Identifying the flexor pollicis longus biel, 2005 university of washington radiology. Nerve recurrent muscular branch of median nerve c8, t1 may also be from deep branch of ulnar nerve t1. Flexor pollicis longus muscle definition of flexor pollicis. Spontaneous rupture of the flexor pollicis longus tendon on a sesamoid bone. The proportional lengths of the thumb and other fingers give us an opposable thumb with. Flexor pollicis brevis musculus flexor pollicis brevis anatomical parts. Extends distal phalanx of thumb at carpometacarpal and interphalangeal joints. Rupture of the tendon of flexor pollicis longus is suspected when active flexion of the interphalangeal joint of the thumb is not possible. The flexor pollicis brevis is a thin, two headed muscle lying medially from the opponens pollicis, beneath the abductor pollicis brevis and above the adductor pollicis. The present study was planned to analyze the accessory head of the flexor pollicis longus muscle ahfpl or gantzers muscle and its incidence. The hand therapists role, tendon and nerve surgery in the hand. Rupture of the flexor pollicis longus may occur spontaneously or may be a result of trauma imai et al.
Jul 31, 2019 the flexor pollicis longus muscle forms a part of the lower half of the arm which means it is located from the elbow moving downwards. The accessory head of the flexor pollicis longus muscle is present in 54. A simple clinical test of flexor pollicis longus rupture. The relationship of gantzers muscle the accessory head of flexor pollicis longus. The deeper and medial head varies in size and may be absent. The prevalence rates of an ahfpl significantly vary between studies, and no consensus has been reached on the numerous variations reported in its origin, innervation, and relationships to the anterior interosseous nerve ain. Posterior interosseous nerve c7 and c8, the continuation of the deep branch of the radial nerve arterial supply. It arises from the lateral part of the dorsal surface of the body of the ulna below the insertion of the anconeus, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius passing obliquely downward and lateralward, it ends in a tendon. It also works together with another tendon to bend the thumb over the base of the little finger. Its principal attachments are from the anterior surface of the radius to the anterior surface of the distal phalanx of the thumb. Flexor pollicis longus how is flexor pollicis longus. The flexor pollicis brevis muscle is a muscle in the hand.
It lies in the same plane as the flexor digitorum profundus this muscle is unique to humans, being either rudimentary or absent in other primates. It is the accessory head of flexor pollicis longus fpl muscle. Accessory head of flexor pollicis longus muscle and its significance in anterior interosseous nerve syndrome. In an anatomical study of 25 limbs, the incidence, origin, insertion, nerve. In human anatomy, the extensor pollicis longus muscle epl is a skeletal muscle located dorsally on the forearm. The extrinsic flexor muscles of the digits are the flexor digitorum superficialis, flexor digitorum profundus, and flexor pollicis longus see figures on pp. The abductor pollicis longus is a muscle that moves the thumb in multiple directions. Flexor pollicis longus muscle, flexor pollicis brevis muscle description. The accessory head of the flexor pollicis longus ahfpl has an oblique trajectory from medial to lateral aspect of the forearm below the flexor digitorum superficialis muscle and then joins the flexor pollicis longus muscle. The flexor pollicis longus muscle is located in the lower half of the arm, from the elbow down. Anterior surface of radius and adjacent interosseous membrane. Extends distal phalanx of thumb at carpometacarpal and interphalangeal joints innervation. The function of this muscle is to facilitate thumb flexion. Insertion base of distal phalanx of thumb via listers tubercle dorsal tubercle of radius.
The muscles superficial head arises from the distal edge of the flexor retinaculum and the tubercle of the trapezium, the most lateral bone in the distal row of carpal bones. Aug 25, 2015 the flexor pollicis brevis has a superficial head and a deep head. Action extends interphalangeal and metacarpophalangeal joints of thumb. Andrews unit in a total of 216 thumbs over 18 years in an attempt to reduce the rupture rate from the initial high level of 17%. Flexor pollicis longus definition of flexor pollicis. The present case reports about a variation in the origin of abductor pollicis longus apl which. Susman, 1988 have related the origin of a welldeveloped flexor pollicis longus muscle to the acquisition of precision. The flexor pollicis longus is a flexor of the phalanges of the thumb. Nerve recurrent muscular branch of median nerve c8, t1 may also be. Flexor pollicis longus muscle article about flexor. The insertion of the fibres continues nearly to the point where the tendon. The unusual suspects flexor pollicis longus muscle of. Attachments and actions of the flexor pollicis longus. The radius and ulna are the two bones that make up the forearm.
