Unusual topography of posterior antebrachial musculature in the first osseofibrous compartment of wrist: clinicomorphological appraisal / Topografía inusual de la musculatura antebraquial posterior en el primer compartimento osteofibroso de la muñeca: valoración clínico-morfológica

Anatomical variations of abductor pollicis longus and extensor pollicis brevis are important in clinical assessment of diseased and traumatized hand. The present case reports an unusual fusion of muscle bellies of abductor pollicis longus and extensor pollicis brevis with two separate tendons of insertion, the medial tendon inserted into the base of first metacarpal and the lateral tendon into the abductor pollicis brevis muscle. Knowledge of such anatomical variations is of utmost importance in the management of De Quervain's disease and reconstructive surgeries of hand.

Las variaciones anatómicas de los músculos abductor largo del pulgar y extensor corto del pulgar son importantes en la evaluación clínica de la mano enferma y traumatizada. El presente caso informa una inusual fusión de los vientres musculares de los Mm. abductor largo del pulgar y extensor corto del pulgar con dos tendones de inserción separados, el tendón medial se insertó en la base del primer metacarpiano y el tendón lateral en el músculo abductor corto del pulgar. El conocimiento de estas variaciones anatómicas es de importancia en el manejo de la enfermedad de De Quervain y cirugía reconstructiva de la mano.

Clinical importance of unusual patterns of tendinous intersections of rectus abdominis muscle.

The objective of the present study was to note the different patterns of tendinous intersections of rectus abdominis muscle and its surgical importance. The tendinous intersections of rectus abdominis muscle were studied in dissected 46 human cadavers dissected over a span of 3 years. Only two unusual patterns of intersections; one with tendinous intersections arched, and the other with the intersections at different levels on the right and left sides of the same cadaver, were observed, in two different cadavers. The tendinous intersections are the sites of anastomosis of numerous blood vessels. Surgeons using the the Transverse Rectus Abdominis (TRAM) flap in autogenous breast constructive surgeries should be aware of such unusual patterns so as to design the TRAM flap accordingly. Biomechanics of rectus abdominis muscle may also be influenced by arched pattern of tendinous intersections instead of normal transverse pattern.