A Morphological Study Of A Rare Variant Of Gantzer’s Muscle

Background: Flexor digitorum profundus (FDP) is a deep flexor of forearm. The accessory heads of flexor pollicislongus(FPLah) and flexor digitorum profundus(FDPah) are named after Gantzer who described the same in1831.The less frequent of the two is FDPah, which simulates soft tissue tumor mass or may cause compressionneuropathy of anterior interosseous nerve leading to anterior interosseous nerve syndrome or Kiloh-Nevinsyndrome.Aim: To determine the prevalence and morphology of accessory head of flexor digitorum profundus.Materials and Methods: 50 upper limbs of equal right and left distribution of unknown sex were dissected andexamined in the department of anatomy. Morphological parameters such as shape, origin, insertion and relationto nerve of accessory head of FDP were studied.Results: The prevalence of accessory head of FDP showed 22% .FDPah was most commonly seen on the left side.Most frequently observed shape for FDPah was fusiform and all the accessory heads originated from undersurfaceof flexor digitorum superficialis and majority of the cases were inserted to middle third of tendon of FDP forindex finger. One of the cases had double muscle belly with their tendons inserting to tendon for index finger andmiddle finger of FDP.Conclusion: Knowledge of existence of Gantzer’s muscle may provide surgeon with information for the differentialdiagnosis of the causes and sites of anterior interosseous nerve syndrome, also surgical interference for nervedecompression or to differentiate from soft tissue tumors.

Concomitant Variations in Flexor Digitorum Superficialis: A Case Report / 체질인류학회지

The flexor digitorum superficialis (FDS) muscle is located in the intermediate layer of the muscles in the anterior compartment of the forearm. Variable but individual variations have been reported in the FDS regarding the number of head and the origin, distribution and interconnections of muscle slip and insertion to finger. In this case, we report a concomitant complex variation in FDS which was observed in a cadaver during a routine dissection classes for the undergraduate medical students. It includes the variation which is the separation of the tendon of FDS into the superficial and deep layers, the structural variations in muscle slips and associated tendon variations, the finding of Gantzer' muscle leading to flexor pollicis longus muscle. These complex variations in FDS are very rare case and this report summarizes the related phylogenetic and embryological significance.

Double Gantzer's Muscles by Four Muscle Bellies and Its Clinical Significance: A Case Report / 체질인류학회지

The Gantzer's muscle (GM) is an additional muscle in the forearm as the accessory head of the flexor pollicis longus (FPL) and accessory head of the flexor digitorum profundus (FDP). We reported a rare case of double GM formed by four muscle bellies. From the dorsal part of flexor digitorum superficialis, small four bellies formed two muscles merging to FDP and FPL, as GMs. These accessory heads of FDP and FPL crossed the ulnar artery and the median nerve, respectively. These additional muscles in the forearm flexor compartment are rare and its clinical and embryological significances should be considered.

Tortuous ulnar artery and Gantzer’s muscle: A rare presentation with clinical implications.

The ulnar artery, larger terminal branch of brachial artery is one of the principal arteries contributing to the vascular supply of forearm. It passes through a narrow tunnel, the Guyon’s canal, along with the ulnar nerve at the level of wrist. Ulnar artery is approached during surgical interventions like, coronary and cerebral angiography, ulnar-cephalic arteriovenous fistula etc., in situations where access to radial artery fails. The lesions of ulnar artery such as aneurysms, tortuosity, aberrancy, etc. may lead to entrapment neuropathies of the ulnar nerve. We have reported here a case of tortuous ulnar artery in the distal forearm and hand of the left side of a 62 years old male, which is a rare finding observed during routine educational cadaveric dissection. The tortuosity was observed in the form of twists and bends at various levels in 15cm long segment of ulnar artery in the distal forearm wrist and hand up to the commencement of superficial palmar arch. An aberrant head of flexor pollicis longus was seen crossing the ulnar artery. The ulnar artery of right side was normal and no other anatomical variations were seen. Such muscular variations may simulate soft tissue tumors resulting in nerve or vascular compressions and also influence the biomechanics of wrist and hand. An understanding of variations in the regional anatomy is essential for surgeons, cardiologists and neuroradiologists for preventing failure of surgical procedures.