ANATOMICAL VARIATIONS OF THE PALMARIS LONGUS, CAUSING CARPAL TUNNEL SYNDROME

✓ The authors describe a modified technique for surgery of the carpal tunnel. The primary cause of the carpal tunnel syndrome is the same as other entrapment neuropathies: an enlarged nerve within a tight tunnel. Electrical studies have shown that the area of compression is in the middle of the tunnel. Treatment is surgical: a palmar incision, which begins at the wrist medial to the palmaris longus, to avoid damage to the sensory branch of the median nerve; and section of the retinaculum from the exit of the tunnel toward the entrance.

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Camitz palmaris longus abductorplasty for severe thenar atrophy secondary to carpal tunnel syndrome

The Journal Of Hand Surgery ◽

10.1016/0363-5023(93)90346-5 ◽

1993 ◽

Vol 18 (2) ◽

pp. 204-206 ◽

Cited By ~ 35

Author(s):

Andrew L. Terrono ◽

Joan H. Rose ◽

John Mulroy ◽

Lewis H. Millender

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Palmaris Longus ◽

Tunnel Syndrome ◽

Thenar Atrophy

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Simultaneous modified Camitz opponensplasty using a pulley at the radial side of the flexor retinaculum in severe carpal tunnel syndrome

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193413498328 ◽

2013 ◽

Vol 39 (6) ◽

pp. 632-636 ◽

Cited By ~ 12

Author(s):

N. Kato ◽

T. Yoshizawa ◽

H. Sakai

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Radial Side ◽

Palmaris Longus ◽

Flexor Retinaculum ◽

Tunnel Syndrome ◽

Open Carpal Tunnel Release

Camitz opponensplasty using the palmaris longus has been used in patients undergoing open carpal tunnel release. It is considered to have several advantages over other opponensplasty techniques, but it provides weak flexion and pronation, which are prerequisites for opposition. To address this shortcoming, we have used a modified Camitz procedure with a pulley at the radial side of the dissected flexor retinaculum and have assessed the results in comparison with the conventional Camitz procedure. Both procedures provided significant improvements in palmar abduction and Disabilities of the Arm, Shoulder, and Hand and Kapandji scores at 3 months post-operatively, but patients who underwent the modified Camitz procedure showed better improvement in pulp pinch, palmar abduction, and thumb pronation.

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Revision of Carpal Tunnel Release due to Palmaris Longus Profundus

Case Reports in Orthopedics ◽

10.1155/2015/616051 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 2

Author(s):

Lyrtzis Christos ◽

Natsis Konstantinos ◽

Pantazis Evagelos

Keyword(s):

Carpal Tunnel Syndrome ◽

Median Nerve ◽

Carpal Tunnel ◽

Carpal Tunnel Release ◽

Transverse Carpal Ligament ◽

Postoperative Course ◽

Palmaris Longus ◽

Tunnel Syndrome

Purpose. The palmaris longus profundus has been documented throughout the literature as a cause of carpal tunnel syndrome. We present a case of palmaris profundus tendon removal during the revision of carpal tunnel release.Method. During a carpal tunnel release in a 66-year-old woman, palmaris profundus tendon was found inside the tunnel under the transverse carpal ligament, just above the median nerve, but it was left intact. The patient complained of pain in the hand at night and weakness of her hand one month after surgery. We decided on a revision of the carpal tunnel release. The palmaris profundus tendon was found and was removed.Results. The patient had a normal postoperative course. Two months later she returned to her normal activities and was asymptomatic.Conclusions. When a palmaris profundus muscle is located in carpal tunnel, we recommend its excision during carpal tunnel release. This excision will eliminate the possibility of recurrent compression over the median nerve.

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Conservative treatment for Carpal Tunnel Syndrome caused by persistent median artery: a case report

Research Society and Development ◽

10.33448/rsd-v10i12.20884 ◽

2021 ◽

Vol 10 (12) ◽

pp. e483101220884

Author(s):

Beatriz Pereira Vaz Tamiozzo ◽

Eduardo Tavares Lima Trajano ◽

Marco Aurélio dos Santos Silva ◽

Larissa Alexsandra da Silva Neto Trajano

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Clinical Manifestations ◽

Clinical Importance ◽

Anatomical Variations ◽

Left Hand ◽

Compressive Neuropathy ◽

Volar Aspect ◽

Tunnel Syndrome ◽

Median Artery

Knowledge of a persistent median artery, defined as an anatomical vascular variation, is of clinical importance because it can be an unusual etiology of carpal tunnel syndrome. This report describes the case of a 42-year-old female patient with acute pain and paresthesia involving the volar aspect of the first, second, and third fingers of the left hand. The clinical manifestations pointed to compressive neuropathy of the median nerve, and diagnostic imaging showed anatomical vascular variation. Details were collected through interviews with the patient, and photographic records of imaging exams were thoroughly analyzed. This case study shows the importance of the identification and knowledge about anatomical variations considering that under specific pathological conditions, they can be a cause of clinical syndromes. Such knowledge is also important in the field of surgery for the prevention of iatrogenic injuries.

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The Clinical Significance of the Palmaris Longus Tendon in the Pathophysiology of Carpal Tunnel Syndrome

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2006.07.015 ◽

2006 ◽

Vol 31 (6) ◽

pp. 657-660 ◽

Cited By ~ 15

Author(s):

G. R. KEESE ◽

M. D. WONGWORAWAT ◽

G. FRYKMAN

Keyword(s):

Risk Factor ◽

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Independent Risk Factor ◽

Prospective Clinical Study ◽

Absolute Increase ◽

Longus Tendon ◽

Palmaris Longus ◽

Tunnel Syndrome ◽

Palmaris Longus Tendon

Carpal tunnel syndrome is associated with increased intracarpal canal pressure. The effect of tendon loading on intracarpal canal pressures is documented in biomechanical studies. Palmaris longus loading in wrist extension induces the greatest absolute increase in intracarpal canal pressure. Despite this fact, the palmaris longus is not yet a proven independent risk factor for the development of carpal tunnel syndrome. The purpose of this prospective clinical study was to assess and quantify the association between the presence of a palmaris longus tendon and carpal tunnel syndrome. Thirty-six carpal tunnel subjects with bilateral disease were compared with 36 controls. Each subject was clinically examined for the presence of the palmaris longus tendon. The prevalence of palmaris longus agenesis was significantly lower in the carpal tunnel group. The palmaris longus tendon is a strong independent risk factor for carpal tunnel syndrome.

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