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International Journal of Trend in Scientific Research and Development (IJTSRD)
Volume 6 Issue 4, May-June 2022 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470
@ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 610
Anatomical Variation of Adductor Brevis Muscle – A Case Report
Dr. Meenakshi Meena1
, Prof. Sunil Kumar2
, Dr. Isha Hershwani3
, Dr. Neha Sharma1
1
MD Scholar, 2
Professor, 3
Assistant Professor,
1, 2, 3
Department of Rachana Sharir, National Institute of Ayurveda
Deemed to be University (de- novo) Jaipur, Rajasthan, India
ABSTRACT
Adductor group of muscles are present in the medial compartment of
the thigh. In this group adductor longus, adductor brevis, adductor
magnus, gracilis, obturator externus and pectineus muscles are
present implementing the function of adduction and medial rotation.
Deviations from normal anatomy are rare and hardly reported. The
occasional mention of additional bellies of adductor brevis muscle is
present in surveys of anatomical archives. The present study reports
an extra belly of adductor brevis (AB) muscle on the right side found
during a cadaveric dissection for postgraduates in the national
institute of Ayurveda, Jaipur, Rajasthan. This case report is an effort
to present the clinical applications of multiple bellies of the adductor
brevis muscle of the thigh. It is possible to classify these muscular
variations upon specialized radiological procedures such as CT and
MRI scans only if the radiologist owns satisfactory knowledge of the
variant anatomy of this region. These extra muscular slips can be
fairly used in the reconstruction.
KEYWORDS: Adductor Brevis, Reconstructions, Variations
How to cite this paper: Dr. Meenakshi
Meena | Prof. Sunil Kumar | Dr. Isha
Hershwani | Dr. Neha Sharma
"Anatomical Variation of Adductor
Brevis Muscle – A Case Report"
Published in
International Journal
of Trend in
Scientific Research
and Development
(ijtsrd), ISSN: 2456-
6470, Volume-6 |
Issue-4, June 2022,
pp.610-612, URL:
www.ijtsrd.com/papers/ijtsrd49593.pdf
Copyright © 2022 by author(s) and
International Journal of Trend in
Scientific Research and Development
Journal. This is an
Open Access article
distributed under the
terms of the Creative Commons
Attribution License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
INTRODUCTION
Adductor Brevis muscle arises from a thin attachment
from the external facet of the body and inferior ramus
of pubis, among gracilis and obturator externus.
Adductor Brevis muscle inserts via an aponeurosis
into the femur, along a line from the lesser trochanter
to the linea aspera, and on the upper part of the line
immediately behind the pectineus and the upper part
of adductor longus1
. The nerve supply was an anterior
division of the obturator nerve. The obturator nerve
has 2 divisions; the anterior division passes vertically
downward on its anterior surface and the posterior
division passes down behind it. The upper border of
the adductor longus lies between the femoral and the
profunda femoral vessels2
and the upper border of the
adductor brevis thus lie between the two-part of the
obturator nerve. The main action of the adductor
muscle group is to medially rotate the thigh, towards
or past the median plane. To stabilize the standing
posture on both feet, to correct lateral control of the
trunk, or side to side shift of the surface on which one
is standing (rocking a boat, standing on a balanced
board) of a person, adductor group of muscles are
used. In kicking with the medial side of the foot in
soccer and in swimming, the Adductor group of
muscles are used. Adductor muscles contribute to
flexion and extension thigh when running or against
resistance. The adductors as a group contribute a
large muscle mass3
and they are also important in
many activities; it has been shown that a reduction of
as much as 70% of their mass or function will result
in only a slight to moderate impairment of the hip
joint4
.
CASE REPORT:
On routine postgraduate dissection, in the Department
of Rachana Sharir, National Institute of Ayurveda,
Jaipur, Rajasthan, we dissected a female cadaver of
age 55 where there were two bellies of adductor
brevis unilaterally [Fig A]. From the outer surface of
the body and inferior ramus of the pubic bone, the
tendon of the adductor brevis originates. The nerve
supply, origin, and insertion of Adductor group
muscles were studied and outlined. The variation was
IJTSRD49593
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 611
photographed [Fig B]. On Right lower limb, the
adductor brevis has a variant muscular slip.
After sectioning and reflecting adductor longus
muscle and pectineus muscle, adductor brevis was
observed. This muscle having typical origin but was
seen in two parts, and inferior down its fibers merged
with the fibers of adductor longus muscle. The nerve
supply was from anterior division of obturator nerve.
