Clinical Detection of Presence and Absence of Palmaris Longus Tendon in Somali Population

Yıl 2023, , 178 - 183, 29.10.2023

Hasan May , Abdullahi Yusuf Mohamed

https://doi.org/10.30565/medalanya.1342908

Öz

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.

Anahtar Kelimeler

Palmaris longus, Tendon grafts, Variation, Somalia

Somali Popülasyonunda Palmaris Longus Tendonunun Varlığı ve Yokluğunun Klinik Tespiti

Öz

Amaç: Bu çalışmada Somali popülasyonunda palmaris longus (PL) yokluğunun sıklığının Afrika ve dünyanın diğer ülkelerindeki popülasyonlardan farklı olup olmadığı araştırıldı ve bu durumun cinsiyet ve tutulan ekstremite tarafı ile olan ilişkisi incelendi.

Yöntem: Toplam 1000 katılımcı (713 erkek ve 287 kadın; yaş aralığı: 7-80 yıl) Schaffer testi ile PL tendon yokluğu açısından değerlendirildi. Schaffer test sonucu negatif olanlara tanıyı doğrulamak amacıyla Thompson testi, Mishra testi I, Mishra testi II ve Pushpakumar "iki parmak işareti" yöntemi yapıldı.

Bulgular: Katılımcıların 95’inde (%9.5) PL tendonu bulunmuyordu. Katılımcıların 42’sinde (%4.4) iki taraflı ve 53’ünde (%5.5) tek taraflı olarak PL kası yoktu. Tek taraflı PL yokluğu sağ elde daha yüksek oranda izlendi (%3.0) (p>0.05). Erkeklerde sağ taraflı agenezi, erkeklerde sol taraflı agenezi ile anlamlı düzeyde ilişkili bulundu (rs=0.556, p<0.01). Kadınlarda sağ taraflı agenezi, sol taraflı agenezi ile anlamlı düzeyde ilişkili bulundu (rs=0.625, p<0.01). Kadınlarda sağ ve sol taraflı agenezi insidansı, erkeklerinkine kıyasla daha yüksek düzeyde ilişkili idi. Yaş, kadınlarda sol taraflı agenezi (rs=0.154, p<0.01) ve sağ taraflı agenezi (rs=0.145, p<0.05) ile anlamlı düzeyde ilişkili bulundu.

Sonuç: Somali popülasyonunda PL agenezi prevalansı bildirilen %15’lik insidanstan daha düşük olup, diğer Afrika popülasyonlarının bazılarından anlamlı düzeyde daha yüksektir. Bu bulgular, özellikle bölgedeki cerrahlar için PL greftleme ile yapılan ortopedi ve rekonstrüktif ameliyatları açısından yararlı olabilir.
Anahtar Kelimeler:

Anahtar Kelimeler

Palmaris longus, Tendon greftleri, Varyasyon, Somali.

