Absence Of Palmaris Longus Research Articles

The possible relationship between the palmaris longus and joint hypermobility.

The palmaris longus (PL) contributes to the palmar fascia, wrist flexion, hand muscle balance, and pinch strength. Also, PL is used as a graft source. So, PL's presence is helpful for joint stability and grafting. On the other hand, joint hypermobility (JH) is associated with many complaints and disorders. Considering the adverse effects of JH and benefit-based evolution, the genesis rather than agenesis of PL can be expected in JH. Herein, it was hypothesized that PL might be together with JH, and individuals with PL may have higher scores of JH than those without. Between June 2023 and October 2023, 200 participants (F/M: 1/1) were included in the study. The Schaeffer's test and the Beighton scores were used to assess PL and JH, respectively. The participants were divided into two bilateral groups according to the presence or absence of PL. Then, the groups were compared for demographics and Beighton scores. Subgroup analyses were also done by considering gender. No significant differences were found between PL (+) and PL (-) groups considering females+males in age (p=0.559), gender (p=0.517), weight (p=0.375), height (p=0.061), work status (p=0.229), Beighton score (p=0.893), and JH (p=1.0). No significant differences were found between PL (+) and PL (-) groups considering females only in age (p=0.871), weight (p=0.189), height (p=0.127), work status (p=0.200), Beighton score (p=0.727), and JH (p=1.0). No significant differences were found between PL (+) and PL (-) groups considering males only in age (p=0.370), weight (p=0.981), height (p=0.400), BMI (p=0.601), work status (p=0.145), Beighton score (p=0.757), and JH (p=1.0). According to the results of this study, no relationship was found between PL and JH. However, this is the first study on the topic and has some limitations.

Somali Popülasyonunda Palmaris Longus Tendonunun Varlığı ve Yokluğunun Klinik Tespiti

Aim: The aim of this study was to investigate whether the frequency of palmaris longus (PL) absence in Somali population differed from other populations in Africa and the rest of the world and to evaluate its association with sex and side of the limb involved. Methods: Totally 1,000 participants (713 males and 287 females; age range: 7 to 80 years) were tested for the absence of PL tendon using Schaffer’s test. In those with a negative Schaffer's test result, Thompson's test, Mishra's test I, Mishra's test II, and Pushpakumar's "two-finger sign" method were used to confirm its absence. Results: Absence of PL tendon was found in 95 (9.5%) participants. The PL muscle was absent bilaterally in 42 (4.4%) and unilaterally in 53 (5.5%) participants. Unilateral absence of PL was higher in the right hand (3.0%) (p>0.05). Agenesis of the right side in males was significantly correlated with the left side in males (rs=0.556, p<0.01). Right agenesis in females was significantly correlated with its left side (rs=0.625, p<0.01). The incidence of right and left agenesis in females was more strongly correlated than that in males. Age was significantly correlated with left agenesis (rs=0.154, p<0.01) and right agenesis (rs=0.145, p<0.05) in females. Conclusion: The prevalence of PL agenesis in the Somali population is lower than the reported incidence of 15%, but more significantly higher than some of the other African populations. These findings may be helpful, particularly for the surgeons in the region, for orthopedic and reconstructive surgeries using PL grafting.

Clinical assessment of absence of palmaris longus muscle and its association with ethnicity.

To compare two clinical tests used for assessment of absence of palmaris longus, and to determine the prevalence of the absence of palmaris longus among ethnic groups in a cosmopolitan setting. The cross-sectional descriptive study was conducted at the Bahria University Health Sciences, Karachi, from April 2021 to May 2022, during which forearms belonging to Sindhi, Punjabi and Urdu-speaking ethnic groups were tested. Assessment of presence or absence of palmaris longus was performed using Schaeffer's and Thompson's tests. Agenesis and association of ethnicity and agenesis were compared. Data was analysed using SPSS 23. Of the 250 subjects, 152(60.8%) were females and 98(39.2%) were males. The overall mean age was 20.4±2.23 years (range: 18-23 years). In terms of ethnicity, 100(40%) subjects each were Punjabis and Urdu-speaking, while 50(20%) were Sindhis. The total forearms assessed were 500. The overall agenesis was 186(37.2%). When the two assessment tests were compared, highly significant differences were noted (p<0.000). Overall agenesis was highest among Sindhis 40%, followed by 38% in Punjabis, and 35% in Urdu-speaking. Significant differences were observed when one-sided palmaris longus absence was compared with two-sided absence (p<0.037). Schaeffer's test had more accuracy compared to the Thompson's test in the determination of palmaris longus agenesis. There were variations in terms of agenesis among the ethnic groups.

