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The accessory muscle was divided and improved the flexion contracture.

At operation, the FDP tendon to the index finger and the intrinsic muscles were intact and of normal appearance.

However, an accessory muscle was seen attached to the index finger FDS tendon in zone 3.

He underwent botulinum toxin injections 4 weeks previously and was undergoing tendon lengthening/release on the right side.

Of note, pre-operatively he had a very tight FPL and wrist flexors but also incidentally a severe flexion deformity of his ring little and fingers which resembled a claw hand.

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