Domiaty, M.A., Zoair, M.M. and Sheta, A.A. (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 Morphologica, 67, 63-711.
- Jones, M., Abrahams, P.H., Sa?udo, J.R. and Campillo, M. (1997) Incidence and morphology of accessory heads of flexor pollicis longus and flexor digitorum profundus (Gantzer’s muscles). Journal of Anatomy, 191, 451-455. http://dx.doi.org/10.1046/j.1469-7580.1997.19130451.x
- Narayana, K., Narendiran, K., Shetty, K.P. and Prashanthi, N. (2004) A case of coexistence of three anatomical variations in the forearm: Gantzer’s muscles, Martin-Gruber anastomosis, and nerve of Henle. European Journal of Anatomy, 8, 81-84.