Frequency of the Palmaris Longus muscle in the Population of Islamabad, Pakistan

Abstract&#x0D; Background: The Palmaris Longus is a variable muscle with differing frequencies of presence in different ethnicities, populations and regions. Our study is a cross-sectional study measuring the frequency of the muscle in our sample size in Islamabad. Our aim is to determine the frequency of the palmaris longus muscle in the population of Islamabad, Pakistan. Absence of the palmaris longus does not result in any functional disability. Our objective is to improve our knowledge and spread awareness of the variability of the palmaris longus muscle and its use as a graft tissue at other sites of injury. &#x0D; Methodology: The presence of the palmaris longus was determined using 4 tests involving various hand movements. Observation of the tendon of the palmaris longus at the wrist confirmed its presence. A sample of 389 participants from the residents of Islamabad was picked randomly. This study was conducted in 2019 at Shifa College of Medicine (Shifa Tameer e Millat University). &#x0D; Results: Absence of palmaris longus in males and females was 4.7% and 6% respectively. Bilateral absence was seen only in 1% of the study population. Unilateral absence in the right and left hands were seen to be 1.3% and 3.3% respectively. In ambidextrous persons, palmaris longus was present in both hands. In right and left-handed persons, 4.80% and 19.2% of the study population exhibited palmaris longus absence, correspondingly.&#x0D; Conclusion: Overall, the palmaris longus was absent in 5.7% of the entire sample. Further studies can be conducted to establish a relationship between the presence of the palmaris longus muscle and different determinants such as ethnicity and hand dominance etc

Prevalence of Absence of Palmaris Longus in Students of a Medical College in Nepal

Prevalence of Absence of Palmaris Longus in Students of a Medical College in Nepal

The palmaris longus muscle: A surface study of the population of North Cyprus

Objective: The aim of this research is to determine the frequency of surface anatomical variations of palmaris longus (PL) muscle inthe population of North Cyprus and their association with gender, body side, and hand dominance.Materials and Methods: The presence of PL was determined in 1280 subjects (660 females and 620 males) using four testing methods;Schaeffer’s test, the Thompson’s test, Pushpakumar’s test and the Bhattacharya’s test. Where the presence of the PL could not bedetermined by any of these tests, palpation was performed as the final confirmatory test.Results: The overall frequency of absence was 17.4%. Female subjects showed a higher frequency of absence of 10.6% compared tomales (6.8%). The absence was more likely to occur in the non-dominant hand. In those that had the PL, there were 28 (2.6%) casesof a split tendon and 3 cases (0.2%) of a laterally displaced tendon of the PL.Conclusion: The overall frequency of absence of PL in North Cyprus was 17.4% and absence is more likely to occur in females, on theleft side and in the non-dominant hand. Other variations recorded are the split tendons and laterally displaced tendons.

Absent palmaris longus with hypoplastic flexor digitorum superficialis of the little finger: A rare case report

Anatomy of the tendons of the hand is of high clinical importance for plastic and reconstructive surgeons operating on hand and dealing with tendon injuries and hand reconstruction surgery. Among the variations in tendon Anatomy, variants of Flexor Digitorum Superficialis (FDS) and Palmaris longus (PL) are common. Here, we report an 18-year-old male patient, presenting to the emergency department with an alleged history of accidental glass cut injury over the volar aspect of the right wrist. On intraoperative exploration, his FDS of the little finger was hypoplastic and PL was found absent. Clinically, the absence of PL and Hypoplastic FDS to little finger can lead to problems in hand reconstructive surgeries. To the best of our knowledge, this case is the first of its kind where absent PL is associated with hypoplastic and thin FDS of the little finger.

