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2015, Singapore Medical Journal
Introduction The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Easy to access and at proximity to the hand, the palmaris longus tendon is considered as the optimal tendon source for hand reconstructive surgery. However, and besides its inconsistency, the size of the palmaris longus tendon is reported to show variability. The aim of this study is to look for the surgical adequacy of the palmaris longus tendon by conducting a quantitative synthesis on its length and width in human populations and its correlation with the forearm length. Methods Twenty-four studies met the inclusion criteria including 1761 cadaveric limbs. Results The results were as following: (a) the mean palmaris longus tendon length was of 13.9 ± 2.6 cm, (b) the mean ratio palmaris longus tendon length/forearm length was of 0.545 ± 0.06, (c) the weighted correlation value was of 0.686, and (d) the mean palmaris longus tendon width was of 4.0 ± 1.7 mm. Only five studies reported a palmaris longus tendon length of more than 15 cm. The palmaris longus tendon length was shown to vary between ancestries; the Japanese had the shortest while Malaysian the longest palmaris longus tendons. All studies but one reported a palmaris longus tendon mean width of more than 3 mm where the minimal mean palmaris longus tendon width was of 2.5 mm. Conclusion While the requested length depends on the recipient site and/or type of reconstructive surgery, the palmaris longus tendon often met the required diameter for grafting. Our review demonstrated that while palmaris longus length varies between ancestries, its width is often adequate for grafting. In addition, the forearm length could be a good predictor of palmaris longus tendon length; such correlation could assist surgeons when planning to use palmaris longus tendon as a graft source.
International Journal of Anatomy and Research
Anatomical Variation of Palmaris Longus: Tendinous Origin and Fleshy Insertion2015 •
The Journal of Hand Surgery
The palmar cutaneous branch of the median nerve and the palmaris longus tendon: A cadaveric study1994 •
Introduction: The palmaris longus muscle is one of the most variable muscles in the human body and there have been numerous variations reported. The different palmaris longus variations are interesting not only from an anatomical point of view, but they could also have definite clinical significance. Aim: The aim of this study was to examine the different types of variations of pal-maris longus muscle in the Bulgarian population. Materials and Methods: Over a period of 15 years, 56 formol–carbol fixed human cadavers were studied to investigate the different variations of PL. Results: The different variations of the palmaris longus muscle were reported: absence (2.68%); reversed palmaris longus coexisting with an additional abductor digiti minimi muscle (0.89%); digastric (0.89%); palmaris longus with intermediate muscle belly (1.79%) and duplication (1.79%). Conclusions: To reveal the wide variety of the types of palmaris longus muscle and their importance for clinical practice, we make a brief literature review concerning the different types of variations, their role in the median and ulnar neu-ropathy in the wrist or as structures simulating a soft tissue tumour and the application of palmaris longus tendon in plastic and reconstructive surgery as grafting material. We also present new systematic anatomical and clinical classifications of palmaris longus variations by dividing them into two simple groups.
Ethiopian Journal of Health Sciences
Presence of Multiple Tendinous Insertions of Palmaris Longus: A Unique Variation of a Retrogressive Muscle2014 •
Folia Morphologica
Hypertrophic reversed palmaris longus muscle: A cadaveric finding2017 •
Variations of the forearm musculature are vastly described in the literature. The palmaris longus muscle is one of the most variable structures of the human body. It usually rises from the medial epicondyle of the humerus and inserts itself into the palmar aponeurosis. Anatomy textbooks and recent papers state that this muscle may act as a weak wrist flexor. The present work aims to report an anatomical variation where the palmaris longus muscle was abnormally hypertrophied and was completely fleshy throughout the whole forearm. Anatomical variations of the palmaris longus may induce symptoms of neurovascular bundle compression, specially the median nerve. The palmaris longus muscle may be used in tendon graft or muscle graft, due to its lack of apparent function. Furthermore, it is one of the anatomical landmarks for local anesthesia procedures.