DISCUSSION:
Adductor Brevis is said to have two or three separate
parts or may be integrated into the adductor magnus5
,
Separation may be at the origin or insertion or
complete6
. A case reported by Ocheltree in which two
separate divisions of the adductor brevis have quite
separate insertions into the linea aspera but he did not
mention it as a different muscle. To merit the separate
name Maybe the gap between the two insertions was
not enough 7
. A nonstandard adductor brevis in
addition to the usual one encountered by Singh et al.
It originated from the anterior surface of the inferior
pubic ramus and was inserted into the upper part of
linea aspera and adjoining part of the line from the
linea aspera to the lesser trochanter. It was separated
from the normal adductor brevis8
. Thus, infrequent
cases of bifurcation of adductor brevis are reported
off and on. Division of adductor brevis into two
distinct fasciculi near the insertion may be even
normal9
.
CLINICAL IMPLICATIONS:
Not only for anatomists but also for orthopaedic
surgeons and radiologists the variant and additional
muscles are useful. Functionally, they may add or
subtract to the strength of a particular group (adductor
in this case). Myelodysplastic patients with
subluxation or dislocation of the hip may be treated
surgically by transferring the origin of the adductor
brevis along with other adductors to the ischial
tuberosity10
. As a result of the transfer, the adductor
group of muscles may be weakened for the
functioning of adduction11
, the additional belly of the
adductor brevis could possibly be utilized for this
purpose. For athletes, variant adductor muscle strain
may prove to be incapacitating. If rehabilitative
procedures fail to cure the patient of pain and
fragility, sports surgeons may have a choice to
adductor release and tenotomy12
. In scrotal
reconstruction, the adductor minimus has been used
as a myocutaneous flap. For the same purpose, an
additional belly of the adductor brevis can be also
used.
CONCLUSION
It can be concluded that a variant adductor complex
of the thigh happens due to greater or less fusion of
different muscles of the adductor group. Anatomical
Fig.A. medial to lateral medial
compartment of thigh showing muscle
with extra slip of AB
1.medial slip of adductor brevis
2.lateral slip of adductor brevis
3.pectineus muscle
4.femoral artery
5. sartorius muscle
Fig.B. showing muscles of medial
compartment of thigh with femoral artery
1.lateral slip of adductor brevis
2. medial slip of adductor brevis
3.femoral artery
4.vastus lateralis
International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470
@ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 612
knowledge of these variations of the medial side of
the thigh with the possible muscular variations is
needed for the proper performance of surgeries and
reconstructions.
REFERENCE
[1] Salmon S. Muscle In: Gray’s Anatomy. The
Anatomical Basis of Clinical Practice. William
PL, Bannis-ter LH, Berry MM, Collins P,
Dyson M, Dussek JE,Ferguson MWJ. Edrs.
38th Ed. Edinburg. Churchill Livingstone.
2005; pp 874-5.
[2] Sinnatamby CS. Lower limb. In: Last’s
Anatomy.12thEd. Edinburgh: Churchill
Livingstone. 1998; p. 121-2.
[3] Moore KL, Dalley AF. Clinically Oriented
Anatomy.5th Ed., Philadelphia, Lippincott
Williams and Wilkins. 1999; 597-8.
[4] Merkede G, Stener G. Function after removal
of various hip and thigh muscles for extirpation
oftumors. Acta Orthop Scand.1981; 52:373.
[5] Salmon S. Muscle In: Gray’s Anatomy. The
Anatomical Basis of Clinical Practice. William
PL, Bannis-ter LH, Berry MM, Collins P,
Dyson M, Dussek JE, Ferguson MWJ. Edrs.
38th Ed. Edinburg. Churchill Livingstone.
2005; pp 874-5.
[6] Hollinshead, W.H. Buttock, Hip Joint and
Thigh. In: Anatomy for Surgeons, Vol 3. 2nd
Ed. New York, Harperand Row. 1969; pp 720-
1.
[7] Ochiltree, A.B. Some muscular anomalies in
lower limb. J Anat Physiol. 1912; 47:31.
[8] Schaeffer JP. Musculature of the lower limb.
In: Mor-ris” Human Anatomy- Complete
Systemic Treatise. J.C. B. Grant. 10th Ed.
Philedelphia, Toronto. The Blakiston Company.
1947; pp 539-40.
[9] Upasna, Rajan Kumar Singla, Arun Sharma,
Mannat Singla. BILATERALLY BIFID
ADDUCTOR BREVIS: A CASE REPORT. Int
J Anat Res 2016; 4(2):2405-2408. DOI:
10.16965/ijar.2016.210.
[10] London JT, Nichols O. Paralytic Dislocation of
the Hip in Myelodysplasia. The role of
adductor transfer. J Bone Joint Surg Am.1975;
57(4):501-6.
