PubMed · 7824124
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R C Katzin. 1995. Arm rolling test.. https://doi.org/10.1212/wnl.45.1.203-a
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The abductor pollicis longus (APL) muscle has been studied bilaterally in 50 cadavers. A variation in the organization of the muscle was found bilaterally in 15 of the 50 specimens. The novel muscular arrangement gives the appearance of being an additional muscle belly arising from the lateral aspect of the distal portion of the typical abductor pollicis longus muscle belly. This variation in the arrangement also creates a retinacular-like tunnel which encases the tendons of the extensor carpi radialis longus and the extensor carpi radialis brevis muscles. To the authors' knowledge, this arrangement has not been cited in the recent medical literature. An understanding of this unusual finding may be clinically relevant in describing the dorso-lateral compartment of the distal forearm.
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Thrombosis is the most frequent cause of failure in microvascular free-tissue transfer. The large communicating vein of the cubital fossa connects the deep and superficial venous drainage of the radial forearm free flap (RFFF). This vein allows the surgeon to simultaneously drain both systems by means of the large veins of the cubital fossa. We prospectively collected data on the venous anatomy of the cubital fossa in 40 consecutive RFFFs over a 3-year period. We then retrospectively reviewed available data from the 14 cases preceding the cases in the prospective series. At least 78% of our patients had a communicating vein that facilitated dual venous drainage; 87% of our RFFFs were drained by both the superficial and deep venous systems, and 90% of our RFFFs had two or more venous anastomoses. We had no RFFF failures in our series of 54 flaps. We present our venous anatomy findings in this series of forearms as well as the venous anastomoses of our 54 patients. The surgi- cal-flap harvest, including the communicating vein and its use, may provide an advantage in the dependability and quality of venous outflow.