The dual tendon palmaris longus variant causing dynamic median nerve compression in the forearm

Markeson, Daniel; Basu, Indraneil; Kulkarni, M.

doi:10.1016/j.bjps.2012.03.023

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…This variation included 3 main configurations -a distal muscle belly, a central muscle belly and digastrics like configuration with a central tendon connecting the two [8]. Mackerson describes a case with the central belly variant causing the median nerve compression but the muscle had a dual tendon [9]. Like other skeletal muscles, atypical PL has the potential for hypertrophy as a result of repetitive exercise, leading to an effort-related compartment syndrome [10].…”

Section: Resultsmentioning

confidence: 99%

Unusual Co-existence of Biaponeurotic Palmaris Longus and Accessory Abductor Digiti Minimi in man

H.L.¹

2014

JCDR

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The present study describes a rarely reported co-existence of variant muscles in the right upper limb of a male cadaver of 57 years of age, observed during routine anatomical dissection. There was a presence of the biaponeurotic palmaris longus with a central muscle belly in the anterior forearm region which was closely related to the median nerve. In addition to this, an accessory abductor digiti minimi muscle was also reported in the corresponding hypothenar region, traversing the Guyon's canal, passing superficial to the ulnar vessels and nerves. Biaponeurotic palmaris longus and accessory abductor digiti minimi are important structural causes of the entrapment neuropathies of forearm and wrist. Diagnosis of these muscles as a cause of entrapment neuropathies requires the sound knowledge of variant muscles in the forearm and wrist region.

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Section: Resultsmentioning

confidence: 99%

Unusual Co-existence of Biaponeurotic Palmaris Longus and Accessory Abductor Digiti Minimi in man

H.L.¹

2014

JCDR

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“…Current literature is scarce and based on single-athlete case reports. 2,4,7 –9 To our knowledge, this is the largest case series of dynamic compressive neuropathies described in the literature to date.…”

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confidence: 87%

Etiology, Diagnosis, and Treatment of Dynamic Nerve Compression Syndromes of the Elbow Among High-Level Pitchers: A Review of 7 Cases

Bergen

Lourie

2018

Orthopaedic Journal of Sports Medicine

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Background:Dynamic compressive neuropathies around the elbow are a rare entity described by a relatively small body of literature, mostly consisting of single-case reports. No standardized diagnostic protocols have been described to date. To the authors’ knowledge, this study represents the largest case series of dynamic compressive neuropathies in the upper extremity.Purpose:To identify various etiologies of dynamic compressive neuropathies around the elbow, devise a systematic diagnostic protocol, and review treatment options.Study Design:Case series; Level of evidence, 4.Methods:A retrospective review was conducted of patients who presented to a single practice between 2013 and 2017 and were diagnosed with a dynamic compressive neuropathy around the elbow.Results:A total of 7 patients were identified, with a mean follow-up of 2 years. All patients were high-level pitchers. One patient was a minor league pitcher; 4 patients were National Collegiate Athletic Association athletes; and 2 patients were high school athletes. All patients underwent a systematic diagnostic workup. The diagnosis was established with dynamic nerve conduction testing. Three etiologies for dynamic nerve compression around the elbow were identified: 1 case of lateral antebrachial cutaneous nerve compression by the biceps tendon, 3 cases of ulnar nerve compression by an anconeus epitrochlearis muscle, and 3 cases of posterior interosseous nerve compression at the arcade of Frohse with hypertrophic extensor carpi radialis brevis and extensor digitorum communis muscles. Two patients were treated conservatively, while 5 patients required surgery. All patients were able to return to pitching.Conclusion:Dynamic compressive neuropathies around the elbow are rare entities that present unique diagnostic challenges to the treating clinician. In this cohort, all patients were young throwing athletes. Physical examination of the patient frequently lacks typical findings of chronic nerve entrapment syndromes. Dynamic nerve conduction studies establish the diagnosis, and treatment often requires surgical decompression to achieve complete resolution of symptoms.

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“…Several authors have associated the distal muscle belly variation with nerve entrapment phenomenon at the wrist. 2 Entrapment is thought to occur due to direct compression but occasionally immediately proximal to the carpal tunnel or muscle lie in a position whereby muscular contraction would lead to compression of the median nerve.…”

Section: Descriptionmentioning

confidence: 99%

Median nerve entrapment due to accessory palmaris longus muscle: MRI and sonography findings

2018

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The dual tendon palmaris longus variant causing dynamic median nerve compression in the forearm

Cited by 7 publications

References 8 publications

Unusual Co-existence of Biaponeurotic Palmaris Longus and Accessory Abductor Digiti Minimi in man

Unusual Co-existence of Biaponeurotic Palmaris Longus and Accessory Abductor Digiti Minimi in man

Etiology, Diagnosis, and Treatment of Dynamic Nerve Compression Syndromes of the Elbow Among High-Level Pitchers: A Review of 7 Cases

Median nerve entrapment due to accessory palmaris longus muscle: MRI and sonography findings

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