English

BACKGROUND Palmaris longus (PL) tendon agenesis varies from 5 % to 30 % in different ethnic groups worldwide. Its agenesis is associated with decreased wrist grip, pinch grip, presence of cheek dimples, difference of prevalence of agenesis with gender and handedness and with flexor carpi superficialis tendon. Student and general population surveys done in previous studies shows the association between these variables. The purpose of this study was to find out the association between the presence of cheek dimples with absence of palmaris long tendon. METHODS We examined 1200 medical and allied health students (600 males, 600 females) aged 18 - 24 years to assess the incidence of palmaris longus absence and the presence of cheek and chin dimples. The presence or absence of palmaris longus was assessed by clinical inspection using standard tests. The effectiveness of these’ standard tests’ is also tested along with wrist strength and pinch strength. RESULTS 163 students had PL agenesis. One hundred and twenty-one subjects had unilateral absence of palmaris longus (13.5 %). The tendon was absent bilaterally in 42 subjects (3.5) 77 students had either unilateral or bilateral cheek dimples out of 163 PL agenesis. The Mishra’s test is found to be most effective for properly defining the PL at wrist. CONCLUSIONS Prevalence of absence of palmaris longus is around 13.5 %. Unilateral agenesis of PL is 10 %. Absence of palmaris longus has strong association to presence of cheek dimples. Up to 45 % of PL agenesis will show either unilateral or bilateral cheek dimples. Studies on cheek dimples, panniculus carnosus are very scanty in literature; more studies might reveal interesting correlation. The grip strength of the wrist is unaffected due to palmaris longus agenesis; however, the pinch grip of 4th finger with thumb appears to be certainly decreased. Mishra’s test proves to be the best in demonstrating the PL. A radiant smile displaying the cheek dimples, has 50 % possibility of absence of PL. KEYWORDS Palmaris Longus Agenesis, Cheek Dimples, Bifid Zygomaticus Major, Panniculus Carnosus, Chin Dimples

An assessment of the effects of variations in the Palmaris longus tendon and the fifth superficial flexor digitorum on pinch and grip strength.

The effect of the absence or presence of the Palmaris longus tendon on pinch and grip strength was investigated in this study. Similarly, the effect of the presence or absence of the fifth superficial flexor digitorum on grip strength in the hand was studied. The aim of the present study was to assess the combined effect of these anatomical variations on pinch and grip strength. In this cross-sectional study, 523 volunteers and their 1046 hands were enrolled. Each hand was assessed for the presence or absence of the Palmaris longus tendon and for variations in the fifth superficial flexor digitorum function. Then the grip and pinch power of the hands were measured with the Jammar Dynamometer. The presence or absence of Palmaris longus had no effect on grip strength in the individuals studied. Likewise, variations in fifth superficial flexor digitorum function had no effect on grip and pinch strengths. But the results of statistical testing showed the effect of the presence of Palmaris longus on pinch strength (25.38 lbs in hands with Palmaris present vs 24.43 lbs in hands without Palmaris). Pinch and grip power was higher in men than in women and in the right hand than in the left. Based on the findings of the present study, it seems that absence of the Palmaris longus tendon is associated with a reduction in pinch strength but has no effect on grip strength, and the variations in the fifth superficial flexor digitorum (flexor digitorum superficialis, or FDS) have no effect on pinch and grip strengths.

Palmaris Longus Tendon Absence in Pre-Clinical Medical Students of Universiti Malaysia Sabah

Palmaris longus (PL) tendon is regularly used in reconstructive surgeries as a donor tendon because it is observed as an accessory muscle and has little practical use to the human hands. It is only found in mammals. For example, the orangutan has PL but it is absent variable in the higher class of apes such as gorillas and chimpanzees. The absence of PL in humans appears to be hereditary, but the genetic transmission is unclear. The main objective of this study is to determine the prevalence of PL tendon absence in pre-clinical medical students of UMS and to compare the lack between gender and ethnic groups. By using standard Schaffer’s test, we examined the presence or absence of PL tendon among the first and second-year medical students of UMS. Four additional tests, Thompson’s test, Mishra’s test I, and II, Pushpakumar’s tests were used to determine whether PL present or not. A total of 134 volunteers were examined, and 91.8% were right-handed, and 8.2% were left-handed. The overall absence (bilateral and unilateral) of PL tendon was 23.9%, whereas unilateral absent was 17.9%, and bilateral absent was 6.0%. The high prevalence of absence of PL tendon among females 25.5% compared to males 20.0%. Chinese and Indian have a higher incidence of PL tendon absence followed by Kadazandusun and Malay. In this study, there were different figures for each ethnic group. The prevalence of absence of PL varies depending on the populations.

