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Anomalous and accessory muscles in the palm are anatomical curiosities until they become symptomatic.
At operation, the FDP tendon to the index finger and the intrinsic muscles were intact and of normal appearance.
However, an accessory muscle was seen attached to the index finger FDS tendon in zone 3.
Because of their rarity, their diagnosis is often delayed or initially missed.
The authors show clear anatomical photographs of this accessory muscle along with an algorithm for investigating suspected anatomical variations.
A tendon ran proximally from this accessory muscle belly into the forearm.