Variations in distal attachment of muscles of the leg, foot and the hand and their clinical implications in population of central Ethiopia

Anatomical variations in the distal attachment of lower and upper limb muscles are of paramount importance in surgical and clinical practice. Reports show variations in the insertion of the fibularis longus and brevis tendon from the lateral compartment of the leg, extensor hallucis longus and fibularis tertius from the anterior compartment of the leg, flexor digitorium brevis from the sole of the foot and the existence of accessory muscles in the dorsum of the hand. However, reports are scanty from Ethiopia. The present study was aimed at assessing the existence of variation in the distal attachments of muscles of the lower and upper limbs in the central Ethiopia population. Twenty-two formalin fixed cadavers were used. Careful dissection, critical observation and imaging were done accordingly. We have found the presence of two tendons of extensor halluces longus in one cases, absence of the lateral tendon to the 5thdigit of the flexor digitorum brevis of the sole of the foot in another case and the presence of the accessory extensor indicis muscle on the dorsum of the hand in a third case. These variations are important owing to the use of the tendons in tendon transfer surgeries to correct deformities of the hand, foot and ankle joint, and also for radiologists, clinicians, and surgeons in order to prevent adverse surgical events.