Kaynakça

• 1. Standring S. 2007. Gray’s Anatomy. 39th Ed. London: Churchill Livingstone p 995–1027.
• 2. Mathew AJ, Sukumaran TT, Joseph S. Versatile but temperamental: a morphological study of palmaris longus in the cadaver. J Clin Diagn Res. 2015;9(2):AC01-3. doi: 10.7860/JCDR/2015/11212.5542.
• 3. Erić M, Krivokuća D, Savović S, Leksan I, Vucinić N. Prevalence of the palmaris longus through clinical evaluation. Surg Radiol Anat. 2010;32(4):357-61. doi:10.1007/s00276-009-0573-0.
• 4. Ioannis D, Anastasios K, Konstantinos N, Lazaros K, Georgios N. Palmaris longus muscle’s prevalence in different nations and interesting anatomical variations: Review of the literature. J Clin Med Res. 2015;7(11):825-30. doi:10.14740/jocmr2243w.
• 5. Johnson CC, Zusstone E, Miller TT, Nwawka OK, Lee SK, Wolfe SW. Clinical tests for assessing the presence and quality of the palmaris longus tendon: diagnostic accuracy of examination compared with ultrasound. J Hand Surg Eur Vol. 2020;45(3):292-8. doi: 10.1177/1753193419895160.
• 6. Holzgrefe RE, Anastasio AT, Farley KX, Daly CA, Mason AR, Gottschalk MB. Detection of the palmaris longus tendon: physical examination versus sonography. J Hand Surg Eur Vol. 2019;44(8):800-4. doi: 10.1177/1753193419863412.
• 7. Ahn DS, Yoon ES, Koo SH, Park SH. A prospective study of the anatomic variations of the median nerve in the carpal tunnel in Asians. Ann Plast Surg. 2000;44(3):282-7. doi: 10.1097/00000637-200044030-00006.
• 8. Ceyhan O, Mavt A. Distribution of agenesis of palmaris longus muscle in 12 to 18 years old age groups. Indian J Med Sci. 1997;51(5):156-60. PMID: 9355719.
• 9. Potu BK, Alnaggar AA, Fatima A, Salem AH, Fadel RA. Physical and ultrasonographic examination of palmaris longus tendon in the Arabian Gulf Region. Eur J Anat. 2021;25(4):397-406.
• 10. Pękala PA, Henry BM, Pękala JR, Skinningsrud B, Walocha JA, Bonczar M, et al. Congenital absence of the palmaris longus muscle: A meta-analysis comparing cadaveric and functional studies. J Plast Reconstr Aesthet Surg. 2017;70(12):1715-24. doi: 10.1016/j.bjps.2017.08.002.
• 11. Andring N, Kennedy SA, Iannuzzi NP. Anomalous Forearm Muscles and Their Clinical Relevance. J Hand Surg Am. 2018;43(5):455-63. doi: 10.1016/j.jhsa.2018.02.028.
• 12. Schaeffer JP. On the variations of the palmaris longus muscle. Anat Rec. 1909;3:275-8.
• 13. Thompson NW, Mockford BJ, Rasheed T, Herbert KJ. Functional absence of flexor digitorum superficialis to the little finger and absence of palmaris longus--is there a link? J Hand Surg Br. 2002;27(5):433-4. doi: 10.1054/jhsb.2002.0797.
• 14. Kumar, Pramod. Alternative Tests To Demonstrate The Presence Of Palmaris Longus. Plastic And Reconstructive Surgery 114(4):P 71e-72e, September 15, 2004.
• 15. Pushpakumar SB, Hanson RP, Carroll S. The 'two finger' sign. Clinical examination of palmaris longus (PL) tendon. Br J Plast Surg. 2004;57(2):184-5. doi: 10.1016/j.bjps.2003.11.024.
• 16. Osonuga A, Mahama HM, Brown AA, Osonuga OA, Serbeh G, Harding AN, et al. The Prevalence of Palmaris longus agenesis among the Ghanaian population. Asian Pacific Journal of Tropical Disease. 2012 Jan 1;2:S887-9. doi: 10.1016/S2222-1808(12)60286-2.
• 17. Kigera JW, Mukwaya S. Frequency of agenesis Palmaris longus through clinical examination--an East African study. PLoS One. 2011;6(12):e28997. doi: 10.1371/journal.pone.0028997.
• 18. Mbaka GO, Ejiwunmi AB. Prevalence of palmaris longus absence--a study in the Yoruba population. Ulster Med J. 2009;78(2):90-3. PMID: 19568443.
• 19. Sadacharan CM, Packiriswamy V. Clinical Assessment of Absence Of The Palmaris Longus Muscle In African Antiguan Population. Ethiop Med J. 2022;60(2):101-8
• 20. Gangata H. The clinical surface anatomy anomalies of the palmaris longus muscle in the Black African population of Zimbabwe and a proposed new testing technique. Clin Anat. 2009;22(2):230-5. doi: 10.1002/ca.20751.
• 21. Berhe T, Bekele A. Agenesis of palmaris longus muscle among selected Ethiopian students. Anat Physiol. 2014;4(2):1-5. doi: 10.4172/2161-0940.1000136.
• 22. Venter G, Van Schoor AN, Bosman MC. Degenerative trends of the palmaris longus muscle in a South African population. Clin Anat. 2014;27(2):222-6. doi: 10.1002/ca.22226.
• 23. Venkatapathy S, Bhargavan R. Clinical Assessment of Existence of Palmaris Longus Muscle among South Indian Population. J Hand Surg Asian Pac Vol. 2020;25(2):137-142. doi: 10.1142/S2424835520500149. .