1Department of Anatomy, Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia; 2Laboratory for Mineralized Tissues, School of Medicine, University of Zagreb, Zagreb, Croatia; 3Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia.
Published: December 2018
AI Article Synopsis
Article Abstract
- Palmaris longus is a very variable muscle in the human body, but it is often used as an applicable tendon graft. We report on differences between one pair of identical twins regarding the existence of the palmaris longus, which were detected accidentally during examination of the presence/absence of this muscle in Caucasian population. In one of the twins, the palmaris longus was present at both forearms, while the other twin was lacking this muscle at both forearms. On search of the available literature, we found no articles about distinctions in the presence or absence of the palmaris longus in twins.
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).
We report this case of a rock climber who sustained a right ring-finger grade-III A2 pulley rupture. After failed nonoperative management, the patient underwent pulley reconstruction with ipsilateral palmaris longus autograft using a double-loop technique. The immediate postoperative course was uncomplicated, and the patient returned to painless rock climbing six months after the index procedure.
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.
Spontaneous midsubstance rupture of the flexor tendon without underlying pathology is rare. This case report describes a healthy 45-year-old man who experienced spontaneous midsubstance flexor tendon rupture at zone III. He presented with pain and disability in flexing his left little finger after carrying a plastic bag containing 20 kg and only sought medical treatment 10 days after the injury.
