Palmaris Longus Tendon Research Articles

018. Supraclavicular Flap and Reconstruction With Radial Forearm Flap In Basal Cell Carcinoma Of The Buccal Region: A Rare Case Report

Background: Basal cell carcinoma (BCC) progression can invade surrounding tissues, causing local destruction and disfigurement. About 85-90% cases of BCC occur on the head, greatly affecting facial appearance of patients. Functional or cosmetic concerns require skin flap or graft. Case: A patient presented with a wound on his left cheek for 8 years, bleeds easily and painful. There is a muscle-based ulcer, penetrating the oral cavity and a post-biopsy wound is covered with granulation tissue. Laboratory examination showed moderate anemia and chest x-ray did not show any metastases. A supraclavicular flap and intraoral and supraclavicular insertion and intraoral and supraclavicular insertion were performed. In addition, harvesting of the radial forearm flap and partial palmaris longus tendon was conducted. Conclusion: Reconstruction of facial defects in different facial esthetic units is essential following excision of BCC. But it is necessary to plan the stages of reconstruction when more than one facial region is involved. Surgeon skills, patient’s preference, defect size and location are important determinants of esthetic outcomes

Two-Stage Flexor Tendon Reconstruction for Finger Contracture Secondary to Phlegmon: A Case Report

Flexor tendon reconstruction is a complex surgical procedure that requires great precision and specialized expertise. It remains a preferred treatment for patients with neglected lacerations of the digital flexor tendon and after the failure of flexor tendon repair. Improvements in tendon repair methods and follow-up techniques have enhanced outcomes after flexor tendon grafting. Case Presentation: A 14-year-old girl with a history of a phlegmon of the 4th finger of the right hand, treated with antibiotics and drainage. The evolution is marked after 2 years by the progressive development of a flexion contracture of the proximal interphalangeal (PIP) joint. On examination, there is a flexion attitude and an inability to extend the PIP joint without vascular or nervous disorders. A two-stage reconstruction was performed using the palmaris longus tendon as a graft. With a follow-up of 3 years, the girl has recovered complete flexion and has limited extension to 25° at the PIP joint. An arthrolysis was proposed, but the girl refused, and she is satisfied with the results.

Physiological and Functional Restoration of the Modiolus Using a Double Tendon Sling in Patients With Full-Thickness Oral Defects.

Reconstruction of the oral modiolus should be considered for facial defects involving the lip and cheek. We have performed free flap reconstruction using a novel technique that includes a vertical and a horizontal sling for full-thickness defects involving the oral commissure. We used a free radial forearm flap and the palmaris longus tendon to correct lip and cheek defects in 6 patients (3 men, 3 women; age, 55-84 years). The tendon was divided into 2 portions for use as the double sling. One sling was used to connect the upper and lower stumps of the orbicularis oris in the vertical direction and the other to connect the vertical sling and masseter muscle. The outcomes assessed were esthetic appearance and functional results. The facial defects ranged in size from 3.0 cm × 4.0 cm to 7.0 cm × 6.0 cm and the mucosal defects from 1.5 cm × 4.0 cm to 6.5 cm × 5.0 cm. The length of the harvested tendon ranged from 11.5 to 13.5 cm. All flaps survived without complications. Good esthetic outcomes were achieved (excellent facial appearance, n = 1; no lip deviation or drooping, n = 5). Functionally, all patients had acceptable mouth opening and were able to eat a regular diet. Good physiological and functional results can be achieved using a double tendon sling for reconstruction of the modiolus in patients with full-thickness defects involving the oral commissure.

An unreported variant of palmaris longus muscle.

Palmaris longus is a highly variable muscle of the forearm. Knowledge of its variability is of importance to plastic surgeons, hand surgeons and radiologists. During our routine dissection classes for undergraduate medical students, a peculiar palmaris longus muscle was noted in the left upper limb of an adult male cadaver. The muscle had a fleshy belly in the middle and two tendons: a proximal and distal. The distal tendon of palmaris longus gave origin to a variant fleshy slip of muscle which was inserted partly to the pisiform bone and partly merged with the hypothenar muscles. The ulnar nerve and artery passed deep to this variant fleshy slip. The ulnar artery was tortuous both proximal and distal to this slip. The distal loop of the ulnar artery was very superficial and was in the median position. Both the palmaris longus and the variant fleshy slip were innervated by median nerve.

