title: Anatomical variation of abductor pollicis longus in Indian population: A cadaveric study.
abstract: BACKGROUND
  Many authors have reported the anatomical variation of abductor pollicis longus (APL) around the wrist and its association with de Quervain tenosynovitis (DQT), first carpo-metacarpal arthritis, and trapezio-metacarpal subluxation. From Indian subcontinent, there is only one original article and a few case reports on the variability of APL tendon insertion.
  
  
  METHODS
  Fifty formaldehyde preserved cadaveric wrists were dissected to look for the anatomical variation of APL in the Indian population.
  
  
  RESULTS
  The APL was found with single tendon in 2, double in 31, triple in 8, and quadruple in 8 extremities. A maximum of 6 tendon-slips were found in one cadaveric wrist. In all hands, the APL had at least one attachment to first metacarpal bone and in 46 hands (92%), there was second insertion to the trapezium bone. Of all tendon-slips of APL (n = 126), 44% of tendons (68 tendons) were inserted into the base of the first metacarpal bone. This was followed by the insertion into the trapezium in 42% tendons (52 tendons).
  
  
  CONCLUSIONS
  Bi-tendinous APL is commonly observed on the dorsal compartment of the wrist in Indian population and these tendon-slips are commonly attached to the first metacarpal base and trapezium. This variation must be understood by the Indian Orthopedic surgeons as the response to treatment of DQT and reason for first carpo-metacarpal arthritis can be dependent on this anatomical variation.
authors.affiliation: Department of Anatomy, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
authors.forename: Jerina
authors.initials: J
authors.lastname: Tewari
authors.affiliation: Department of Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Pravash Ranjan
authors.initials: PR
authors.lastname: Mishra
authors.affiliation: Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India.
authors.forename: Sujit Kumar
authors.initials: SK
authors.lastname: Tripathy
keywords: Abductor pollicis longus; Indian; Tendons; anatomical snuff box; cadaver; first dorsal compartment of wrist; tenosynovitis; wrist