{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:38:26Z","timestamp":1786473506687,"version":"build-2736575974"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 35-year-old woman with prior bilateral open carpal tunnel release presented with recurrent right-hand pain, numbness, tingling, nocturnal awakening, and weakness. Examination showed positive Phalen compression and Tinel signs at the carpal tunnel. Electrodiagnostic testing revealed mild median neuropathy, and ultrasonography demonstrated a bifid median nerve with focal enlargement. Revision exploration identified an accessory flexor digitorum superficialis (FDS) indicis muscle within the carpal tunnel. Repeat decompression, muscle excision, and hypothenar fat flap coverage resulted in resolution of symptoms at 5 months postrevision surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Accessory FDS indicis is a rare but possible structural cause of recalcitrant carpal tunnel syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.26.00233","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T18:00:22Z","timestamp":1786471222000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Accessory Flexor Digitorum Superficialis Indicis as Likely Cause of Recalcitrant Carpal Tunnel Syndrome"],"prefix":"10.2106","volume":"16","author":[{"given":"Caroline M.","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6230-5044","authenticated-orcid":false,"given":"Jackson M.","family":"Cathey","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7767-4124","authenticated-orcid":false,"given":"Warren C.","family":"Hammert","sequence":"additional","affiliation":[{"name":"Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-2883","authenticated-orcid":false,"given":"Tyler S.","family":"Pidgeon","sequence":"additional","affiliation":[{"name":"Division of Hand Surgery, Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7]]},"reference":[{"issue":"9","key":"bib1-20260811","doi-asserted-by":"crossref","first-page":"537","DOI":"10.5435\/00124635-200709000-00004","article-title":"Carpal tunnel syndrome","volume":"15","author":"Cranford","year":"2007","journal-title":"J Am Acad Orthop Surg."},{"issue":"7","key":"bib2-20260811","doi-asserted-by":"crossref","first-page":"1830","DOI":"10.1097\/00006534-200106000-00031","article-title":"Secondary carpal tunnel surgery","volume":"107","author":"Tung","year":"2001","journal-title":"Plast Reconstr Surg."},{"issue":"15","key":"bib3-20260811","doi-asserted-by":"crossref","first-page":"551","DOI":"10.5435\/JAAOS-D-18-00004","article-title":"Management of recalcitrant carpal tunnel syndrome","volume":"27","author":"Lauder","year":"2019","journal-title":"J Am Acad Orthop Surg."},{"issue":"8","key":"bib4-20260811","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.jhsa.2013.04.024","article-title":"Revision carpal tunnel surgery: a 10-year review of intraoperative findings and outcomes","volume":"38","author":"Zieske","year":"2013","journal-title":"J Hand Surg Am."},{"key":"bib5-20260811","doi-asserted-by":"crossref","first-page":"e402","DOI":"10.1016\/j.wneu.2022.11.045","article-title":"Accessory hand muscles over the transverse carpal ligament: an obstacle in carpal tunnel surgery","volume":"170","author":"B\u00f6rekci","year":"2023","journal-title":"World Neurosurg."},{"key":"bib6-20260811","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1097\/00003086-200111000-00043","article-title":"Anatomic variations and carpal tunnel syndrome: 10-year clinical experience","volume":"392","author":"Singer","year":"2001","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib7-20260811","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0363-5023(03)00365-4","article-title":"Prevalence of anatomic variations encountered in elective carpal tunnel release1","volume":"28","author":"Lindley","year":"2003","journal-title":"J Hand Surg."},{"issue":"4","key":"bib8-20260811","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1007\/s11552-014-9622-1","article-title":"Carpal tunnel syndrome secondary to an accessory flexor digitorum superficialis muscle belly: case report and review of the literature","volume":"9","author":"Javed","year":"2014","journal-title":"Hand (N Y)."},{"issue":"6","key":"bib9-20260811","doi-asserted-by":"crossref","first-page":"1215","DOI":"10.2106\/00004623-197153060-00020","article-title":"Anomalous muscle belly of the flexor digitorum superficialis causing carpal-tunnel syndrome. 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