The Figure-of-Eight Ligament Reconstruction in Thumb Carpometacarpal Instability: Surgical Technique and Clinical Outcomes

This study reviewed the results of the figure-of-eight ligament reconstruction, a technique used in the surgical management of thumb carpometacarpal (CMC) instability. This technique establishes joint stability through forces originating within the CMC joint, providing volar and dorsal support. We evaluated the outcomes of 15 patients with nontraumatic, nonarthritic thumb CMC instability treated with the figure-of-eight ligament reconstruction technique. This technique involves routing a graft of the palmaris longus tendon through the base of the first metacarpal and trapezium bone in a figure-of-eight fashion. Preoperative visual analog scale (0-100) for pain and Michigan Hand Outcomes Questionnaire total scores were compared with 3- and 12-month postoperative scores. Secondary outcomes included strength, range of motion, patient satisfaction, return to work, and complications. A significant improvement between intake and 12 months after surgery was observed for both Michigan Hand Outcomes Questionnaire total scores (53, SD 3 vs 70, SD 4) and visual analog scale pain scores (63, SD 4 vs 36, SD 7). Additionally, after surgery, restored thumb CMC joint stability was reported for all patients. Strength and range of motion improved between intake and 12 months after surgery. The median return to work was 6 weeks. Nine (60%) patients rated their satisfaction as "excellent" or "good," and 11 (73%) patients said that they would undergo the surgery again. The figure-of-eight ligament reconstruction significantly improves pain and function in patients with thumb CMC instability while restoring joint stability and preserving range of motion, making it a suitable technique. Therapeutic IV.

Ulnar Collateral Ligament Reconstruction Utilizing a 3-Strand Palmaris Tendon Autograft With a Hybrid Linear Construct

The integrity of the medial ulnar collateral ligament (UCL) of the elbow is vital for the throwing athlete. Although newer techniques exist, reconstruction remains the gold standard for full-thickness UCL tears. An increase in throwing velocity, inadequate recovery, and early sports specialization have contributed to increased rates of UCL injury. As increasing numbers of athletes undergo UCL reconstruction, we continue to search for the optimal technique to return athletes to the same level of competition. We present a UCL reconstruction utilizing a 3-stranded palmaris longus tendon autograft with an inlay linear construct.

Enhancing Lower Eyelid Suspension Outcomes Through Pre-surgical Facial Nerve Reanimation: A Comparative Study.

Lower eyelid suspension, a common therapeutic procedure for facial paralysis-induced eyelid retraction, faces challenges due to high recurrence in patients lacking facial muscle function and impedes wider adoption. This research aims to explore the potential effects of restoring orbicularis oculi muscle tension through facial nerve reanimation prior to lower eyelid suspension and to define the indications for lower eyelid suspension. The study encompassed 32 individuals with complete facial paralysis, segmented into group A (reanimation group) and group B (non-reanimation group), based on whether the orbicularis oculi muscle's tension was restored through facial nerve reconstruction prior to lower eyelid suspension. Subjective assessments of eyelid closure (the inter-eyelid gap upon gentle closure) and objective methods measures of scleral show (the distance from the pupil's center to the lower eyelid margin, MRD2) were used to provide a comprehensive analysis of long-term effectiveness. The group A exhibited significantly greater long-term improvement in lagophthalmos and lower eyelid ectropion. The alterations in MRD2 measured 2.66 ± 0.27mm in the group A versus 2.08 ± 0.53 mm in the group B, denoting a statistically significant variance (p < 0.001). Moreover, while the ratio of MRD2 preoperative 6 months postoperative revealed no significant difference between groups, a significant difference emerged in 12 months postoperative (group A: 1.02 ± 0.21; group B: 1.18 ± 0.24; p < 0.05), with the values in group A closer to 1, indicative of enhanced symmetry. Restoring the tension in the orbicularis oculi muscle through facial nerve reconstruction prior to palmaris longus tendon sling could effectively sustain long-term outcomes of lower eyelid retraction correction and reduce the recurrence rate. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Impact of age and donor sites on bioactivities of tendon cells in autologous tenocyte implantation (OrthoATI™) for treatment of chronic tendinopathy

