Bilateral reversed palmaris longus muscle with trifid insertion, a rare variation

Gune, Anita R.; Pote, Anand J.; Patil, Ashalata D.; Patil, Prashant; Nikam, Vasudha R.

doi:10.5455/2320-6012.ijrms20140570

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…Conversely, the remaining RPL attached to their distal insertion points via the distal muscular bellies directly [23]. Another case reported on a trifid insertion, which was laterally continuous with the fascia of the thenar muscles, centrally continuous with the palmar aponeurosis, and medially continuous with the fascia covering abductor digiti minimi [21]. The reported cases of RPL also showed differences in their relationship with the median nerve in the wrist.…”

Section: Discussionmentioning

confidence: 97%

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Bilateral reversed palmaris longus muscle: a case report and systematic literature review

2019

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Purpose We present a case of a bilateral reversed palmaris longus muscle and a systematic review of the literature on this anatomical variation. Methods Routine dissection of a 90-year-old male cadaver revealed a rare bilateral reversed palmaris longus. This was documented photographically, and length and relation to anatomical landmarks were recorded. This finding stimulated a systematic review of the literature on the reversed palmaris longus variation, from which measurements were collated and statistical analysis performed to determine the prevalence, average length, relationship to side and sex, and to discuss its clinical and evolutionary implications. Results The average length of the muscle belly and tendon of reversed palmaris longus was 135 mm and 126 mm, respectively. Statistical analysis revealed no disparity in presentation due to sex and side; however, bilateral reversed palmaris longus has only been reported in males. A high proportion (70.8%) of reversed palmaris longus were discovered in the right upper limb compared to the left. Conclusion Variations in palmaris longus are purported to be as a result of phylogenetic regression. Clinically, patients with this variant may present with pain or swelling of the distal forearm, often as a result of intense physical exertion related to occupation or sport. Clinicians should be aware of this muscle variant as its presence could lead to confusion during tendon allograft harvesting procedures in reconstructive and tendon grafting surgery.

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Section: Discussionmentioning

confidence: 97%

“…Resection of the muscle belly relieved the symptoms immediately [19]. Three cases of bilateral RPL were reported in male donors from Chile [39], Brazil [23] and India [21]. All reports of RPL originated from the medial epicondyle of the humerus; however, the distal insertion points varied.…”

Section: Discussionmentioning

confidence: 99%

Bilateral reversed palmaris longus muscle: a case report and systematic literature review

2019

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“…The knowledge of the variability of Palmaris longus is essential for surgeons, clinicians, orthopedic surgeons, anatomists, researchers and interventional radiologists 12 . Gune AR et al, 13 found a case with bilateral reversed palmaris longus muscle with insertion on three different sites, first in fascia covering the thenar muscles, second into palmar aponeurosis and third with abductor digiti minimi. Reversed palmaris longus can compress the median nerve or ulnar nerve and may cause compartment syndrome leading to swelling and pain in the wrist.…”

Section: Methodsmentioning

confidence: 99%

“…Reversed palmaris longus can compress the median nerve or ulnar nerve and may cause compartment syndrome leading to swelling and pain in the wrist. Using this knowledge, a surgeon can use it as a graft while doing procedures on the wrist region and hands 13 . Lalit M et al, 14 while teaching undergraduate students, noticed the right forearm of a 54 years old male cadaver having a reversed palmaris longus with the tendinous origin and muscular belly with two slips near insertion.…”

Section: Methodsmentioning

confidence: 99%

An Indigenous Study on The Palmaris Longus Muscle Anatomical Variations

Alvia Batool,

Faizia Batool,

Afifa Waseem

et al. 2023

Proceedings S.Z.M.C

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Introduction: The Palmaris longus muscle is one of the superficial flexor muscles of the forearm that flexes the hand on the wrist and makes the palmar aponeurosis tense for gripping. It is variable both in number and form like inverted, doubled, split, three-headed or absent palmaris longus. These variabilities may cause clinical features due to abnormal pressure on the median and ulnar nerves. Its tendon can be used as a graft in various transplant surgeries. Aims & Objectives: This study was conducted to observethe number of cadavers showing anatomical variations of palmaris longus muscle in the Pakistani population. Place and Duration of Study: This study was conducted in the Anatomy Department of FMHCM&D, Lahore. The duration of the study was January 2019 - January 2022. Material & Methods: Cadaveric dissected upper limb specimens with normal palmaris longus were listed in Group: A, upper limbs having reversed palmaris longus were listed in Group: B, while upper limbs with absent palmaris longus were listed in Group: C. The RPL (reversed palmaris longus) muscle is the structure that is tendinous proximally and muscular distally (opposite of normal palmaris longus).Results were tabulated and percentages calculated. Results: It was observed that out of 80 dissected cadaveric upper limbs,77 (96.25%) showed normal palmaris longus while a right cadaveric upper limb (1.25%) showed anomalous palmaris longus with the reversed tendon. Palmaris longus muscle was found absent in two cadaveric left upper limbs (2.5%). Conclusion: Our study highlighted the percentage of different anatomical variations of the Palmaris longus muscle in terms of its presence with reversed tendons as well as its absence in a few human cadaveric upper limbs. This information may help anatomists, radiologists, physiotherapists and plastic surgeons.

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Bilateral reversed palmaris longus muscle with trifid insertion, a rare variation

Cited by 2 publications

References 8 publications

Bilateral reversed palmaris longus muscle: a case report and systematic literature review

Bilateral reversed palmaris longus muscle: a case report and systematic literature review

An Indigenous Study on The Palmaris Longus Muscle Anatomical Variations

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