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Kilic KK, Kose O, Egerci OF, Dogruoz F, Aykanat F. Prediction Of Palmaris Longus Tendon Length And Thickness Through Simple Anthropometric Measurements. HANDCHIR MIKROCHIR P 2024; 56:368-375. [PMID: 38359865 DOI: 10.1055/a-2239-6341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVE This study aimed to test whether palmaris longus tendon (PLT) length and thickness can be predicted from simple anthropometric measurements. MATERIALS AND METHODS 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. RESULTS 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. CONCLUSIONS 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.
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Affiliation(s)
- Koray Kaya Kilic
- Radiology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Ozkan Kose
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Omer Faruk Egerci
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Firat Dogruoz
- Orthoapedics and Traumatology Department, Antalya Training and Research Hospital, Antalya, Turkey
| | - Faruk Aykanat
- Vocational School of Health Services, Sanko Universitesi, Gaziantep, Turkey
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Park J, Park KR, Kwon HW, Choi YJ, Lee M, Kim D, Choi SW, Cho J. Evaluating the Suitability of the Plantaris Tendon for Sports Trauma Reconstruction and a Predictive Model of Tendon Length Based on Height and Leg Length. J Clin Med 2023; 12:6932. [PMID: 37959397 PMCID: PMC10648430 DOI: 10.3390/jcm12216932] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/17/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
This study evaluates the suitability of the plantaris tendon (PT) as a tendon graft donor for sports trauma reconstruction and proposes a predictive model for estimating PT length by using an individual's height and leg length. Anatomical dissection of 50 cadavers (32 males and 18 females) yielded precise measurements of PT length and width while also recording height and leg length. Among the lower limbs, 89% were suitable for at least one recommended graft suitability criterion. In addition, PT length exhibited robust positive correlations with height and leg length. Predictive equations were established for estimating the PT length based on leg length and height with consistency across sexes and sides: PT length = 0.605 + 0.396 × leg length (r = 0.721) and PT length = 1.480 + 0.193 × height (r = 0.626). This study underscores the grafting potential of the PT, providing a predictive tool that can aid surgeons in addressing tendon graft challenges within sports trauma scenarios.
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Affiliation(s)
- JeongHyun Park
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.P.); (H.-W.K.); (Y.-J.C.); (M.L.); (D.K.)
| | - Kwang-Rak Park
- Department of Anatomy, College of Korean Medicine, Sangji University, Wonju 26339, Republic of Korea;
| | - Hyung-Wook Kwon
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.P.); (H.-W.K.); (Y.-J.C.); (M.L.); (D.K.)
| | - Yu-Jin Choi
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.P.); (H.-W.K.); (Y.-J.C.); (M.L.); (D.K.)
| | - Mijeong Lee
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.P.); (H.-W.K.); (Y.-J.C.); (M.L.); (D.K.)
| | - Digud Kim
- Department of Anatomy & Cell Biology, School of Medicine, Kangwon National University, Chuncheon 24341, Republic of Korea; (J.P.); (H.-W.K.); (Y.-J.C.); (M.L.); (D.K.)
| | - Sung Wook Choi
- Division of Forensic Medical Examination, National Forensic Service, 10, Ipchun-ro, Wonju 26460, Republic of Korea;
| | - Jaeho Cho
- Department of Orthopaedic Surgery, Chuncheon Sacred Heart Hospital, Hallym University, 77, Sakju-ro, Chuncheon 24253, Republic of Korea
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Vinitpairot C, Luangjarmekorn P, Huanmanop T, Kitidumrongsook P. Anatomy of the toe extensor tendons and its suitability for tendon grafts in the hand: a cadaveric study. J Hand Surg Eur Vol 2021; 46:80-81. [PMID: 32615832 DOI: 10.1177/1753193420936612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Chaiyos Vinitpairot
- Hand and Microreconstructive Unit, Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pobe Luangjarmekorn
- Hand and Microreconstructive Unit, Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Thanasil Huanmanop
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pravit Kitidumrongsook
- Hand and Microreconstructive Unit, Department of Orthopedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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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; 45:292-298. [PMID: 31847681 DOI: 10.1177/1753193419895160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Various clinical tests are used to evaluate the palmaris longus tendon, but their accuracy is unknown. We assessed the accuracy of clinical tests (Schaeffer's, Thompson's, Mishra-I, Mishra-II) against ultrasound as the reference standard. We hypothesized that Schaeffer's was most accurate and that examination can reliably assess the palmaris longus tendon's length. Ninety-six wrists were examined clinically and evaluated with ultrasound by radiologists who were blinded to examination results. We calculated diagnostic accuracy and agreement between length measurements. Sensitivity values were as follows: Schaeffer's 94%, Mishra-I 100%, Mishra-II 100%, Thompson's 72%. Specificity values were as follows: Schaeffer's 94%, Mishra-I 83%, Mishra-II 89%, Thompson's 91%. Intraclass correlation coefficient between palmaris longus tendon length measurement on examination and ultrasound was 0.54. Schaeffer's test accurately detected this tendon with >90% sensitivity and specificity, but clinical examination less reliably measured palmaris longus tendon length. Ultrasound may be a useful adjunct to assess potential graft length preoperatively. Level of evidence: I.