International Journal of Cadaveric Studies and Anatomical Variations
Palmaris Longus Inversus Muscle Present Bilaterally in an 82-Year-old Cadaver and Unilaterally in a 68-Year-old CadaverThe palmaris longus muscle is one of the most variable muscles in the human body. Palmaris longus muscle anatomical variations include reversed (palmaris longus inversus muscle), duplicated, triplicated, bifid, hypertrophied, accessory (additional) slips, and/or complete absence. During anatomical dissection of fifty cadavers in the 2019 undergraduate first-year anatomy course at the Uniformed Services University of the Health Sciences, we found a palmaris longus inversus muscle bilaterally on an 82 year-old White female cadaver and a unilateral palmaris longus inversus muscle on the right forearm of a 68 year-old White female cadaver. Due to the prevalence of anatomical variations in the palmaris longus muscle, adequate knowledge of such prevalence and clinical significance is needed in multiple medical specialties for its reconstructive use, and the possibility and treatment of clinical syndromes. An accessory (additional) palmaris longus muscle, hypertrophied palmaris longus muscle, hypertrophied palmaris longus inversus muscle, or just the presence of a palmaris longus inversus muscle, can all cause compression to adjacent neurovascular structures, such as the median nerve, ulnar nerve, ulnar artery, and/or the anterior interosseous artery, in the distal forearm and wrist. Palmaris longus tendons are used as grafts in various surgeries, such as extensor tendon repair in rheumatoid arthritis patients, injuries of flexor tendons and repair, lip augmentation, reconstructive hand surgery, frontalis suspension sling in ptosis correction, plastic surgery, and pulley reconstructions. Surgeons, physicians, radiologists, and physiotherapists must be knowledgeable of the many PLM anatomical variations and their possible contributions to pathological processes.
Hippokratia
Fleshy palmaris longus muscle - a cadaveric finding and its clinical significance: a case report2012 •
Palmaris longus variations may include complete agenesis, variation in the location and form of the fleshy portion, aberrancy in attachment, duplication or triplication, accessory tendinous slips, replacing elements of similar form or position. Description of case: An anomalous palmaris longus muscle was found in the right upper extremity of a 63 year-old male cadaver. The muscle was totally fleshy without a long insertion tendon. Its origin was normal, the belly was rather broad and long, fusiform at the upper half and unipennate at the lower half of the forearm, and it was toggled into a short and thick tendon. At its insertion the tendon was split forming a second thinner tendon. The thick tendon was inserted into the flexor retinaculum and the thinner one into the palmar aponeurosis. The muscle compressed the median nerve although no related symptoms were reported on the cadaver's medical history. This variation is of clinical importance because it may cause carpal tunnel sy...
Background: The palmaris longus is one of the most variable muscle in the human body, this variations are important not only for the anatomist but also radiologist, orthopaedic, plastic surgeons, clinicians, therapists. In view of this significance is performed this study with the purpose to determine the morphological variations of palmaris longus muscle. Methods and Findings: A total of 17 cadavers with different age groups were used for this study. The upper limbs region (34 sides) were dissected carefully and photographed in the Morphology Laboratory at the University of Pamplona. Of the 34 limbs studied, 30 showed normal morphology of the palmaris longus muscle (PL) (88.2%); PL was absent in 3 subjects (8.85% of all examined forearm). Unilateral absence was found in 1 male subject (2.95% of all examined forearm); bilateral agenesis was found in 2 female subjects (5.9% of all examined forearm). Duplicated palmaris longus muscle was found in 1 male subject (2.95 % of all examined forearm). The palmaris longus muscle was innervated by branches of the median nerve. The accessory palmaris longus muscle was supplied by the deep branch of the ulnar nerve. Palmaris longus is a muscle located in the superficial layer of the anterior compartment of the forearm. It has a small belly arising from the medial epicondyle of the humerus, and its long thin tendon inserts into the palmar aponeurosis in the hand, the muscle has importance in medical clinic, surgery, radiological analysis, in studies about high-performance athletes, in genetics and anthropologic studies. Conclusions: The anatomical variations of the palmaris longus muscle must be documented of their clinical significance and their potential use in orthopaedic and reconstructive surgery.
2009 •
Soils and Foundations
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Application of Internet Technology in Assembling Literature for Palaeontological Research2017 •
Photodiagnosis and Photodynamic Therapy
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