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Hi All

I was investigating a mid shaft 5th metatarsal pain that was difficult to diagnose and radiographs revealed nothing much. In Kapanji, 'The Physiology of the Joints' I came across the muscle Oppenens Digiti Minimi. I have never been aware of this muscle before and can find it mentioned nowhere else, even in Grays on line. Anyone else unaware of this or find this unusual? Shown centre top diagram Op.5.



Regards Dave

 

Hi Dave. Oppenens is in the hand. However having had a flick through one of my relic surgery books it seems the variants found in the attachment of flexor digiti minimi brevis specifically when it inserts along the lateral midshaft of the 5th met are sometimes classed as a seperate muscle, thus, oppenens digiti minimi

George

 

Thanks for your reply George

I knew that there was also a muscle in the hand by the same name and Kapanji describes the similarity of origin, insertion and action between the two.
The x-ray of the foot of this patient shows quite a curved 5th metatarsal and I was thinking that this muscle if over stressed may cause a kind of bending stress syndrome of the 5th met shaft similar to medial tibial stress syndrome or, as it is also in just the right place, it could be an insertional stress trauma.

RegardsDave Smith

 

My hero, Colonel Sherm Potter, (MASH) used to say that when the going gets tough, you go back to basics. Right now, we need to revisit manual and pedal anatomy. Both have 18 muscles, but not the same 18; well, 18-ish. Lets take this slowly. In the foot we have flexor digitorum brevis - which either migrated out of the hand to form flexor digitorum superficialis in the forearm, or has migrated into the foot - either way who cares, its the same muscle. Adductor p(Ha)ollucis is clearly the same muscle. The lumbricals and interosei are the same apart from their distribution about different midlines and their nerve supplies (Lumbricals subtely different). So where does that leave us? Abductor Hallucis is clearly the same as abdutor pollucis; Flexor hallucis brevis like wise; flexor digiti mini brevis also, and abductor digiti minimi. So what is left? In the hand the two opponens are perhaps the key features of their myology, and there is little serious doubt that they once existed in in the foot. Thus, the two opponens muscles in the foot seem to have been sacrificed, which is not an reasonable hypotheis, since we are talking a HUGE change of function; thus they well turn up from time to time as extras. That's the very nature of evolution. Rob