Clinical Significance of a Duplicated Palmaris Longus Muscle with One Reversed Muscle: A Case Report
DOI:
https://doi.org/10.3889/oamjms.2020.4545Keywords:
Palmaris Longus, Duplicate, Anatomical variations, Tendon graftAbstract
BACKGROUND: Multiple variations of the palmaris longus (PL) muscle are reported throughout literature and include variations such as double muscle bellies, inversion of muscle belly and tendon, and the absence of the muscle. The muscle functions as a weak flexor of the wrist. It originates from the medial epicondyle of the humerus, projects as a superficial muscle of the anterior compartment of the forearm, lies over the transverse carpal ligament, and inserts into the palmar aponeurosis.
CASE REPORT: Routine dissection of the right forearm of a 70-year-old Caucasian male revealed a rare duplicated PL muscle with the medial PL muscle being reversed. The left forearm appeared normal, with no such variations. The cadaver showed no significant pathological findings due to this variation. Innervation and vasculature of the variant muscle appeared normal.
CONCLUSION: The PL muscle is highly variable, and clinicians need to be aware of its many possible presentations due to its involvement in surgery, symptomatic clinical presentations, and as an anatomical landmark.
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Salgado G, Cantin O, Moños M, Saez J, Macuer M. Bilateral reversed palmaris longus muscle: A rare anatomical variation. Folio Morphol. 2012;71(1):52-5. PMid:22532187
Aversi-Ferreira R, Bretas VR, Maior RS, Davaasuren M, Paraguassuú-Chaves, Nishijo H et al. Morphometric and statistical analysis of the palmaris longus muscle in human and non-human primates. BioMed Res Int. 2014;2014:6. https://doi.org/10.1155/2014/178906
Pai MM, Prabhu LV, Nayak SR, Madhyastha S, Vadgaonkar R, Krishnamurthy A, et al. The palmaris longus muscle: Its anatomic variations and functional morphology. Rom J Morphol Embryol. 2008;49(2):215-7. PMid:18516329
Olewnik L, Waśneiewska A, Polguj M, Podgórski M, Labętowicz P, Ruzik K, et al. Morphological variability of the palmaris longus muscle in human fetuses. Surg Radiol Anat. 2018;40(11):1283-91. https://doi.org/10.1007/s00276-018-2069-2 PMid:30022223
Bashyam A, Harper C, Iorio M. Reversed palmaris longus muscle causing volar forearm pain and ulnar nerve paresthesia. J Hand Surg Am. 2017;42(2):298. https://doi.org/10.1016/j.jhsa.2016.11.016
Reimann AF, Daseler EH, Anson BJ, Beaton LE. The palmaris longus muscle and tendon. A study of 1600 ex-tremities. Anat Rec. 1994;89(4):495-505. https://doi.org/10.1002/ar.1090890408
Ioannisa D, Anastasiosb K, Konstantinosc N, Lazarosa K, Goergiosa N. Palmaris longus muscle’s prevalence in different nations and interesting anatomical variations: Review of the literature. J Clin Med Res. 2015;7(11):825-30. https://doi.org/10.14740/jocmr2243w PMid:26491493
Thompson NW, Mockford BJ, Cran GW. Absence of the palmaris longus muscle: A population study. Ulster Med J. 2001;70(1):22-4. PMid:11428320
Natsis K, Levva S, Totlis T, Anastasopoulous N, Paraskevas G. Three headed reversed palmaris longus muscle and its clinical significance. Ann Anat. 2007;189(1):97-101. https://doi.org/10.1016/j.aanat.2006.07.008 PMid:17319615
Keese GR, Wongworawat MD, Frykman G. The clinical significance of the palmaris longus tendon in the pathophysiology of carpal tunnel syndrome. J Hand Surg Br. 2006;31(6):657-60. https://doi.org/10.1016/j.jhsb.2006.07.015 PMid:16979803
Naveen K, Jyothsna P, Ravindra S, Surekha S, Abhinitha P, Mohandas R, et al. Presence of multiple tendinous insertions of palmaris longus: A unique variation of a retrogressive muscle. Ethiop J Health Sci. 2014;24(2):175-8. https://doi.org/10.4314/ejhs.v24i2.11 PMid:24795520
Longhurst G, Stone D, Mahony N. Bilateral reversed palmaris longus muscle: A case report and systematic literature review. Surg Radiol Anat. 2020;42(3):289-95. https://doi.org/10.1007/s00276-019-02363-z PMid:31720753
Christos L, Konstantinos N, Evagelos P. Revision of carpal tunnel release due to palmaris longus profundus. Case Rep Orthop. 2015;2015:616051. https://doi.org/10.1155/2015/616051 PMid:26075127
Getzmann J, Schweizer A. Surgical resection of a reversed palmaris longus muscle causing chronic exertional compartment syndrome in a competitive swimmer: A case report. Orthop J Sports Med. 2018;6(5):2325967118769615. https://doi.org/10.1177/2325967118769615 PMid:29881730
Twoon M, Jones CD, Foley J, Davidson D. Reversed palmaris longus muscle: A report of two cases. Case Reports Plast Surg Hand Surg. 2017;40(1):73-6. https://doi.org/10.1080/23320885.2017.1353424 PMid:28804743
Georgiev GP, Iliev AA, Dimitrova IN, Kotov GN, Malinova LG, Landzhov BV. Palmaris longus muscle variations: Clinical significance and proposal of new classifications. Folia Med. 2017;59(3):289-97. https://doi.org/10.1515/folmed-2017-0035 PMid:28976893
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Copyright (c) 2020 Adegbenro Omotuyi John Fakoya, Jordan D'Souza, Andrea Mary Thomas Kallumadyil, Tess McClenahan, Allyson Talaroc, Ananya Vungarala, Abayomi Gbolahan Afolabi, Thomas McCracken, David Otohinoyi (Author)
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