INTERNATIONAL JOURNAL OF ADVANCES IN CASE REPORTS VARIANT ULNAR HEAD OF FLEXOR CARPI ULNARIS MUSCLE

ABSTRACT During routine dissection, of the right upper limb of 70 years old donated embalmed male cadaver in the Department of Anatomy, K.J. Somaiya Medical College, Sion, Mumbai, India, we observed a separate humeral and ulnar heads of flexor carpi ulnaris muscle. To recognise Anatomical variations it is necessary to know the normal Anatomy. Normally the flexor carpi ulnaris muscle arises by two heads, humeral and ulnar, connected by a tendinous arch. The humeral head arises from the medial epicondyle via the common flexor tendon. The ulnar head arises from the medial margin of the olecranon process and an aponeurosis attached to the posterior sub cutaneous border of the ulna. The tendon of flexor carpi ulnaris inserted into the hamate and the fifth metacarpal bone through pisohamate and pisometacarpal ligaments. In the present case the ulnar head of flexor carpi ulnaris muscle was more bulky. It separated ulnar nerve and artery. The humeral and ulnar heads were separated from each other by ulnar nerve. These two heads fused with each other just before their insertion, where the ulnar artery came in contact with ulnar nerve. The further course and distribution of ulnar artery and ulnar nerve were normal. The knowledge of such unusual ulnar head separating ulnar artery and ulnar nerve may be clinically important for plastic surgeons doing flap surgeries and for the surgeon dealing with cubital tunnel syndrome. INTRODUCTION Flexor carpi ulnaris muscle is the medial most muscle of the superficial flexor group. It arises by two heads, humeral and ulnar, connected by a tendinous arch. The small humeral head arises from the medial epicondyle via the common flexor tendon. The ulnar head has an extensive origin from the medial margin of the olecranon process and proximal two-thirds of the posterior border of the ulna, an aponeurosis (along with flexor digitorum profundus and extensor carpi ulnaris) and from the intermuscular septum between it and flexor digitorum superficialis. A thick tendon forms along its anterolateral border in its distal half. The tendon is attached to the pisiform, and thence prolonged to the hamate and the fifth metacarpal bone by pisohamate and pisometacarpal ligaments (pisiform is the sesamoid bone developing in the tendon of flexor carpi ulnaris). Acting with the flexor carp