Origin lower third of posterior shaft of radius and adjacent interosseous membrane. The flexor pollicis longus arises beneath the flexor digitorum sublimis by fleshy fibres from the volar surface of the shaft of the radius in its middle two fourths, and from a corresponding portion of the interosseous mem brane. Pdf anatomical diversity in flexor pollicis longus muscle. The flexor pollicis longus is supplied by the anterior interosseous c8t1 branch of the median nerve c5t1. Flexor pollicis longus muscle origin, insertion, innervation. Anterior interosseous nerve from median nerve c8 and t1 arterial supply. Fashion a shortarm dorsal blocking splint with the wrist in 20 degrees of exion, the. The flexor pollicis longus originates from the anterior surface of the radius and the interosseous membrane insertion.
The present case reports about a variation in the origin of abductor pollicis longus apl. The flexor pollicis longus muscle has its origin at the anterior side of the radius and the interosseous membrane, sometimes also at the medial epicondyle of the humerus. The extensor pollicis longus arises from the dorsal surface of the ulna and from the interosseous membrane, next to the origins of abductor pollicis longus and extensor pollicis brevis passing through the third tendon compartment, lying in a narrow, oblique groove on the back of the lower end of the radius, it crosses the wrist close to the dorsal midline before turning towards. The fingertips are broad and equipped with highly sensitive pads of skin. It is of a triangular form arising by a broad base from the lower twothirds of the volar surface of the third metacarpal bone. The superficial head originates from the flexor retinaculum, whereas the deep head has its origin on the capitate and trapezium. Slips may connect with flexor digitorum superficialis muscle, flexor digitorum profundus muscle resulting. Rupture of the flexor pollicis longus tendon after 30 years due to migration of a retained foreign body.
Flexor pollicis longus repair weeks 04 rehabilitation fpl repair weeks 0 to 4 rehabilitation you have injured the long tendon on the front of your ythumb flexor pollicis longus. A study on the accessory head of the flexor pollicis longus muscle. The flexor pollicis longus is a long thin muscle on the outer aspect of your forearm. Extension of the thumb metacarpophalangeal and interphalangeal antagonist. Tendinous connections between flexor pollicis longus and flexor digitorum profundus muscles were found in 20% of the study population. This difference may in part explained by the vascular anatomy of the fpl tendon. The accessory head of the flexor pollicis longus muscle ahfpl, also known as the gantzers muscle, was first described in 18. It usually also has a small attachment to the medial epicondyle of the humerus figure 4 note. However, plate prominence on followup radiographs is common.
The prevalence and anatomical characteristics of the. Volar locking plates not touching the flexor pollicis longus. Initial physical exam revealed good strength in the flexor pollicis longus, flexor digitorum. Abductor pollicis longus muscle takes origin from the. Aug 20, 2019 plate protrusion is a risk factor for flexor pollicis longus fpl rupture following volar locking plate vlp surgery. Because of its ability to pronate the forearm, the stretch position should include full forearm supination as well figure 7. Insertion over tendons of radial extensors and brachioradialis to base of proximal phalanx of thumb. The abductor pollicis longus originates from the back surfaces of the radius and ulna bones and the interosseous membrane. Because the flexor pollicis longus flexes the elbow, wrist, and thumb joints, it is stretched by extending the elbow, wrist, and thumb. It passes along the radial side of the tendon of the flexor pollicis longus. We studied six current designs of widely used plates in formalin. Jul 09, 2015 the flexor pollicis longus muscle has its origin at the anterior side of the radius and the interosseous membrane, sometimes also at the medial epicondyle of the humerus.
When the anterior interosseous nerve ain courses underneath the muscle belly of the ahfpl an entrapment neuropathy may occur, known as anterior interosseous. Adductor pollicis musculus adductor pollicis imaios. The flexor pollicis longus is a muscle of the anterior forearm and hand. It flexes the thumb at the first metacarpophalagneal joint. The flexor pollicis longus originates from the anterior surface of the radius and the interosseous membrane. The abductor pollicis longus lies immediately below the supinator and is sometimes united with it. Listen to the audio pronunciation in the cambridge english dictionary. Jan 26, 2015 the flexor pollicis longus muscle is located in the lower half of the arm, from the elbow down. A report on the accessory head of flexor pollicis longus and variations of forearm musculature. It has also been described in association with a variety of conditions, including scaphoid fracture and nonunion saitoh et al. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Flexor pollicis brevis is the most medial of the thenar muscles. Flexor pollicis longus washington university in st. Evaluation of the continuity of the flexor pollicis longus tendon is clinically important with disorders of thumb flexion.
Flexor pollicis longus muscle article about flexor pollicis. The stubborn flexor pollicis longus clinicians classroom. Flexor pollicis longus originates from a large area on the anterior surface of the radius, extending between the radial tuberosity superiorly and the attachment of pronator quadratus inferiorly. In addition, a removable dorsal blocking splint is fashioned. Other articles where flexor pollicis longus is discussed. Start studying extensor carpi radialis longus, extensor carpi radialis brevis, extensor carpi ulnaris, extensor digitorum, extensor digiti minimi, extensor indicis, supinator, extensor pollicis longus, extensor pollicis brevis. Includes the extensor pollicis longus by hyperextending the interphalangeal joint and allowing it to relax. This can be a result of trauma but, when spontaneous, diagnostic confusion can exist as incomplete palsy of the anterior interosseous nerve can present in a similar way. The medical illustrations contained in this online atlas are.
