Anomalous muscles and nerves in the hand of a 94-year-old cadaver—A case report

Introduction: During an anatomical dissection of the distal upper extremities, numerous muscular and nervous anomalies were found in the forearm and hand of a 94-year-old cadaver. These anomalies are clinically relevant with regard to medical or surgical interventions. Presentation of case: The presence of a “flexor digiti minimi longus” muscle was observed passing through Guyon's canal; to our knowledge this passageway has never been previously reported. An aberrant first lumbrical with three origins was noted. Additionally, numerous atypical nerves were found innervating the hand; the dorsal branch of the ulnar nerve contributed to cutaneous innervation of the palm of the hand (Kaplan's anastomosis), the superficial ulnar nerve provided muscular innervation to the flexor digiti minimi brevis muscle, and two connections between the common palmar digital branches of the median and superficial ulnar nerves were observed (Berrettini anastomosis). Discussion: Here, we describe an extranumerary muscle associated with the hypothenar group of muscles. We also describe unusual origins of the first lumbrical muscle, and atypical cutaneous and muscular innervation to the palm of the hand. Conclusion: Clinically, understanding the existence of these anatomical variations may influence medical care or surgical procedures.