Presented herein is a case of one different morphological anomaly of pronator quadratus (PQ) muscle. Here, the shape of PQ was not similar to the normal morphology of the muscle. The PQ muscle appeared to be in distinct triangular-shaped instead of quadrangular-shaped. In addition, this triangular-shaped was found in two sites i.e. proximal and distal. Significantly, the PQ muscle consisted of two fleshy red fibres and white aponeurosis. Proximally placed portion had a wide base and a narrower apex. The larger base was attached to the ulna and formed of fleshy red fibres which converged laterally to be continuous with aponeurosis ending on the radius. In contrast, the distal triangular portion had the fleshy fibres attached to the radius and converged medially to be continuous with aponeurotic portions on the ulna. Each portion were referred as pronator triangularis proximalis and pronator triangularis distalis. These variations might affect atypically in cases of forearm pronation. Information of these variations is important in hand surgeries and provide an additional knowledge on the relationship between morphology of PQ muscle and the limitation or the strength in the action of it.
Spigelian hernia (SH) occurs due to the protrusion through a congenital or acquired defect or weakness in the Spigelian aponeurosis. SH accounts for only 0.1-0.4% of occurrence and a 17-24% risk of strangulation. We hereby report a case of a 34-year-old gentleman presented with concomitant incarceration of the omentum with small intestine and testis in Spigelian hernia sac. We have successfully operated on this patient via a transperitoneal approach with a small incision over the hernia site. This incision could be an alternative to midline laparotomy as a safe and effective method in managing incarcerated SH in an emergency setting.