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A very rare case of the accessory palmaris longus muscle and clinical significance
Affiliations- Department of Anatomical Dissection and Donation, Medical University of Lodz, Poland
- Orthopaedics and Paediatric Orthopaedics Department, Medical University of Lodz, Poland
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Abstract
The palmaris longus muscle is located in the forearm region. It morphological variability was noted during standard anatomical dissection of the upper limb. The muscle was characterized by a normal course, i.e. originating from the medial humeral epicondyle and inserting to the palmaris aponeurosis, but a small additional tendon attached to the flexor retinaculum was observed in its distal part. An accessory palmaris longus muscle was also observed nearby. Interestingly, this accessory muscle was reversed, and the first part was not muscular, but tendinous, represented by two tendons originating from the common muscular mass attached to the medial epicondyle of the humerus; these later connected together, creating one muscle belly distally attached to the flexor retinaculum. This additional structure was innervated by a neural branch from the median nerve and the ulnar artery was responsible for blood supply. The course of the median nerve is also clinically important, because before entering the carpal tunnel, it was located directly under the accessory palmaris longus muscle. In turn, the ulnar artery passed through a special hole created by the flexor digiti minimi brevis and flexor retinaculum, before passing under the palmaris brevis muscle.
Abstract
The palmaris longus muscle is located in the forearm region. It morphological variability was noted during standard anatomical dissection of the upper limb. The muscle was characterized by a normal course, i.e. originating from the medial humeral epicondyle and inserting to the palmaris aponeurosis, but a small additional tendon attached to the flexor retinaculum was observed in its distal part. An accessory palmaris longus muscle was also observed nearby. Interestingly, this accessory muscle was reversed, and the first part was not muscular, but tendinous, represented by two tendons originating from the common muscular mass attached to the medial epicondyle of the humerus; these later connected together, creating one muscle belly distally attached to the flexor retinaculum. This additional structure was innervated by a neural branch from the median nerve and the ulnar artery was responsible for blood supply. The course of the median nerve is also clinically important, because before entering the carpal tunnel, it was located directly under the accessory palmaris longus muscle. In turn, the ulnar artery passed through a special hole created by the flexor digiti minimi brevis and flexor retinaculum, before passing under the palmaris brevis muscle.
Keywords
accessory palmaris longus, bifurcated palmaris longus, median nerve compression, morphological variations, Palmaris longus, palmaris profundus, reversed palmaris longus
About this articleTitle
A very rare case of the accessory palmaris longus muscle and clinical significance
Journal
Issue
Article type
Case report
Published online
2023-11-08
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192
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222
DOI
Pubmed
Keywords
accessory palmaris longus
bifurcated palmaris longus
median nerve compression
morphological variations
Palmaris longus
palmaris profundus
reversed palmaris longus
Authors
Nicol Zielinska
Andrzej Borowski
Marek Drobniewski
Krystian Maślanka
Piotr Karauda
Łukasz Olewnik
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