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Behiery A, Bakir M, Dawalibi A, Elhossiny AH. Reversed Palmaris Longus: A Rare Anatomical Phenomenon Discovered. Cureus 2023; 15:e38424. [PMID: 37273359 PMCID: PMC10235925 DOI: 10.7759/cureus.38424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 06/06/2023] Open
Abstract
The palmaris longus (PL) muscle is considered by many to be a vestigial muscle due to it having little to no functional significance on the upper limb. This, however, made it highly valuable in surgical procedures, especially as a graft in plastic and reconstructive cases. Variations in the muscle's morphology were discussed in the literature, but some are more rare than others. Those variations may have clinical implications on different pathologies such as Guyon's syndrome or Carpal tunnel syndrome based on the nerves and vessels surrounding it, and thus demand a proper understanding of the variation's anatomy. Here, we report a case of one of the rarer variations, a unilaterally reversed palmaris longus muscle in the left forearm of a 55-year-old male cadaver, discovered in a routine teaching session. Throughout the case, we will discuss the normal anatomy, the variation, and the clinical implications this variation may have.
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Affiliation(s)
- Ayman Behiery
- Department of Anatomy, College of Medicine, Alfaisal University, Riyadh, SAU
| | - Mohamad Bakir
- College of Medicine, Alfaisal University, Riyadh, SAU
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Joo Y, Moon J, Lee YJ, Bang YS, Yi J, Jang JN, Su MY, Kim YU. A new diagnostic morphological parameter for the Carpal tunnel syndrome: The palmaris longus tendon cross-sectional area. Medicine (Baltimore) 2022; 101:e30906. [PMID: 36221400 PMCID: PMC9542913 DOI: 10.1097/md.0000000000030906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Carpal tunnel syndrome (CTS) is correlated with increased intracarpal canal pressure (ICP). The effect of palmaris longus tendon (PLT) loading on ICP is documented in previous researches. PLT loading induces the greatest absolute increase in ICP. Therefore, to analyze the connection between the PLT and CTS, we newly made the measurement of the PLT cross-sectional area (PLTCSA). We assumed that PLTCSA is a reliable diagnostic parameter in the CTS. PLTCSA measurement data were acquired from 21 patients with CTS, and from 21 normal subjects who underwent wrist magnetic resonance imaging (W-MRI). We measured the PLTCSA at the level of pisiform on W-MRI. The PLTCSA was measured on the outlining of PLT. The two different cutoff values in the analysis were determined using receiver operating characteristic (ROC) analysis. The mean PLTCSA was 2.34 ± 0.82 mm2 in the normal group and 3.97 ± 1.18 mm2 in the CTS group. ROC curve analysis concluded that the best cutoff point for the PLTCSA was 2.81 mm2, with 76.2% sensitivity, 71.4% specificity, and area under the curve of 0.88 (95% CI, 0.78-0.98). PLTCSA is a sensitive, new, objective morphological parameter for evaluating CTS.
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Affiliation(s)
- Young Joo
- Department of Anesthesiology and Pain Medicine, CHA Ilsan Medical Center, CHA University, Goyang, Republic of Korea
| | - JeeYoun Moon
- Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University School of Medicine, Seoul, Republic of Korea
| | - Yoon Jin Lee
- Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Yun-Sic Bang
- Department of Anesthesiology and Pain Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Jungmin Yi
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Jae Ni Jang
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary’s Hospital, Incheon, Republic of Korea
| | - Min-Ying Su
- Department of Radiological Sciences, University of California, Irvine, CA, USA
| | - Young Uk Kim
- Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary’s Hospital, Incheon, Republic of Korea
- Department of Radiological Sciences, University of California, Irvine, CA, USA
- * Correspondence: Young Uk Kim, Department of Anesthesiology and Pain Medicine, Catholic Kwandong University of Korea College of Medicine, International St. Mary’s Hospital, Simgokro, 100 Gil 25, Seo-Gu, Incheon City, Republic of Korea (e-mail: )
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