Prevalence of Absence of Palmaris Longus Tendon in Nepalese Population

INTRODUCTION: The palmaris longus (PL) is a tendinous superficial flexor of forearm. It basically, anchor skin and fascia of hand resist the horizontal shear force in distal direction. It also helps in tightening of palmar aponeurosis. Along with other flexor muscle it also helps in flexion of wrist joint. The incidence of absence of palmaris longus is in great variation from 1.5 to 63.9%. Its variation of absence has attracted many researchers globally. The aim of the present study is to know occurrence of absence of PL in Nepalese population.&#x0D; MATERIAL AND METHODS: This is a cross sectional descriptive observational study conducted among 270 medical students (MBBS, BDS) at Universal College of Medical Science, Bhairawaha in year the 2018-2019. Ethical approval for study was taken from institutional review committee (IRC). Four tests-Schaeffer's Test, Thompson's Fist, Mishra's Test and Puspa Kumar's two finger sign were used to see the absence/presence of Palmaris longus. A semi-structured proforma was used to collect the data.&#x0D; RESULTS: Out of 270 students, there were 145 (53.7%) females and 125 (46.3%) males. Age of the subject range from 19-23 years with a mean age of 19.91 years. The overall absence of palmaris longus was seen in 40 students (14.8%) which included 18 males (14.4%) and 22 females (15.2%). Bilateral absence of palmaris longus was seen in 10 students (3.7%) whereas unilateral absence of palmaris longus was seen 14 males (11.2%) and 16 females (11.03%).&#x0D; CONCLUSION: This present study concluded that overall absence of palmaris longus was seen in 14.8% subjects. Gender wise distribution showed that 14.4% males and 15.2% had the absence of palmaris longus. Thus, sound knowledge about this variation is important in planning graft surgeries.

Musculus Palmaris Longus: Influence on Playing Capability of Keyboard Musicians - Preliminary Report.

Musculus Palmaris Longus (PL) is one of the most variable anatomical structures in the human body. Despite being biomechanically active, it is vastly considered to have no impact on the functionality of the upper extremity in the general population. The aim of this study is to examine the relation between playing capability of young musicians and morphology of Musculus PL and to compare it with the relation between manual capability of non-musicians and morphology of their Musculus PL. 42 forearms of 21 healthy individuals (11 musicians and 10 non-musicians) were subjected to Shaeffer’s test and ultrasound imaging and tested by dynamometer for hand grip strength and the first and fifth finger opposition before and after exertion. No difference in morphology pattern was observed between the groups. In the musicians, a substantial loss of a hand grip strength of the left hand compared to the right hand after exertion, regardless of lateralization, was observed. A disproportion in exhaustion of the musician’s hands with unilateral absence of PL was observed – the difference in grip strength between the dominant and non-dominant hand before and after exertion increased over eight times more than in the musicians with bilateral presence. There is no difference in PL morphology between either the musicians or non-musicians. Regardless of lateralization, the musician’s left hand in musicians seems weaker and therefore more prone to misuse related injuries. PL may play a role in musicians in balancing muscular exhaustion.

