Incidence of agenesis of palmaris longus in the Andhra population of India

ABSTRACT

Background: The knowledge of Palmaris longus (PL) is a growing interest for its wide role in reconstructive plastic surgeries as a donor tendon for transfer or transplant. The prevalence of the PL agenesis has been well-documented by many authors in different ethnic groups or populations. Many conventional tests for determining the presence of the PL has been described, but lamentably there are many discrepancies in confirming its presence or absence. Slight modifications of the prevailing methods can still give authenticate results. Aim: This prospective study was conducted to determine the incidence of unilateral and bilateral agenesis of PL and its association with sex and side of the limb in the Andhra population of India. Materials and Methods: A total of 942 subjects of both sexes belonging to 18-23 years were used to access the PL using various tendon examination techniques including our modified Schaeffer's test. The data collected were analyzed by Pearsons χ²test using SPSS software. Results: Overall agenesis of muscle in both sexes was 264 (28.0%), out of which 40.2% was seen in females and 14.7% in males with the ratio of 3:1. The unilateral agenesis was seen in 70.5% and bilateral agenesis in 29.5% subjects. The left side agenesis was seen in 51.6% and right side in 48.4% subjects. Conclusions: The prevalence of bilateral and unilateral agenesis was more common on left side with a greater likelihood in the female subjects. The proposed technique could bring better results in all subjects and can be implemented in manual examination of PL.

KEY WORDS

Muscle agenesis - palmaris longus - tendon anomalies - tendon graft

• REFERENCES

• 1 Vanderhooft E. The frequency and relationship between the palmaris longus and Plantaris tendons. Am J Orthop 1996;25: 38-41.
• 2 Ito MM, Aiko M, Kida MY, Ishii S, Kumaki K, Tanaka S. Length and width of the tendinous portion of the palmaris longus: A cadaver study of adult Japanese. J Hand Surg Am 2001;26:706-10.
• 3 Davidson BA. Lip augmentation using the palmaris longus tendon. Plast Reconstr Surg 1995;5:1108-10.
• 4 Naugle TC Jr, Faust DC. Autogeneous palmaris longus tendon as frontalis suspension material for ptosis correction in children. Am J Ophthal 1999;127:488.
• 5 Troha F, Baibak G J, Kelleher J C. Frequency of the palmaris longus tendon in North American Caucasians. Ann Plast Surg 1990;25:477-8.
• 6 Kapoor SK, Tiwari A, Kumar A, Bhatia R, Tantuway V, Kapoor S. Clinical relevance of palmaris longus agenesis: Common anatomical aberration. Anat Sci Int 2008;83:45-8.
• 7 Sebastin SJ, Lim AY, Wong HB. Clinical assessment of absence of the palmaris longus and its association with other anatomical anomalies: A Chinese population study. Ann Acad Med Sing 2006;35:249-53.
• 8 Sebastin SJ, Lim AY, Bee WH, Wong TC, Methil BV. Does the absence of the palmaris longus affect grip and pinch strength? J Hand Surg Br 2005;30:406-8.
• 9 Schaeffer JP. On the variations of the palmaris longus muscle. Anat Rec 1909;3:275-8.
• 10 Thompson JW, McBatts J, Danforth CH. Hereditary and racial variations in the musculus palmaris longus. Am J Phys Anthrop 1921;4:205-20.
• 11 Mishra S. Alternative tests in demonstrating the presence of palmaris longus. Indian J Plast Surg 2001;34:12.
• 12 Pushpakumar SB, Hanson RP, Carroll S. The ‘two finger’ sign: Clinical examination of palmaris longus (PL) tendon. Br J Plast Surg 2004;57:184-5.
• 13 Reimann AF, Daseler EH, Anson BJ, Beaton LE. The palmaris longus muscle and tendon; A study of 1600 extremities. Anat Rec 1944;89:495-505.
• 14 Koo CC, Roberts AH. The palmaris longus tendon: Another variation in its anatomy. J Hand Surg Br 1997;22:138-9.
• 15 Oommen, Rajarajeshwari A. Palmaris longus: Upside down. J Anat Soc India 2002;51:232-3.
• 16 Wehbe MA. Tendon graft donor sites. J Hand Surg Am 1992;17:1130-2.
• 17 Tallia AF, Cardone DA. Diagnostic and therapeutic injection of the wrist and hand region. Am Fam Physician 2003;67:745-50.
• 18 Salam GA. Regional anesthesia for office procedures: Part II, Extremity and inguinal area surgeries. Am Fam Physician 2004;69:896.
• 19 Bhattacharya V, Raveendra Reddy G. The palmaris longus tendon-rationality of the finger manoeuvres. Br J Plast Surg 2005;58:419-21.
• 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;22:230-5.
• 21 Kose O, Adanir O, Cirpar M, Kurklu M, Komurcu M. The prevalence of absence of the palmaris longus: A study in Turkish population. Arch Orthop Trauma Surg 2009;129:609-11.
• 22 Ceyhan O, Mavt A. Distribution of agenesis of the palmaris longus muscle in 12-18 years old age groups. Indian J Med Sci 1997;51:156-60.
• 23 Machado AB, DiDio LJ. Frequency of the musculus palmaris longus studied in vivo in some Amazon Indians. Am J Phys Anthrop 1967;27:11-20.
• 24 Thompson NW, Mockford BF, Cran GW. Absence of the palmaris longus muscle: A population study. Ulster Med J 2001;70:22-4.
• 25 Park S, Shin Y. Results of long-term follow-up observations: Blepharoptosis correction using the palmaris longus tendon. Aesth Plast Surg 2008;32:614-9.
• 26 Schuurman AH, Van Gils AP. Reversed palmaris longus muscle on MRI: Report of four cases. Eur Radiol 2000;10:1242-4.
• 27 Igbigbi PS, Ssekitoleko HA. Incidence of agenesis of the palmaris longus muscle in Ugandans. West Afr J Anat 1998;6:21-3.
• 28 Roohi SA, Choon-Sian L, Shalimar A, Tan GH, Naicker AS. A Study on the absence of palmaris longus in a multiracial population. Malaysian Ortho J 2007;1:126-8.
• 29 Pai MM, Prabhu LV, Nayak SR, Madhyastha S, Vadgaonkar R, Krishnamurthy A, et al. The palmaris longus muscle: Its anatomic variations and functional morphology. Roma J Morpho Emb 2008;49:215-7.
• 30 Mbaka GO, Ejiwunmi AB. Prevalence of palmaris longus absence: A study in the Yoruba population. Ulster Med J 2009;78:90-3.