Four cases of variations in the forearm extensor musculature in a study of hundred limbs and review of literature

All surgeons must bear in mind the existence of muscular variations when performing common tendon transfers. Presence of additional bellies and tendons of existing muscles or presence of additional muscles in unusual locations might misguide a surgeon, during surgery and also during diagnosis. In the present paper we are reporting four cases of variations encountered during the study of extensor muscles of the forearm in 100 limbs. In Case 1, additional bellies of extensor carpi radialis longus and extensor carpi radialis brevis and multiple tendons of insertion of abductor pollicis longus were observed in a single limb. In Case 2, an additional belly of the abductor pollicis longus was observed. In Case 3, a short muscle on the dorsum of the hand going to the index finger [extensor indicis brevis (EIB)] was found in addition to the normal extensor indicis (EI). It was also observed that some of the most superficial fleshy fibers of EIB were getting inserted into the tendon of EI. In Case 4, a rare incidence of extensor digiti medii proprius was observed. Further, the related literature is reviewed and the clinical and surgical importance of these muscular variations in diagnosis and proper planning of treatment is discussed.