[11] London JT, Nichols O. Paralytic Dislocation of
the Hip in Myelodysplasia. The role of
adductor transfer. J Bone Joint Surg Am.1975;
57(4):501-6.
[12] Nicholas SJ, Tyler TF. Adductor muscle strains
in sport. Sports Med. 2002; 32:339–344.

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Anatomical Variation of Adductor Brevis Muscle – A Case Report

  • 1. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 6 Issue 4, May-June 2022 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470 @ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 610 Anatomical Variation of Adductor Brevis Muscle – A Case Report Dr. Meenakshi Meena1 , Prof. Sunil Kumar2 , Dr. Isha Hershwani3 , Dr. Neha Sharma1 1 MD Scholar, 2 Professor, 3 Assistant Professor, 1, 2, 3 Department of Rachana Sharir, National Institute of Ayurveda Deemed to be University (de- novo) Jaipur, Rajasthan, India ABSTRACT Adductor group of muscles are present in the medial compartment of the thigh. In this group adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus and pectineus muscles are present implementing the function of adduction and medial rotation. Deviations from normal anatomy are rare and hardly reported. The occasional mention of additional bellies of adductor brevis muscle is present in surveys of anatomical archives. The present study reports an extra belly of adductor brevis (AB) muscle on the right side found during a cadaveric dissection for postgraduates in the national institute of Ayurveda, Jaipur, Rajasthan. This case report is an effort to present the clinical applications of multiple bellies of the adductor brevis muscle of the thigh. It is possible to classify these muscular variations upon specialized radiological procedures such as CT and MRI scans only if the radiologist owns satisfactory knowledge of the variant anatomy of this region. These extra muscular slips can be fairly used in the reconstruction. KEYWORDS: Adductor Brevis, Reconstructions, Variations How to cite this paper: Dr. Meenakshi Meena | Prof. Sunil Kumar | Dr. Isha Hershwani | Dr. Neha Sharma "Anatomical Variation of Adductor Brevis Muscle – A Case Report" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456- 6470, Volume-6 | Issue-4, June 2022, pp.610-612, URL: www.ijtsrd.com/papers/ijtsrd49593.pdf Copyright © 2022 by author(s) and International Journal of Trend in Scientific Research and Development Journal. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) (http://creativecommons.org/licenses/by/4.0) INTRODUCTION Adductor Brevis muscle arises from a thin attachment from the external facet of the body and inferior ramus of pubis, among gracilis and obturator externus. Adductor Brevis muscle inserts via an aponeurosis into the femur, along a line from the lesser trochanter to the linea aspera, and on the upper part of the line immediately behind the pectineus and the upper part of adductor longus1 . The nerve supply was an anterior division of the obturator nerve. The obturator nerve has 2 divisions; the anterior division passes vertically downward on its anterior surface and the posterior division passes down behind it. The upper border of the adductor longus lies between the femoral and the profunda femoral vessels2 and the upper border of the adductor brevis thus lie between the two-part of the obturator nerve. The main action of the adductor muscle group is to medially rotate the thigh, towards or past the median plane. To stabilize the standing posture on both feet, to correct lateral control of the trunk, or side to side shift of the surface on which one is standing (rocking a boat, standing on a balanced board) of a person, adductor group of muscles are used. In kicking with the medial side of the foot in soccer and in swimming, the Adductor group of muscles are used. Adductor muscles contribute to flexion and extension thigh when running or against resistance. The adductors as a group contribute a large muscle mass3 and they are also important in many activities; it has been shown that a reduction of as much as 70% of their mass or function will result in only a slight to moderate impairment of the hip joint4 . CASE REPORT: On routine postgraduate dissection, in the Department of Rachana Sharir, National Institute of Ayurveda, Jaipur, Rajasthan, we dissected a female cadaver of age 55 where there were two bellies of adductor brevis unilaterally [Fig A]. From the outer surface of the body and inferior ramus of the pubic bone, the tendon of the adductor brevis originates. The nerve supply, origin, and insertion of Adductor group muscles were studied and outlined. The variation was IJTSRD49593
