Anatomical variations of the extensor tendons of the fetal thumb
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ORIGINAL ARTICLE
Anatomical variations of the extensor tendons of the fetal thumb Kenan Öztürk1 · Ahmet Dursun1 · Yadigar Kastamoni1 · Soner Albay1 Received: 15 June 2020 / Accepted: 26 October 2020 © Springer-Verlag France SAS, part of Springer Nature 2020
Abstract Purpose The extensor pollicis longus (EPL) and brevis (EPB) and abductor pollicis longus (APL) are muscles located in the posterior compartment of the forearm. These muscles allow the thumb to move independently from the other four fingers by attaching to the thumb separately. This study’s goal was to investigate the tendon variations and insertions of these muscles. Methods Our study was conducted on 43 fetal cadavers (86 upper extremities) aged between 17 and 40 weeks of gestation. This study investigated the tendon numbers and insertions of the EPL, EPB, and APL. Results The tendon numbers of the EPL and EPB were observed to range between 1 and 2, and the tendon numbers of the APL ranged between 1 and 5. The EPL was found to insert into the distal phalanx via the dorsal aponeurosis in all extremities. It was observed that the EPB tendons inserted into the proximal phalanx, distal phalanx, and dorsal aponeurosis. It was determined that the APL tendons inserted into the basis of the first metacarpal, abductor pollicis brevis, opponens pollicis, and trapezium bone. Conclusion Knowing the tendon variations and insertions of the EPL, EPB, and APL muscles during the fetal period will be useful in planning treatments to correct the congenital thumb anomalies and the loss of function after injury. Keywords Fetus · Hand · Variation · Thumb · Forearm · De quervain
Introduction The extensor tendon injuries of the thumb are more common than flexor tendon injuries. The complex system of the extrinsic and intrinsic tendons of the thumb can make the management of treatment more difficult. Therefore, understanding the anatomy of the thumb extensor tendons is important to determine the appropriate treatment. The diagnosis of extensor tendon injuries is often evident. However, open lesions should be investigated surgically to determine the extent of the injury and prevent possible tears [15]. Most of the extensor muscles in the forearm carry out important functions such as moving the thumb of the hand or controlling the position of the wrist to optimize hand grip. Variations in these muscles or tendons can lead to inflammatory conditions that impair the function of the hand [16]. The extensor tendons of the hand and thumb are one of the most common areas of variations in the human body [28]. * Kenan Öztürk [email protected] 1
These variations are quite different from the normal anatomical structure described in anatomy textbooks. However, these variations are mostly asymptomatic and are noticed by chance during surgical interventions. Considering the importance of the thumb and wrist mobility in the hand function and the complexity of surgical procedures that are currently used, the knowledge of the existence of such anatomical variations may be usefu
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