Accessory first lumbrical muscle within the carpal tunnel: a case report

Case Reports Plast Surg Hand Surg. 2024 May 13;11(1):2351130. doi: 10.1080/23320885.2024.2351130. eCollection 2024.

Abstract

Carpal tunnel syndrome is the most common entrapment neuropathy in the upper extremity. Palmaris longus, flexor digitorum superficialis, and lumbricals have infrequently been reported as causes of nerve compression. During routine Korean cadaver dissection, we incidentally identified an anatomic variant of first lumbrical muscle within the carpal tunnel in both wrists. The aberrant musculature originated from the radial side of the second FDS muscle at distal forearm level, running separately across the wrist beneath the flexor retinaculum. The dissected anomalous muscle was identified as an additional muscle belly of the first lumbrical muscle. Compression of the median nerve at the wrist might rarely be caused by the presence of such a tendon or muscle anomaly found in this study. Surgeons should be aware of possible anatomic variations in the carpal tunnel, and be prepared to modify their surgical plan accordingly.

Keywords: Wrist; anomalous muscle belly; carpal tunnel release; carpal tunnel syndrome; lumbrical muscle; nerve compression.

Publication types

  • Case Reports

Grants and funding

The authors received no financial support for the research, authorship, and/or publication of this article.