  • 2. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 611 photographed [Fig B]. On Right lower limb, the adductor brevis has a variant muscular slip. After sectioning and reflecting adductor longus muscle and pectineus muscle, adductor brevis was observed. This muscle having typical origin but was seen in two parts, and inferior down its fibers merged with the fibers of adductor longus muscle. The nerve supply was from anterior division of obturator nerve. DISCUSSION: Adductor Brevis is said to have two or three separate parts or may be integrated into the adductor magnus5 , Separation may be at the origin or insertion or complete6 . A case reported by Ocheltree in which two separate divisions of the adductor brevis have quite separate insertions into the linea aspera but he did not mention it as a different muscle. To merit the separate name Maybe the gap between the two insertions was not enough 7 . A nonstandard adductor brevis in addition to the usual one encountered by Singh et al. It originated from the anterior surface of the inferior pubic ramus and was inserted into the upper part of linea aspera and adjoining part of the line from the linea aspera to the lesser trochanter. It was separated from the normal adductor brevis8 . Thus, infrequent cases of bifurcation of adductor brevis are reported off and on. Division of adductor brevis into two distinct fasciculi near the insertion may be even normal9 . CLINICAL IMPLICATIONS: Not only for anatomists but also for orthopaedic surgeons and radiologists the variant and additional muscles are useful. Functionally, they may add or subtract to the strength of a particular group (adductor in this case). Myelodysplastic patients with subluxation or dislocation of the hip may be treated surgically by transferring the origin of the adductor brevis along with other adductors to the ischial tuberosity10 . As a result of the transfer, the adductor group of muscles may be weakened for the functioning of adduction11 , the additional belly of the adductor brevis could possibly be utilized for this purpose. For athletes, variant adductor muscle strain may prove to be incapacitating. If rehabilitative procedures fail to cure the patient of pain and fragility, sports surgeons may have a choice to adductor release and tenotomy12 . In scrotal reconstruction, the adductor minimus has been used as a myocutaneous flap. For the same purpose, an additional belly of the adductor brevis can be also used. CONCLUSION It can be concluded that a variant adductor complex of the thigh happens due to greater or less fusion of different muscles of the adductor group. Anatomical Fig.A. medial to lateral medial compartment of thigh showing muscle with extra slip of AB 1.medial slip of adductor brevis 2.lateral slip of adductor brevis 3.pectineus muscle 4.femoral artery 5. sartorius muscle Fig.B. showing muscles of medial compartment of thigh with femoral artery 1.lateral slip of adductor brevis 2. medial slip of adductor brevis 3.femoral artery 4.vastus lateralis
  • 3. International Journal of Trend in Scientific Research and Development @ www.ijtsrd.com eISSN: 2456-6470 @ IJTSRD | Unique Paper ID – IJTSRD49593 | Volume – 6 | Issue – 4 | May-June 2022 Page 612 knowledge of these variations of the medial side of the thigh with the possible muscular variations is needed for the proper performance of surgeries and reconstructions. REFERENCE [1] Salmon S. Muscle In: Gray’s Anatomy. The Anatomical Basis of Clinical Practice. William PL, Bannis-ter LH, Berry MM, Collins P, Dyson M, Dussek JE,Ferguson MWJ. Edrs. 38th Ed. Edinburg. Churchill Livingstone. 2005; pp 874-5. [2] Sinnatamby CS. Lower limb. In: Last’s Anatomy.12thEd. Edinburgh: Churchill Livingstone. 1998; p. 121-2. [3] Moore KL, Dalley AF. Clinically Oriented Anatomy.5th Ed., Philadelphia, Lippincott Williams and Wilkins. 1999; 597-8. [4] Merkede G, Stener G. Function after removal of various hip and thigh muscles for extirpation oftumors. Acta Orthop Scand.1981; 52:373. [5] Salmon S. Muscle In: Gray’s Anatomy. The Anatomical Basis of Clinical Practice. William PL, Bannis-ter LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MWJ. Edrs. 38th Ed. Edinburg. Churchill Livingstone. 2005; pp 874-5. [6] Hollinshead, W.H. Buttock, Hip Joint and Thigh. In: Anatomy for Surgeons, Vol 3. 2nd Ed. New York, Harperand Row. 1969; pp 720- 1. [7] Ochiltree, A.B. Some muscular anomalies in lower limb. J Anat Physiol. 1912; 47:31. [8] Schaeffer JP. Musculature of the lower limb. In: Mor-ris” Human Anatomy- Complete Systemic Treatise. J.C. B. Grant. 10th Ed. Philedelphia, Toronto. The Blakiston Company. 1947; pp 539-40. [9] Upasna, Rajan Kumar Singla, Arun Sharma, Mannat Singla. BILATERALLY BIFID ADDUCTOR BREVIS: A CASE REPORT. Int J Anat Res 2016; 4(2):2405-2408. DOI: 10.16965/ijar.2016.210. [10] London JT, Nichols O. Paralytic Dislocation of the Hip in Myelodysplasia. The role of adductor transfer. J Bone Joint Surg Am.1975; 57(4):501-6. [11] London JT, Nichols O. Paralytic Dislocation of the Hip in Myelodysplasia. The role of adductor transfer. J Bone Joint Surg Am.1975; 57(4):501-6. [12] Nicholas SJ, Tyler TF. Adductor muscle strains in sport. Sports Med. 2002; 32:339–344.