ObjectivesAutologous tenocyte implantation (OrthoATI™) therapy has demonstrated efficacy in treating patients with tendinopathy at various anatomical sites. This study evaluates the effect of patient age, gender, and tendon biopsy site on morphology, growth, and gene expression of autologous tendon cells used to treat chronic tendinopathy. MethodsPatients undergoing OrthoATI™ for tendinopathies between 2020 and 2022 were initially treated by biopsies taken from patella tendon (PT) or palmaris longus tendon (PL). The biopsies were sent to a Good Manufacturing Practice (GMP) cell laboratory where tendon cells were isolated, cultured, and expanded for four to six weeks. Cell morphology was assessed using phase contrast microscopy. Droplet digital PCR (ddPCR) was utilized for gene expression analysis. Dichotomous results were compared between groups using x2 or Fisher's exact tests with no adjustment for multiple comparisons. The nonparametric Mann–Whitney U and Kruskal–Wallis tests were utilized for the sex and age (<35y, 35-44y, 45-54y, >55y) analyses, respectively. All analyses were performed using IBM SPSS v27, and a two-tailed P-value of <0.05 was considered statistically significant. Results149 patients were included in the analysis. The PT was biopsied in 63 patients, and PL in 86 patients. There were no observer effects for age and gender between the PT and PL groups. There was no statistical significance between the PT and PL tendons for cell morphology, average cell population doubling time (PDT) (PT 83.9 vs PL 82.7 ​h, p ​= ​0.482), cellular yield (PT 16.2 vs PL 15.2 ​× ​106, p ​= ​0.099), and cell viability (PT 98.7 vs PL 99.0%, p ​= ​0.277). Additionally, ddPCR analyses showed no statistical significance found in tenogenic gene expression, including collagen type I (COL1, p ​= ​0.86), tenomodulin (TNMD, p ​= ​0.837) and scleraxis (SCX, p ​= ​0.331) between PT- and PL-derived tendon cells. An age stratification analysis found no effect on growth and gene expression. COL1 was found to be higher in males when compared to females (P ​< ​0.001), but otherwise no difference was seen in growth and gene expression in the gender analysis. No postbiopsy clinical complications were reported for either group. ConclusionThis study has shown that the growth and bioactivities of tendon cells from tendon biopsies for OrthoATI™ are not affected by tendon donor site and age. Level of evidenceIV.

SURGICAL TECHNIQUE FOR ANATOMICAL RE-CONSTRUCTION OF THE DISTAL RADIOULNAR LIGAMENTS IN CHRONIC TRAUMATIC INJURY OF THE TRIANGULAR FIBROCARTILAGE COMPLEX

Abstract-Injury to the triangular fibrocartilage complex (TFCC) can lead to instability of the distal radioulnar joint (DRUJ). In this article, we have presented a treatment method for patients with chronic traumatic TFCC injury. The surgical technique described here demonstrates anatomical reconstruction of the volar and dorsal distal radioulnar ligament using an autologous palmaris longus tendon graft.In the period 2014-2023, 22 patients with chronic traumatic injury to the triangular fibrocartilage complex, leading to instability of the DRUJ, were operated on in our clinic. The main parameters studied pre- and post-operatively were: degree of pain during active movements in the wrist joint and prono-supination of the forearm,range of active movements in the same joints, stability of DRUJ and grip strength relative to the contralateral limb.All 22 patients reported pain reduction with active wrist movements and forearm prono-supination. This surgical technique with anatomically based reconstruction of the distal volar and dorsal radioulnar ligament provides restoration of stability of the distal radioulnar joint and reduction of pain in patients with chronic injury to the triangular fibrocartilage complex.

Multispectral Optoacoustic Tomography Enables In Vivo Anatomical and Functional Assessment of Human Tendons.

Tendon injuries resulting from accidents and aging are increasing globally. However, key tendon functional parameters such as microvascularity and oxygen perfusion remain inaccessible via the currently available clinical diagnostic tools, resulting in disagreements on optimal treatment options. Here, a new noninvasive method for anatomical and functional characterization of human tendons based on multispectral optoacoustic tomography (MSOT) is reported. Healthy subjects are investigated using a hand-held scanner delivering real-time volumetric images. Tendons in the wrist, ankle, and lower leg are imaged in the near-infrared optical spectrum to utilize endogenous contrast from Type I collagen. Morphology of the flexor carpi ulnaris, carpi radialis, palmaris longus, and Achilles tendons are reconstructed in full. The functional roles of the flexor digitorium longus, hallicus longus, and the tibialis posterior tendons have been visualized by dynamic tracking during toe extension-flexion motion. Furthermore, major vessels and microvasculature near the Achilles tendon are localized, and the global increase in oxygen saturation in response to targeted exercise is confirmed by perfusion studies. MSOT is shown to be a versatile tool capable of anatomical and functional tendon assessments. Future studies including abnormal subjects can validate the method as a viable noninvasive clinical tool for tendinopathy management and healing monitoring.

