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Introduction: Anatomical variations of the flexor pollicis longus(FPL) muscle are well described, the common two being an accessory head of FPL also known as Gantzer’s muscle described in 1813 and the anomalous tendon slips from the FPL to the flexor digitorum profundus(FDP) of the index and more rarely middle finger described by Linburg and Comstock in 1979.We present an anomaly not previously described in the literature where the FDP to the ring finger was found to originate from the FPL tendon, causing tight flexion contracture of both due to underlying muscle spasticity.The Cohen kappa and Fleiss kappa statistics were used for estimating the intra- and inter-observer reliabilities.The compatibility of the lunate types with the MRA findings, as assessed by each observer, was investigated.On the CTD analysis, 76 (50.7%) of the total wrists were classified into the intermediate group; excluding them, 27 of 29 Type II lunates (93.1%) and 39 of 45 Type I lunates (86.7%) were compatible with the MRA findings.Conclusions: Both systems had moderate inter-observer and intra-observer reliabilities.Methods: Plain radiographs of a total of 150 wrists were reviewed by three observers.

We present the case of a 28 year old male mechanic who presented with a painful swelling over his right thenar eminence following a road traffic accident.The first purpose of this study was to examine the reliability and reproducibility of the two methods of determining the lunate type: posteroanterior (PA) radiographic analysis (PA analysis) and capitate-triquetrum distance analysis (CTD analysis).The second purpose was to investigate the compatibility of the radiographic classification of lunate types with MR arthrography (MRA) findings.His grip strength was compromised and had reduced abduction of his index finger. No intrinsic muscle rupture was detected and no mass lesion was detected.Hypertrophy of the index intrinsic muscles was suggested.Results: The overall intra-observer reliability was 0.517 for the PA analysis and 0.589 for the CTD analysis.

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