Morphometric analysis of the palmaris longus muscle: a fetal study

Year 2013, Volume: 7 Issue: 1, 42 - 47, 01.10.2013

Necdet Kocabıyık Selda Yıldız Sedat Develi Hasan Ozan Fatih Yazar

https://doi.org/10.2399/ana.11.158

Abstract

Objectives: The palmaris longus muscle is absent in 10-15% of forearms. Its long, flat tendon broadens as it passes in front of flexor retinaculum, to which it is partly adherent. In the palm it splits to attach the longitudinally directed fibres of the palmar aponeurosis. This fetus study is made to evaluate morphometric and topographic differences of adult and fetal palmaris longus muscle.

Methods: The present study is carried out on 24 human fetuses aged 17-40 weeks of gestation. All upper limbs were carefully dissected with the aid of a stereomicroscope at 1.6x magnification. Digital calliper was used for all the measurements.

Results: The palmaris longus muscles were absent in both forearms in 7 fetuses and in a unilateral forearm in 5 fetuses. Reversed palmaris longus muscle was found in 2 forearms. Most fetuses had a typical palmaris longus muscle and tendon shape. The mean length and width of the tendons were 18.42±9.55 and 0.66±0.37 mm, respectively, in second trimester and, 25.9±13.90 and 1.71±0.95 mm in third trimester, respectively. The mean length and width of the muscular belly were 13.33±7.05 and 2.03±1.04 mm, respectively, in second trimester and, 30.42±16.81 and 3.77±2.07 mm in third trimester, respectively.

Conclusion: The results of our study show to more pronounced loss of the muscle on the left side. This detailed fetal study in relationship to the palmaris longus muscle would be useful for educational anatomy dissections and surgical interventions for relevant clinical procedures.

Keywords

agenesis, fetus, morphologic evaluation, palmaris longus muscle, tendon variations

References

• Standring S (ed.) Forearm. In: Gray’s anatomy. The anatomical basis of clinical practice. 40th ed. Edinburgh: Churchill Livingstone Elsevier; 2008. p. 847.
• Sinnatamby CS. Last’s anatomy. Regional and applied. 10th ed. Edinburgh: Churchill Livingstone; 1999. p. 63.
• Moore KL, Dalley AF. Clinically oriented anatomy. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 1999. p. 737.
• Yıldız M, Şener M, Aynacı O. Three-headed reversed palmaris longus muscle: a case report and review of the literature. Surg Radiol Anat 2000;22:217-9.
• Schlafly B, Lister G. Median nerve compression secondary to bifid reversed palmaris longus. J Hand Surg Am 1987;12:371-3.
• Atiyeh BA, Hashim HA, Hamdan AM, Kayle DI, Musharafieh RS. Lower reconstruction and restoration of oral competence with dynamic palmaris longus vascularised sling. Arch Otolaryngol Head Neck Surg 1998; 24:1390-2.
• Troha F, Baibak GJ, Kelleher JC. Frequency of the palmaris longus tendon in North American Caucasians. Ann Plast Surg 1990; 25:477-8.
• Schneider LH. Flexor tendons-late reconstruction. In: Green DP, Hotchkiss RN, Pederson WC, editors. Green’s operative hand sur- gery. 4th ed. Edinburgh: Churchill Livingstone; 1999. p. 1898-950.
• Pai MM, Prabhu LV, Nayak SR, et al. The palmaris longus mus- cle: its anatomic variations and functional morphology. Rom J Morphol Embryol 2008;49:215-7.
• Koo CC, Roberts AH. The palmaris longus tendon. Another vari- ation in its anatomy. J Hand Surg Br 1997;22:138-9.
• Vanderhooft E. The frequency and relationship between the pal- maris longus and plantaris tendons. Am J Orthop 1996;25:38-41.
• Wehbe MA. Tendon graft donor sites. J Hand Surg Am 1992;17:1130-2.
• Kayode AO, Olamide AA, Blessing IO, Victor OU. Incidence of palmaris longus muscle absence in Nigerian population. Int J Morphol 2008;26:305-308.
• Ceyhan O, Mavi A. Distribution of agenesis of palmaris longus muscle in 12 to 15 years old age groups. Indian J Med Sci 1997;51:156-60.
• Adachi B. Beiträge zur Anatomie der Japaner. XII. Die Statistik der Muskelvarietäten. Zeitsch Morphol Anthropol 1909;12:261-312.
• Sebastin SJ, Puhaindran ME, Lim AY, Lim IJ, Bee WH. The prevalence of absence of the palmaris longus - A study in a Chinese population and a review of the literature. J Hand Surg Br 2005;30:525-7.
• Eriç M, Krivokuça D, Savoviç S, Leksan I, Vuciniç N. Prevalence of the palmaris longus through clinical evaluation. Surg Radiol Anat 2010;32:357-61.
• Igbigbi PS, Ssekitoleko HA. Incidence of agenesis of the palmaris longus muscle in Ugandans. West African J Anat 1998; 6:21-3.
• Kopuz C. Yenido¤anlarda m. palmaris longus’un morfolojik olarak incelenmesi. Morfoloji Dergisi 1999;7:6-9.
• Köse O, Adanır O, Çırpar M, Kürklü M, Kömürcü M. The preva- lence of absence of the palmaris longus: a study in Turkish popu- lation. Arch Orthop Trauma Surg 2009;129:609-11.
• Harvey JF, Chu G, Harvey PM. Surgical availability of the plan- taris tendon. J Hand Surg 1983; 8:243-7.
• Mbaka GO, Ejiwunmi AB. Prevalence of palmaris longus absence – A study in the Yoruba population. Ulster Med J 2009;78:90-3.
• Alagöz MS, Uysal AC, Tüccar E, Tekdemir ‹. Morphologic assess- ment of the tendon graft donor sites: palmaris longus, plantaris, tensor fascia lata. J Craniofac Surg 2008;19:246-50.
• Stecco C, Lancerotto L, Porzionato A, et al. The palmaris longus muscle and its relations with the antebrachial fascia and the palmar aponeurosis. Clin Anat 2009;22:221-9.
• Ito MM, Aoki M, Kida MY, Ishii S, Kumaki K, Tanaka S. Length and width of the tendinous portion of the palmaris longus: a cadav- er study of adult Japanese. J Hand Surg Am 2001;26:706-10.
• Georgiev GP, Jelev L. Unusual coexistence of a variant abductor digiti minimi and reversed palmaris longus and their possible rela- tion to median and ulnar nerves entrapment at the wrist. Rom J Morphol Embryol 2009;50:725-7.
• Çınar C, Arslan H, Ogur S. Reconstruction of massive lower lip defect with the composite radial forearm palmaris longus free flap: empowered static and partial dynamic reconstruction. J Craniofac Surg 2007;18:237-241.
• Bachelor EP, Jobe RP. The absent lateral canthal tendon: recon- struction using a Y graft of palmaris longus tendon. Ann Plast Surg 1980;5:362-8.
• Song IC, Bromberg BE. Pharyngo-palatoplasty with free trans- plantation of the palmaris longus. Br J Plast Surg 1974;27:337-43.
• Zeybek A, Gürünlüo¤lu R, Çavdar S, Bayramiçli M. A clinical reminder: a palmaris longus muscle variation. Ann Plast Surg 1998;41:224-5.