Biomechanical Comparison of Ulnar Collateral Ligament Reconstruction Between Palmaris Longus Autograft and Knee Medial Collateral Ligament Allograft

Background: Medial ulnar collateral ligament (mUCL) injury can cause significant pain and alter throwing mechanics. Common autograft options for mUCL reconstruction (UCLR) include the palmaris longus (PL) and hamstring tendons. Allograft use may reduce donor site morbidity and decrease function related to PL autografts. Purpose: To compare varus stability and load to failure between a novel allograft for UCLR—knee medial collateral ligament (kMCL)—and a PL autograft in human donor elbow specimens. Study Design: Controlled laboratory study. Methods: A total of 24 fresh-frozen human elbows were dissected to expose the mUCL. Medial elbow stability was tested with the mUCL intact (native), deficient, and reconstructed utilizing the humeral single-docking technique with either a (1) kMCL allograft (n = 12) or (2) a PL autograft (n = 12). A 3-N·m valgus torque was applied to the elbow, and valgus rotation of the ulna was recorded via motion tracking cameras. The elbow was cycled through a full range of motion 5 times. After kinematic testing, specimens were loaded to failure at 70° of elbow flexion, and failure modes were recorded. Results: The mUCL-deficient elbows demonstrated significantly greater valgus rotation compared with the intact and reconstructed elbows at every flexion angle tested (10°-120°) ( P &lt;.001). Both kMCL- and PL-reconstructed elbows exhibited significantly higher mean valgus rotation compared with the intact state between 10° and 40° of flexion ( P &lt; .01). There were no significant differences in valgus rotation at any flexion angle between the kMCL and PL graft groups. When loaded to failure, elbows reconstructed with both kMCL and PL grafts failed at similar torque values (18.6 ± 4 and 18.1 ± 3.4 N·m, respectively; P = .765). Conclusion: Fresh-frozen and aseptically processed kMCL allografts demonstrated similar kinematic and failure properties to PL tendon autografts in UCL-reconstructed elbows, although neither graft fully restored kinematics between 10° and 40°. Clinical Relevance: Prepared kMCL ligament allografts may provide a viable graft material when reconstructing elbow ligaments while avoiding the potential complications related to PL autografts— including donor site morbidity.

Outcome of Transfer Flexor Carpi Ulnaris And Plmaris Longus Tendons for Hand Deformity in Persistance Radial Nerve Palsy

Objective; the aim of our study is to evaluate the functional outcome of transfer flexor carpi ulnaris and palmaris longus for patients with persistence radial nerve palsy by minimal tendon transfer technique.&#x0D; Methods; The study included 10 patients 8 male and two female, mean age 25 years, range from 20 to 30 years. They underwent transfer of flexor carpi ulnaris (FCU) and palmaris longus (PL) tendon for patient with persistence radial nerve palsy, the duration of outcome of tendon transfer after radial nerve injury evaluated after one year. Clinical evaluation include wrist joint range of movement by Geniometry and compared with the contralateral normal side.&#x0D; Results; The average ranges of wrist movements were as the follows: the mean wrist flexion was 52⁰(range 46⁰–56⁰), the mean wrist extension was 34⁰(range 30–38), radial deviation 18⁰(range 16⁰–20⁰) and ulnar deviation 21⁰ (range 18–23). The mean extension of the fingers in wrist extension was 7⁰(range 5⁰–10⁰) and in wrist neutral position was 12⁰(range 9⁰–16⁰). The mean abduction of the thumb was 38⁰(range 35⁰–44⁰). In comparison to the measure of joints in the contralateral normal hand, the final extension of the wrist was less, but extension of the fingers and MCP joints was similar to that of the normal hand. All of the patients in our study were able to extend their fingers with the wrist in the neutral position. Thumb abduction and extension was sufficient to deal with daily activities and, even, heavy jobs in most of the patients. Postoperative follow up of the patients was ranged (12–24) months. After 45 days, 8o% of the patients were able to do the normal non heavy daily work. In 20% of cases recovery was not progressing satisfactorily at 5 weeks. These were referred to physiotherapy for a planned exercise program, which the two patients improved their movements.&#x0D; Conclusion; The purpose of this study was to evaluate function of the hand after transfer of the FCU to EDC and PL to EPL, with persistence high nerve injuries. The FCU &amp; PL tendons transfer has some advantages over the other techniques, short duration of operation time, no morbidity, improve range of motion of hand and less surgical scares. It is a viable option to restore hand function and strength following radial nerve injuries.