The Frequency of Palmaris Longus Absence among Female Students in King Faisal University in Al-Ahsa, Saudi Arabia

Background: Palmaris longus (PL) is one of the forearm muscles that lie between the flexor carpi ulnaris and the flexor carpi radialis muscles. PL action is flexion of the hand at the wrist and making the palmar aponerurosis tense. Plastic surgeons utilize the Palmaris longus in restoration of lip and chin defects. Objectives: We sought to determine the frequency of the absence of the palmaris longus in Saudi Arabia among female students in King Faisal University, AL-Ahsa. Materials and Methods:Two hundred normal subjects were chosen randomly from King Faisal University female students. Subjects who had gone through a surgical procedure or have any deformities in the forearm were excluded. We have examined the presence or absence of palmaris longus using three tests. Subjects were asked to do standard test for the assessment of PL tendon. If PL cannot be detected by the standard test, two more tests were performed to confirm the absence. Results: The overall prevalence of absence both unilaterally and bilaterally is 40.5 %. Unilateral absence was 20.5%. The bilateral absence was 20%. The distribution on the right and left was 29% and 31.5% respectively. Conclusions: The present study found palmaris longus to be absent equally bilateral and unilateral in more than one third of the sample and significantly more common in the left side.

Does agenesis of Palmaris Longus tendon affect the hand grip strength?

Background: The agenesis of Palmaris longus (PL) tendon varies with each Ethnic group of the population across the world. Literature review suggests Asians have the least prevalence of absence of Palmaris longus tendon whereas Turkish and Africans have the highest incidence. Lots of studies have been done to report the incidence of agenesis of the PL, and its association with hand-dominance, gender, laterality and hand grip strength with varying results. There has been no study conducted in the Mysorean population. Methods: 248 consecutive adults attending the outpatient department of orthopedics in JSS were included in this study. Patients were included based on selection criteria. Three tests were done to confirm the absence of PL by two independent observers including one senior author. The hand grip was recorded based on the mean value of three readings in each hand using a dynamometer. The results were statistically analyzed. Results: Females had a higher incidence of agenesis of PL. Right-hand dominant individuals had a higher rate of agenesis of PL. Unilateral agenesis was more common than bilateral agenesis. Conclusion: Absence of PL does not affect the hand grip strength of the patient. The PL tendon is an extremely useful donor tendon and may be sacrificed during reconstructive surgeries.

Prevalence of Absence of Palmaris Longus and Its Association with Gender, Hand Dominance and Absence of FDS Tendon to Little Finger Among Malay Population.

Palmaris Longus is being widely used in reconstructive, plastic and cosmetic surgeries due to its long tendon. It is the most readily available source for tendon grafting. The objective of this study was to determine the prevalence of absence of Palmaris Longus and its association with gender, hand dominance and absence of FDS (flexor digitorum superficialis) tendon to little finger among Malay population. An analytical cross sectional study design was used and a self-administered proforma was distributed for data collection. 1239 Malay secondary school children in Putrajaya were tested for absence of Palmaris Longus using Schaffer's test. 4 additional tests namely Thompson's test, Mishra's test I, Mishra's test II and Pushpakumar's 'two-finger sign' method were used to confirm its absence in respondents with negative Schaffer's test. Function of Flexor Digitorum Superficialis tendon to little finger was determined by flexing PIP of little finger while hyperextend the other fingers. The prevalence of absence of Palmaris Longus was 11.7%. Left side absence of Palmaris Longus was much common. There was a significant association between absence of Palmaris Longus with gender in which female had higher prevalence of absence of Palmaris Longus than male. In conclusion, the prevalence of absence of Palmaris Longus in Malay population was lower than Indian but higher than Chinese population. Females had higher prevalence of absence of Palmaris Longus and no association can be found with hand dominance and absence of Flexor Digitorum Superficialis tendon to little finger.

Assessment of the Presence or Absence of Palmaris Longus and the Fifth Superficial Flexor Tendon in the Iranian Population : Are These Tendons Evolutionary ?

Assessment of the Presence or Absence of Palmaris Longus and the Fifth Superficial Flexor Tendon in the Iranian Population : Are These Tendons Evolutionary ?

Clinical Assessment of the Congenital Absence of Palmaris Longus and Flexor Digitorum Superficialis Muscles in Young Saudi Population.

