Possible implications of an accessory abductor digiti minimi muscle: a case report^[*]

Abstract

Background Accessory ADM was first reported in 1868 although muscular, vascular and nervous variations of the hypothenar eminence are rare, contrary to anomalous muscles in the wrist which are relatively common.

Case presentation This case report presents a bilateral variation of an accessory abductor digiti minimi muscle in a male specimen. Ulnar artery and ulnar nerves were taken into account regarding their position and trajectory related to this variation.

Conclusion Muscle size may be an important factor in considering whether a variation is able to produce neurovascular compression and clinical implications.

^*This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

• References

• 1 Curry B, Kuz J. A new variation of abductor digiti minimi accessorius. J Hand Surg 2000; 25: 585-7
• 2 Soldado-Carrera F, Vilar-Coromina N, Rodriguez-Baeza A. An accessory belly of the abductor digiti minimi muscle: a case report and embryologic aspects. Surg Radiol Anat 2000; 22: 51-4 10.1007/s00276-000-0051-1 10863748
• 3 Kanaya K, Wada T, Isogai S, Murakami G, Ishii S. Variation in insertion of the abductor digiti minimi: an anatomic study. J Hand Surg 2002; 27 (2) 325-8 10.1053/jhsu.2002.31155
• 4 Bozkurt MC, Tagil SM, Ersoy M, Tekdemir I. Muscle variations and abnormal branching and course of the ulnar nerve in the forearm and hand. Clin Anat 2004; 17: 64-6 10.1002/ca.10094 14695591
• 5 Sheppard JE, Prebble TB, Rahn K. Ulnar neuropathy caused by an accessory abductor digiti minimi muscle. Wis Med J 1991; 90: 628-31 1759467
• 6 Netscher D, Cohen V. Ulnar nerve compression at the wrist secondary to anomalous muscles: a patient with a variant of abductor digiti minimi. Ann Plast Surg 1997; 39: 647-51 10.1097/00000637-199712000-00017 9418928
• 7 Murata K, Tamai M, Gupta A. Anatomic study of variations of hypothenar muscles and arborization patterns of the ulnar nerve in the hand. J Hand Surg 2004; 29: 500-9 10.1016/j.jhsa.2004.01.006
• 8 Wulle CM. abductor digiti minimi longus: anatomical rarity?. Handchir Mikrochir Plast Chir 1987; 19: 43-5 3557205
• 9 Harvie P, Patel N, Ostlere SJ. Ulnar nerve compression at Guyon’s canal by an anomalous abductor digiti minimi muscle: the role of ultrasound in clinical diagnosis. Hand Surg 2003; 8: 271-5 10.1142/S0218810403001819 15002110
• 10 Harvie P, Patel N, Ostlere SJ. Prevalence and epidemiological variation of anomalous muscles at Guyon’s canal. J Hand Surg 2004; 29: 26-9
• 11 Madhavi C, Holla SJ. Anomalous flexor digiti minimi brevis in Guyon’s canal. Clin Anat 2003; 16: 340-3 10.1002/ca.10087 12794919
• 12 Hankins CL, Flemming S. A variant of Kaplan’s accessory branch of the dorsal cutaneous branch of the ulnar nerve: a case report and review of the literature. J Hand Surg 2005; 30: 1231-5 10.1016/j.jhsa.2005.06.015
• 13 Dworkin RH, Backonja M, Rowbotham MC, Allen RR, Argoff CR, Bennett GJ, Bushnell MC, Farrar JT, Galer BS, Haythornthwaite JA, Hewitt DJ, Loeser JD, Max MB, Saltarelli M, Schmader KE, Stein C, Thompson D, Turk DC, Wallace MS, Watkins LR, Weinstein SM. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol 2003; 60: 1524-34 10.1001/archneur.60.11.1524 14623723
• 14 Castaldo JE, Ochoa JL. Mechanical injury of peripheral nerves: fine structure and dysfunction. Clin Plast Surg 1984; 11: 9-16 6323088
• 15 Ginanneschi F, Dominici F, Milani P, Biasella A, Rossi A. Evidence of altered motor axon properties of the ulnar nerve in carpal tunnel syndrome. Clin Neurophysiol 2007; 118: 1569-76 10.1016/j.clinph.2007.03.024 17475547
• 16 Hoffman KD, Matthews MA. Comparison of sympathetic neurons in orofacial and upper-extremity nerves: implications for causalgia. J Oral Maxillof Surg 1990; 48: 720-6
• 17 Tracey DJ, Cunningham JE, Romm MA. Peripheral hyperalgesia in experimental neuropathy : mediation by a2-adrenoreceptors on post-ganglionic sympathetic terminals. Pain 1995; 60: 317-27 10.1016/0304-3959(94)00141-Z 7596628
• 18 Gordon L, Ritland GD. Nerve entrapment syndromes. Conn Med 1974; 38: 97-102 4814278
• 19 Sarno JB. Suprascapular nerve entrapment. Surg Neurol 1983; 20: 493-97 10.1016/0090-3019(83)90033-2 6648789
• 20 Basbaum AI. Distinct neurochemical features of acute and persistent pain. Proc Natl Acad Sci 1999; 96: 7739-43 33612 10393891 10.1073/pnas.96.14.7739
• 21 Simone DA, Ochoa J. Early and late effects of prolonged topical capsaicin on cutaneous sensibility and neurogenic vasodilatation in humans. Pain 1991; 47: 285-94 10.1016/0304-3959(91)90217-L 1784499
• 22 Nawaz S, Walker RD, Wilkinson CH, Saxton JM, Pockley AG, Wood RF. The inflammatory response to upper and lower limb exercise and the effects of exercise training in patients with claudication. J Vasc Surg 2001; 33: 392-9 10.1067/mva.2001.111988 11174795
• 23 Pritchard MH, Pugh N, Wright I, Brownlee M. A vascular basis for repetitive strain injury. Rheumatology (Oxford) 1999; 38: 636-9 10.1093/rheumatology/38.7.636 10461477