Palmaris longus muscle, although of little functional use to the human upper limb, assumes great importance when used as a donor tendon for transfer or transplant. The variability in the prevalence of palmaris longus agenesis among various ethnic groups has been established, and the surgeon's awareness of the prevalence in a population or ethnic group is desirable. The prevalence of palmaris longus agenesis has, to the best of the authors' knowledge, not been reported in Indian patients. Five hundred Indian patients were examined for the presence or absence of palmaris longus tendon, using the conventional test for presence of palmaris longus. The prevalence and pattern of palmaris longus agenesis was analyzed statistically and any difference in prevalence or pattern of palmaris longus agenesis with regard to body side or sex was looked for. All statistical analysis was done using SPSS (version 12). chi2 test was used to analyze the association of agenesis with limb laterality and sex. The prevalence of palmaris longus agenesis was found to be 17.2% (8% bilateral and 9.2% unilateral). The prevalence of agenesis was significantly more common on the left side. Male subjects had a greater likelihood of unilateral agenesis, while female subjects were more likely to have bilateral agenesis. That prevalence of palmaris longus agenesis is race dependent is reaffirmed in the present study. Although the prevalence of palmaris longus agenesis in Indian patients was found to be much higher than the reported average prevalence in an Asian population, this tendon can still be counted on by surgeons treating Indian patients for use as a donor tendon, which will be present in a vast majority of Indian patients.
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http://dx.doi.org/10.1111/j.1447-073X.2007.00199.x | DOI Listing |
Arch Bone Jt Surg
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Department of Hand and Reconstructive Microsurgery, National University Hospital, Singapore.
Prague Med Rep
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Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India.
Several muscle variations have been observed in flexor aspect of forearm which can hamper normal functioning of hand or may remain silent. One such unreported variation has been described in this report. An accessory muscle in the left forearm was found involving flexor carpi ulnaris (FCU) and palmaris longus (PL).
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Since Dr. Frank Jobe performed the initial surgery on Tommy John in 1974, the ulnar collateral ligament (UCL) reconstruction (UCLR), colloquially "Tommy John Surgery," described in 1986 has evolved as the gold standard treatment for UCL tears. The crux of technique modifications involve flexor pronator mass (FPM) management, ulnar nerve transposition (UNT), graft selection, or graft-fixation options.
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