Study on accessory abductor digiti minimi

Aruna Subramanian, Hannah Sugirthabai Rajila Rajendran, Vaithianathan Gnanasundaram, Balaji Thotakura, Saran Sharmila



Abductor digiti minimi (ADM) along with other hypothenar muscles, is prone to lot of variations. Its close relation to the ulnar neurovascular bundle makes it an important muscle. The most common being the presence of accessory slips (accessory ADM [AADM]). The embryological basis for such slips, their morphology and their relation to ulnar neurovascular bundle were studied in detail.

Materials and Methods:

A total of 100 upper limbs (80 males and 20 females) were studied for the presence or absence of AADM and its relation to ulnar nerve (UN) and vessels were studied in detail.


Of these 100, four limbs had AADM, in which three were superficial to the ulnar artery and nerve and hence compressing them.


Presence of AADM can result in hypothenar hammer syndrome of ulnar artery and/or in compression neuropathy of UN and cause undue problems during any flap surgeries and other procedures of the hand. 


Accessory abductor digiti minimi, compression neuropathies, hypothenar hammer syndrome, ulnar artery, ulnar nerve

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Shea JD, McClain EJ. Ulnar-nerve compression syndromes at and below the wrist. J Bone Joint Surg Am 1969;51:1095-1103

Murata K, Shih JT, Tsai TM. Causes of ulnar tunnel syndrome: A retrospective study of 31 subjects. J Hand Surg Am 2003;28:647-51.

Napier JR. The prehensile movements of the human hand. J Bone Joint Surg Br 1956;38-B:902-13.

Young RW. Evolution of the human hand: The role of throwing and clubbing. J Anat 2003;202:165-74.

Moore KL, Persaud TV. The Developing Human. 8th ed. Philadelphia, PA: Saunders; 2011. p. 358-9.

Soldado-Carrera F, Vilar-Coromina N, Rodríguez-Baeza A. An accessory belly of the abductor digiti minimi muscle: A case report and embryologic aspects. Surg Radiol Anat. 2000;22:51-4.

Macalister A. Additional observations on muscular anomalies in human anatomy (third series), with a catalogue of muscular variations hitherto published. Trans R Ir Acad 1875;25:1-134.

Sañudo JR, Mirapeix RM, Ferreira B. A rare anomaly of abductor digiti minimi. J Anat 1993;182:439-42.

Jackson DW, Harkins PD. An aberrant muscle belly of the abductor digiti quinti associated with median nerve paresthesias. Bull Hosp Joint Dis 1972;33:111-5.

Tubiana R. Anatomie de la Main. Paris: Masson; 1981. P. 390-3.

Bakinde N, Yotovski P, Voigt T, Rager G. Accessory muscle in the hypothenar region: A functional approach. Ann Anat 2005;187:149-52.

Wingerter S, Gupta S, Le S, Shamasunder S, Bernstein R, Rabitaille W, et al. Unusual origin of the flexor digiti minimi brevis muscle. Clin Anat 2003;16:531-3.

Rajendran HS, Gnanasundaram V, Balaji T, Rajendran SS. Flexor digiti minimi brevis – Variations, development & its significance to ulnar neurovascular bundle. Int J Res Health Sci 2014;2:320-5.

Sheppard JE, Prebble TB, Rahn K. Ulnar neuropathy caused by an accessory abductor digiti minimi muscle. Wis Med J 1991;90:628-31.

Winterer JT, Ghanem N, Roth M, Schaefer O, Lehnhardt S, Thürl C, et al. Diagnosis of the hypothenar hammer syndrome by high-resolution contrast-enhanced MR angiography. Eur Radiol 2002;12:2457-62.

Bloom RJ, Kane AJ, Maxwell R. The abductor digiti minimi flap: A case report and review. Aust N Z J Surg 1997;67:582-3.

Upton J, Taghinia AH. Abductor digiti minimi myocutaneous flap for opponensplasty in congenital hypoplastic thumbs. Plast Reconstr Surg 2008;122:1807-11.

Ogino T, Minami A, Fukuda K. Abductor digiti minimi opponensplasty in hypoplastic thumb. J Hand Surg Br 1986;11:372-7.


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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.