Introduction. Congenital Palmaris Longus (PL) absence was found in 15%–20.25% of population globally. This condition and Flexor Digitorum Superficialis (FDS) tendon absence in little finger are not known in Saudi Arabia. We studied prevalence of PL and FDS agenesis in Saudi Arabian population. Methods. A random cross-sectional study was carried out after an ethical approval in the Riyadh universities. Schaeffer's test was used to examine PL absence. The Modified test was used to examine FDS absence. Data was analyzed using Microsoft Excel and the SPSS Software version 22. Results. The volunteers, 331, males 164 (49.5%) and females 167 (50.5%), mean age of 23 (SD ± 5.3), showed right hand dominance in 294 (88.8%) and bilateral absence of PL and FDS in 15.1% and 14.8%, respectively. The hand dominance showed no significant relation between PL and FDS absence, p value = 0.788, 0.835, respectively. Generally, we found a weak correlation between absence of the PL and FDS, p value ≥ 0.595. Conclusion. The bilateral absence of PL and FDS was found as 15.1% and 14.8%, respectively. Variation of the FDS tendon absence was an independent entity for the PL absence. The dominance of hands was not related to the tested variables found in PL and FDS agenesis.

Bilateral superficial brachioulnar artery in a cadaver along with bilateral absence of palmaris longus.

Bilateral superficial brachioulnar artery in a cadaver along with bilateral absence of palmaris longus.

The angular course of the median nerve in the distal forearm and its anatomical importance in preventing nerve injury in a modern era of carpal tunnel release.

OBJECTIVE A thorough understanding of anatomy is critical for successful carpal tunnel release. Several texts depict the median nerve (MN) as taking a course parallel to the long axis of the forearm (LAF). The authors report on their attempt to formally assess the course of the MN as it travels to the carpal tunnel in the distal wrist and discuss its potential clinical significance. METHODS The width of the wrist, the distance from the radial wrist to the MN, and the distance from the distal volar wrist crease to the point where the MN emerges between the flexor carpi radialis (FCR) tendon and the flexor digitorum superficialis (FDS) tendons were recorded during cadaveric dissection of 76 wrist specimens. The presence or absence of palmaris longus was documented. Finally, the angles between the MN and FCR tendon and between the MN and the LAF were measured using ImageJ. RESULTS The relative position of the MN at the distal wrist crease, as determined by the ratio of the distance from the MN to the radial wrist divided by wrist width, revealed a mean value of 0.48, indicating that the nerve was usually located just radial to midline. The mean distance between the distal wrist crease and the MN's emergence was 34.6 mm. The mean angle between the MN and the FCR tendon was 14.1°. The angle between the MN and the LAF had a mean value of 8.8° (range 0.0°-32.2°). The nerve was parallel to the LAF in only 10.7% of the studied wrists. Palmaris longus was absent in 14 (18.4%) of the 76 wrists. CONCLUSIONS The MN takes an angular approach to the carpal tunnel in the distal wrist in the vast majority of cases. This newly described finding will be useful to both clinicians and anatomists.

THE PREVALENCE OF AGENESIS OF PALMARIS LONGUS MUSCLE IN STUDENTS OF NISHTAR MEDICAL UNIVERSITY, MULTAN

Background: Palmaris longus muscle belongs to the superficial group of muscles of forearm. This group normally have five muscles. It is the weak flexor of wrist joint and also anchor the skin and fascia of the hand. It is among the very useful muscles which are used for plastic and reconstructive surgery. The agenesis of Palmaris longus is variable in different population and countries. Objective: To determine the prevalence of agenesis of Palmaris longus muscle in students of Nishtar Medical University, Multan.&#x0D; Materials and Methods: The study was carried out on 567 randomly selected normal students of 1st year and 2nd year MBBS classes. There were 236 male students and 331 female students. The age was ranging from 17 years to 25 years. The anterior aspect of forearm and wrist was inspected and different tests were applied to find out the presence or absence of Palmaris longus muscle. Result: The bilateral agenesis of palmaris longus was 5.64%. The unilateral absence of palmaris longus was 7.23%. The right and left arm agenesis of palmaris longus was 4.05% and 3.17% respectively. The bilaterally agenesis in males and females is 6.35% and 5.13% respectively. Right arm and left arm agenesis in males is 4.66% on both sides while in females is 3.62% and 2.11% respectively.&#x0D; Conclusion: The prevalence of agenesis of palmaris longus in our study group was 12.87%. It is similar as mentioned in Standard Anatomy Text Books. There was no significant dominance in any arm side (P&gt;0.05%) but when compared in gender it was significantly higher in males (P&lt;0.05%).