Palmaris longus musclepalmaris longus muscle, palmaris longus muscle function
The palmaris longus is a muscle visible as a small tendon between the flexor carpi radialis and the flexor carpi ulnaris, although it is not always present It is absent in about 14 percent of the population; however, this number varies greatly in African, Asian, and Native American populations1 Absence of the palmaris longus does not have an effect on grip strength2
The palmaris longus muscle can be seen by touching the pads of the fifth finger and thumb and flexing the wrist The tendon, if present, will be visible in the midline of the anterior wrist
- 1 Structure
- 11 Innervation
- 12 Variation
- 2 Clinical significance
- 21 Use in tendon grafts
- 3 See also
- 4 References
- 5 External links
Palmaris longus is a slender, elongated, spindle shaped muscle, lying on the medial side of the flexor carpi radialis It is widest in the middle, and narrowest at the proximal and distal attachments3
It arises mainly from the medial epicondyle of the humerus via the common flexor tendon It also takes origin from the adjacent intermuscular septa and from the antebrachial fascia3
It ends in a slender, flattened tendon, which passes over the upper part of the flexor retinaculum and inserts onto the central part of the flexor retinaculum and lower part of the palmar aponeurosis Frequently, it sends a tendinous slip to the short muscles of the thumb3
The palmaris longus is supplied by the median nerve4
VariationeditPalmaris Longus: misplaced or absent
The fleshy belly occasionally migrates distally and comes to lie close above the wrist, as here
Palmaris Longus was absent in 98 of 716 dissected limbs ie, in 137% of 358 paired limbs, 26 times in both limbs, 26 in the right only, and 20 in the left only R K George5
The palmaris longus muscle is a variable muscle The most common variation is its absence Several in vivo and in vitro studies have documented the prevalence of absence of the PL tendon in different ethnic groups Between 55 and 24% of Caucasian populations European and North American and 46 to 266% of Asian populations Chinese, Japanese, Indian, Turkish, Malaysian have been reported to lack the PL tendon6
There are also variations related to its form It may be tendinous above and muscular below; or it may be muscular in the center with a tendon above and below; or it may present two muscular bundles with a central tendon; or finally it may consist solely of a tendinous band The muscle may be double, or missing entirely Slips of origin from the coronoid process or from the radius have been seen Partial or complete insertion into the fascia of the forearm, into the tendon of the flexor carpi ulnaris and pisiform bone, into the scaphoid, and into the muscles of the little finger have been observed
Use in tendon graftseditCross-section through the middle of the forearm
The palmaris longus muscle is the most popular for use in tendon grafts for the wrist due to the length and diameter of the palmaris longus tendon, and the fact that it can be used without producing any functional deformities When a tendon becomes ruptured in the wrist, the palmaris longus tendon may be removed from the flexor retinaculum and grafted to take the place of the ruptured tendon The tendons most commonly replaced or supplemented by the palmaris longus tendon when ruptured are the long flexors of the fingers and the flexor pollicis longus tendon7
The palmaris longus muscle itself is a weak flexor, and provides no substantial flexing force that would inhibit movement in the wrist if its tendon were cut and moved elsewhere If the palmaris longus muscle is not available for harvesting in an individual, the anatomically analogous plantaris muscle in the leg may be taken instead8 Using the patient’s own tendon is advantageous, as it does not introduce foreign material into the body
See alsoeditThis article uses anatomical terminology; for an overview, see Anatomical terminology
- Palmaris brevis muscle
This article incorporates text in the public domain from the 20th edition of Gray's Anatomy 1918
- ^ Sebastin SJ, Puhaindran ME, Lim AY, Lim IJ, Bee WH October 2005 "The prevalence of absence of the palmaris longus--a study in a Chinese population and a review of the literature" Journal of Hand Surgery 30 5: 525–7 PMID 16006020 doi:101016/jjhsb200505003
- ^ Sebastin SJ, Lim AY, Bee WH, Wong TC, Methil BV August 2005 "Does the absence of the palmaris longus affect grip and pinch strength" Journal of Hand Surgery 30 4: 406–8 PMID 15935531 doi:101016/jjhsb200503011
- ^ a b c Gray's Anatomy 1918, see infobox
- ^ Drake, Richard L; Vogl, Wayne; Mitchell, Adam W M 2005 Gray's anatomy for students Philadelphia: Elsevier/Churchill Livingstone p 693 ISBN 978-0-8089-2306-0
- ^ Grant's Atlas of Anatomy 1962
- ^ Kose O, Adanir O, Cirpar M, Kurklu M, Komurcu M May 2009 "The prevalence of absence of the palmaris longus: a study in Turkish population" Archives of Orthopaedic and Trauma Surgery 129 5: 609–11 PMID 18418616 doi:101007/s00402-008-0631-9
- ^ Thejodhar P, Potu BK, Vasavi RG January 2008 "Unusual palmaris longus muscle" Indian Journal of Plastic Surgery 41 1: 95–6 PMC 2739544 PMID 19753215 doi:104103/0970-035841125
- ^ Wheeless, Clifford R December 2009 "Palmaris Longus Tendon Graft Harvest" Wheeless' Textbook of Orthopaedics Retrieved February 2012 Check date values in: |access-date= help
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