We hypothesised that a vlp that does not touch the fpl tendon can appear as a plate prominence projected over the volar ridge on lateral radiographs. Accessory head of the flexor pollicis longus muscle. The flexor pollicis longus muscle forms a part of the lower half of the arm which means it is located from the elbow moving downwards. It has been repaired but it will take at least 12 weeks until it is strong enough for you to return to unlimited activities. Modern humans possess a distinct and welldeveloped flexor pollicis longus muscle, an extrinsic thumb flexor which is either rudimentary or absent in great apes straus, 1942, p. This is in opposition to the extensor pollicis brevis muscle, which extends. It is an additional muscle in the forearm which might cause pressure symptoms to the underlying structures, especially to the anterior interosseus nerve. May 09, 2017 the flexor pollicis longus is a long thin muscle on the outer aspect of your forearm.
Pdf abductor pollicis longus is known for its variations in the form of multiple tendons at its insertion. Flexor pollicis longus medical definition merriamwebster. The flexor pollicis longus or flexor pollicis longus muscle, latin. Origin flexor retinaculum and tubercle of trapezium. This can sometimes appear to be flexor pollicis longus function when actually it is the relaxation of the extensor pollicis longus. This muscle is believed to be unique and present only in humans. Despite the fact the tendon insertion is a weaker link than the tendon in the musculoskeletal chain 3, 22, only one case of idiopathic fpl tendon avulsion has been reported. In addition, the flexor pollicis longus muscle may have an additional origin from the. Flexor pollicis longus muscle synonyms, flexor pollicis longus muscle pronunciation, flexor pollicis longus muscle translation, english dictionary definition of flexor pollicis longus muscle. The adductor pollicis transversus adductor transversus pollicis is the most deeply seated of this group of muscles. Also occasionally a small origin slightly on the medial epicondyle of the humerus. Flexor pollicis brevis musculus flexor pollicis brevis imaios.
It passes along the radial side of the tendon of the flexor pollicis longus the deeper and medial head varies in size and may be absent. Muscles of the leg origin, insertion, action, antagonist and synergist 73 terms. The flexor pollicis brevis or flexor pollicis brevis muscle, latin. Insertion base of proximal phalanx of thumb via radial sesamoid action flexes metacarpophalangeal joint of thumb. It is much larger than the extensor pollicis brevis, the origin of which it partly covers and acts to stretch the thumb together with this muscle. The flexor pollicis longus is a muscle in the forearm and hand that flexes the thumb. The unusual suspects flexor pollicis longus muscle of the. The flexor pollicus longus attaches at the anterior surface of the radius, the bone in your forearm that forms the bend of your elbow. Identifying the flexor pollicis longus biel, 2005 origin.
The superficial head of the flexor pollicis brevis originates from the flexor retinaculum. Pdf a rare origin of abductor pollicis longus researchgate. The extensor pollicis longus extensor secundi internodii pollicis is much larger than the preceding muscle, the origin of which it. The superfical head lateral and more superficial portion arises from the lower border of the transverse carpal ligament and the lower part of the ridge on the greater multangular bone. A series of changes of primary treatment of divisions of the flexor pollicis longus tendon were carried out in the st. These muscles originate primarily from the medial epicondyle of the humerus and from palmar surfaces of the radius and ulna.
Flexor pollicis longus muscle definition of flexor. A study on the accessory head of the flexor pollicis. Primary repair of the flexor pollicis longus tendon. This origin point of flexor pollicis longus often also includes the adjacent anterior surface of the interosseous membrane andor the lateral border of the coronoid process of ulna. A study on the accessory head of the flexor pollicis longus. Origin middle third of posterior ulna below abductor pollicis longus and adjacent interosseous membrane. Initial physical exam revealed good strength in the flexor pollicis longus, flexor digitorum profundus, and intrinsic muscles of the hand. Flexor pollicis longus rupture in rheumatoid arthritis secondary to attrition on a sesamoid. It lies medial to the abductor pollicis brevis and opponens pollicis muscles, while it is lateral to adductor pollicis muscle along its course, the superficial head of the muscle passes along the radial side of the tendon of flexor pollicis longus, whereas the deep head passes deep to the same tendon. Flexor pollicis longus definition of flexor pollicis longus. The flexor pollicis brevis has a superficial head and a deep head.
Your fpl starts in the tip of your thumb, travels through the wrist and attaches to a muscle in your. Want a crash course in the origin, insertion, and innervation. The extensor carpi radialis longus inserts ends at the bottom of the second metacarpal, which means that this muscle inserts onto the bottom of the index finger bone that is located in the hand. Abductor pollicis longus is known for its variations in the form of multiple tendons at its insertion.