PubMed · 242462
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1977-08-11. [Incorrectly performed hand surgery: liability case].. https://pubmed.ncbi.nlm.nih.gov/242462/
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Examination of the thenar muscles in 30 anatomical preparations of the hand have shown that the abductor pollicis brevis, the opponens pollicis, and the adductor pollicis muscles are made up of several muscle bellies. The number and insertions of these bellies are varied. Both heads of flexor pollicis brevis do not originate from any particular muscle belly. The superficial head of this muscle always inserted into the head of the thumb metacarpal, either completely, or, some of the fibres of the dorsal aponeurosis of the thumb were attached to the base of the proximal phalanx. Furthermore the anatomy of the abductor pollicis brevis muscle was related to the presence of a tendinous slip from abductor pollicis longus. These variations could have an influence on proprioception in the thumb ray.
The architectural features of twenty different muscles (18 intrinsics and 2 thumb extrinsics, n = 180 total muscles) were studied. Muscle length, mass, fiber pennation angle, fiber length, and sarcomere length were determined. From these values, physiologic cross-sectional area and fiber length/muscle length ratio were calculated. Intrinsic muscle lengths were relatively similar to one another, which we interpreted as representing a space constraint within the hand. However, several specialized architectural designs were observed: lumbrical muscles had an extremely high fiber length/muscle length ratio, implying a design toward high excursion. The first dorsal interosseous and adductor pollicis had physiologic cross-sectional areas comparable to those of extrinsic muscles and much greater than those of the other intrinsic muscles. The interosseous muscles had relatively high physiologic cross-sectional areas with low fiber length/muscle length ratios, suggesting their adaptation for high force production and low excursion. Taken together, these observations illustrate the underlying structural basis for the functional capacities of the intrinsic muscles.