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Affiliation(s)
| | | | | | | | - Steve K Lee
- Hospital for Special Surgery, New York, NY, USA
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Yammine K, Erić M. Morphometric analysis and surgical adequacy of palmaris longus as a tendon graft. A systematic review of cadaveric studies. Surg Radiol Anat 2019; 42:259-267. [PMID: 31741040 DOI: 10.1007/s00276-019-02381-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 11/07/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The tendon of the palmaris longus is commonly used as a tendon graft in many reconstructive surgeries. Easy to access and at proximity to the hand, the palmaris longus tendon is considered as the optimal tendon source for hand reconstructive surgery. However, and besides its inconsistency, the size of the palmaris longus tendon is reported to show variability. The aim of this study is to look for the surgical adequacy of the palmaris longus tendon by conducting a quantitative synthesis on its length and width in human populations and its correlation with the forearm length. METHODS Twenty-four studies met the inclusion criteria including 1761 cadaveric limbs. RESULTS The results were as following: (a) the mean palmaris longus tendon length was of 13.9 ± 2.6 cm, (b) the mean ratio palmaris longus tendon length/forearm length was of 0.545 ± 0.06, (c) the weighted correlation value was of 0.686, and (d) the mean palmaris longus tendon width was of 4.0 ± 1.7 mm. Only five studies reported a palmaris longus tendon length of more than 15 cm. The palmaris longus tendon length was shown to vary between ancestries; the Japanese had the shortest while Malaysian the longest palmaris longus tendons. All studies but one reported a palmaris longus tendon mean width of more than 3 mm where the minimal mean palmaris longus tendon width was of 2.5 mm. CONCLUSION While the requested length depends on the recipient site and/or type of reconstructive surgery, the palmaris longus tendon often met the required diameter for grafting. Our review demonstrated that while palmaris longus length varies between ancestries, its width is often adequate for grafting. In addition, the forearm length could be a good predictor of palmaris longus tendon length; such correlation could assist surgeons when planning to use palmaris longus tendon as a graft source.
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Affiliation(s)
- Kaissar Yammine
- Department of Orthopedics, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University School of Medicine, Beirut, Lebanon
- The Center for Evidence-Based Anatomy, Sport and Orthopedic Research, Beirut, Lebanon
| | - Mirela Erić
- Department of Anatomy, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, Novi Sad, 21000, Serbia.
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Johnson CC, Vutescu ES, Miller TT, Nwawka OK, Lee SK, Wolfe SW. Ultrasound determination of presence, length and diameter of the palmaris longus tendon. J Hand Surg Eur Vol 2018; 43:948-953. [PMID: 29879859 DOI: 10.1177/1753193418778990] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Inadvertent median nerve harvest is a devastating complication of palmaris longus harvest. Accurate assessment of palmaris longus presence and dimensions preoperatively would minimize this risk and assure safe harvest. We hypothesized that ultrasound would accurately predict palmaris longus presence, length and diameter. Seventeen cadaveric forearms were studied using a LOGIQ-E9 ultrasound. Two radiologists assessed palmaris longus presence and dimensions. Each wrist was explored, and the tendon was harvested and measured. Inter-rater reliability and agreement between measurements was assessed. The palmaris longus was present in 13 of 17 forearms. Both radiologists correctly identified the tendon and its absence (sensitivity and specificity, 100%). Ultrasound assessment of palmaris longus dimensions significantly correlated with surgical measurements. Intraclass correlation coefficient between radiologists was 0.97. We conclude that ultrasound can determine palmaris longus presence and dimensions with excellent accuracy and inter-observer reliability. Ultrasound is useful for preoperative evaluation of the palmaris longus and its use will increase patient safety.
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Affiliation(s)
| | | | | | | | - Steve K Lee
- Hospital for Special Surgery, New York, NY, USA
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