Tendon of Flexor Carpi Radialis in carpal tunnel: a radiologic and cadaveric study

Morphologic observation for anomalous patterns of the flexor carpi radialis muscle and atypical insertions: a proposal for a new classification

In the present study, four types of variations of the flexor carpi radialis with accessory muscular bundles were classified depending on the origin of the accessory muscular bundle and relationships with the bicipital aponeurosis, biceps brachii, pronator teres, and coracobrachialis. Six types of insertions of the tendon of the flexor carpi radialis were also divided according to their inserted positions on the carpal and metacarpal bones. An accessory muscular bundle of the flexor carpi radialis was found in 4 (1 female and 3 males) of 68 cadavers (5.88%), with five examples in 136 arms (3.68%). It was bilateral in one cadaver and unilateral (two on the right and one on the left) in three. The insertion of the flexor carpi radialis tendon was not only on the proximal surface of the base of the second metacarpal bone but also on the third metacarpal bone, the tubercle of the trapezium, and the scaphoid. These findings and classifications are important in anatomical education, and have important significances in clinical diagnosis and therapies.

Surgical Management of the Trapezium Canal Syndrome: An Uncommon Presentation of Tenosynovitis of Flexor Carpi Radialis

Flexor carpi radialis (FCR) tenosynovitis is a condition characterized by pain over the volar radial wrist caused by inflammation of the FCR tendon sheath. It is an uncommon and often unrecognized pathology that could be misleading from a diagnostic and therapeutic point of view. Treatment usually involves immobilization, nonsteroidal anti-inflammatory drugs, and injections. In refractory cases, operative release of the FCR tendon sheath may be indicated. In this article, we report our experience in treating FCR tenosynovitis by surgically decompressing the trapezium canal, through which the tendon runs, at the wrist. In our experience, this surgical technique allows a good functional recovery with the resolution of painful symptoms without notable complications.