Prediction Of Palmaris Longus Tendon Length And Thickness Through Simple Anthropometric Measurements.

This study aimed to test whether palmaris longus tendon (PLT) length and thickness can be predicted from simple anthropometric measurements. 120 healthy volunteers with bilateral PL muscles were enrolled in this prospective study. PLT length and thickness were measured by ultrasonographic examination. Anthropometric measurements included body height, weight, forearm length, and wrist circumference. Correlation, linear regression, and Bland-Altman plot were used for analysis. The mean PLT length and thickness were 10.8±1.4 cm and 4.0±0.9 mm, respectively. Body height and PLT length had a moderate positive correlation (r:0.407, p:0.001), and forearm length and PLT thickness had a weak positive correlation (r:0.229, p:0.001). The regression analysis showed that body height was the best predictor for PLT length, and forearm length was the best predictor for PLT thickness. The regression equations were as follows: PLT length=0.276+(0.062×height) (r2=0.165, p<0.001) and PLT thickness=1.373+(0.108×forearm length) (r2=0.052, p<0.001). The predicted PLT lengths and thicknesses were calculated using these regression formulas and compared with the actual thicknesses and lengths using the Bland-Altman plot. The upper and lower limits of agreement (95% CI) ranged from -2.54 cm to 2.51 cm for actual PLT length and predicted PLT length and from -1.76 mm to 1.74 mm for actual PLT thickness and predicted PLT thickness in the Bland-Altman plot with a weak agreement and proportional bias. These findings indicate that height and forearm length have limited accuracy in predicting PLT length and thickness. The preoperative ultrasonographic examination can provide valuable assistance, particularly in cases that require grafts with precise length and thickness requirements.

A Rare Variation of Palmaris Longus Muscle and Flexor Carpi Ulnaris Muscle with Clinical Significance: Case Report

Not so many variations of the muscles belonging to the flexor muscle group of the forearm are described in comparison to the tendons of extensor muscle group of the forearm. During routine dissection in the section hall of the Department of Anatomy, Histology and Embryology in Medical University of Sofia we came across a very interesting variation of palmaris longus muscle and the tendons of flexor carpi ulnaris muscle. We observed the division of the tendon of palmaris longus into two wide and flat tendon bellies called lateral and medial. These bellies formed a Y-shaped figure. The lateral tendon belly passed over the upper part of the flexor retinaculum and inserted into the palmar aponeurosis. The medial tendon however ran deeper than the lateral one and the beginning of the palmar aponeurosis and finally reached the flexor retinaculum where it was inserted. We also came across the presence of additional tendon belly belonging to the flexor carpi ulnaris muscle. That additional belly arose from the pisiform like the pisohamate and pisometacarpal ligaments, then ran deeper than usual and finally joined the fourth metacarpal bone.

Modified Weaver Dunn Versus Ligamentous Reconstruction Grafts in Chronic Acromioclavicular Joint Dislocation: A Systematic Review and Meta-Analysis of Comparative Studies.

Acromioclavicular (AC) joint trauma is a frequent sports injury. Modified Weaver Dunn (MWD) is a commonly used technique to address this injury. However, tendinous grafts (Autogenous Palmaris Longus or Semitendinosus tendons) are increasingly being used due to the biologic weakness of MWD. Three search was done until January 2024 with data extraction consisting of adverse events (infections and failures), Constant-Murley score, American Shoulder and Elbow Surgeons score, and postoperative coracoclavicular distance. Four studies were included in this metaanalysis. Tendinous graft was shown to have statistically better ASES and Constant-Murley scores. Furthermore, there were no difference in adverse events, and postoperative coracoclavicular distance. The tendinous graft showed no differences in adverse events, and postoperative coracoclavicular distance when compared to modified Weaver Dunn. However, it showed higher postoperative ASES and Constant-Murley score without analysis of the minimal clinical important difference making the difference solely statistical. 3.

Prevalence of Absence of Palmaris Longus Tendon in a Population Sample from a Multiethnic Brazilian City.

