A case of an accessory palmaris longus muscle and a duplicate palmaris longus muscle with special reference to their nerve supply--morphologic significance of a common innervation trunk.

Abstract

During a dissection of the forearm and hand, a duplicate palmaris longus muscle with an accessory palmaris longus muscle was observed on the right side of a 73-year-old Japanese male cadaver. Duplications of the palmaris longus muscle have been reported by many authors. Humphry (1872) suggested the presence of radial, intermediate, and ulnar sectors in the superficial layers of the forearm flexor muscular angulus, based on a comparison of fore- and hind limbs and comparative anatomical theory. The palmaris longus muscle usually differentiates from the intermediate sector but differentiation from the other two sectors may also be possible. Some authors have asserted that a common innervation trunk is critical for determining an ontogenetic relation between the muscles (Fuchino, 1960; Honma, 1980; Yamada, 1986). We examined the nerve supply in addition to scrutinize these anomalous palmaris longus muscles. In our case, the ramification of the innervating nerves was specific. The branches to the second palmaris longus muscle and the flexor carpi radialis arose as a common trunk from the median nerve. The branches to the first palmaris longus muscle and the accessory palmaris longus muscle originated as another common trunk from the median nerve. From these observations, we speculated that the second palmaris longus muscle has differentiated from the flexor carpi radialis, while the accessory palmaris longus muscle has differentiated from the first palmaris longus muscle, based on Humphry's suggestion.