Objective The objective of the study was to determine the prevalence of absence of palmaris longus tendon in a population sample from a multiethnic Brazilian city. Methods A cross-sectional observational study was carried out between October 2017 and April 2018. We included male and female volunteers aged 18 years or older. The absence of palmaris longus tendon was determined by asking the volunteers to perform the Schaeffer test bilaterally. Results We prospectively collected data on 1,008 volunteers, 531 male and 477 female, with age between 18 and 74 years (mean 38.4 years). The absence of palmaris longus tendon was observed in 264 (26.2%) volunteers. Bilateral absence was detected in 123 volunteers (12.2%), 60 female (48.8%) and 63 male (51.2%). Unilateral absence was found in 141 patients (14.0%), 54 female (38.2%) and 87 male (61.8%) ( p < 0.05). Conclusion The prevalence of absence of palmaris longus tendon in our study was 26.2%. There was no statistically significant difference between gender and bilaterally. The absence of palmaris longus tendon was predominant on unilateral right side in males.

Thumb pronation efficacy of Camitz tendon transfer with insertion on the ulnar capsule of the metacarpophalangeal joint: a cadaver study.

Several studies have indicated that Camitz transfer for severe carpal tunnel does not adequately restore thumb opposition. The aim of this study was to determine whether modification of the distal insertion of the transferred palmaris longus tendon could provide more effective opposition. We used 12 fresh-frozen upper extremity specimens. For spatial analysis, we used a three-dimensional motion-tracking device. At 0 N and 5 N of traction force, the pronation angle was significantly larger for the modified procedure than for the conventional procedure. There was no significant difference in the palmar abduction angle between the two groups. The modified palmaris longus tendon insertion on the ulnar side of the thumb metacarpophalangeal joint provides more effective thumb pronation than conventional Camitz opponensplasty in a cadaver model. .

The Central Facial Defect Reconstruction Using a Radial Forearm Free Flap after Malignant Cutaneous Tumor Ablation.

Acquired defects of the central face pose significant challenges in achieving acceptable cosmetic and functional outcomes. The site, size, and depth of tissue loss often render local tissues inadequate for the repair of major nasal defects. In this article, we aim to demonstrate the efficacy of radial forearm-free flaps as an ideal choice for various central facial unit reconstructions. This study encompassed patients treated between 2020 and 2022 who underwent facial reconstruction using radial forearm flaps. These flaps were employed in eleven patients with defects involving the lower lid, nose, upper lip, and lower lip. Additionally, we used osteocutaneous flaps in one patient to reconstruct a right nasal bone defect. In three patients requiring medial and lateral canthal tendon reconstruction in one case and oral sphincter reconstruction in two cases, the palmaris longus tendon was included with the flap. In the majority of cases, we achieved good to excellent aesthetic and functional results. Notably, there were no instances of flap failure or partial necrosis in this series. All patients experienced uneventful healing at the donor site. The radial forearm-free flap stands as an ideal and reliable method for reconstructing various facial defects. It offers efficient and thin-conforming skin coverage.

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&amp;gt;0.05). Agenesis of the right side in males was significantly correlated with the left side in males (rs=0.556, p&amp;lt;0.01). Right agenesis in females was significantly correlated with its left side (rs=0.625, p&amp;lt;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&amp;lt;0.01) and right agenesis (rs=0.145, p&amp;lt;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.

Assessing the Accuracy of Common Clinical Tests for Detecting Palmaris Longus: A Prospective Study in a Tertiary Center.

Background Palmaris longus (PL) is a short-bellied muscle with a long tendon that merges with the palmar aponeurosis. It is supplied by the median nerve and acts as a tensor of the palmar aponeurosis and flexes the wrist. This tendon is commonly used for tendon transfers and as a donor for tendon graft. There are numerous clinical tests to detect the presence of PL like Schaeffer's test, Thompson's test, Mishra's test I, Mishra's test II, Pushpakumar's "two-finger sign" method, and AIIMS test. The principle of all these tests is to make the tendon prominent by eliciting its flexor action and then its identification by inspection and palpation. Objectives The tests that are consistently easy to perform with good understandability would be easy to explain to the general population (patients). The aim of our study is to find out the accuracy and easy comprehensibility of various tests using compulsive postures for detecting PL tendon clinically. Materials and Methods This is a prospective study on 137 participants. All the patients were subjected to six clinical tests to detect the presence or absence of PL tendon. The results were recorded for both hands by a single observer. Results Of the 137 participants, 75 were males (54.74%) and 62 were females (45.26%). The mean age was 21 years. The AIIMS test showed the maximum number of tendons, that is, 113 (82.4%) in the right hand and 108 (78.8%) in the left hand. In view of the ability to comprehend the tests, 119 (86.9%) subjects understood Schaeffer's test very easily. Conclusion According to this study, the AIIMS test best demonstrates the PL tendon, and Schaeffer's test was the test most easily understood by the subjects.