scholarly journals Hypertrophied reverse palmaris longus muscle: a rare cause of carpal tunnel syndrome

2020 ◽  
Vol 7 (2) ◽  
pp. 576
Author(s):  
Narayanamurthy Sundaramurthy ◽  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Palmaris Longus ◽  
Longus Muscle ◽  
Palmaris Longus Muscle ◽  
Palmar Aponeurosis ◽  
Tunnel Syndrome ◽  
Phalen's Test ◽  
Flexor Digitorum

Carpal tunnel syndrome (CTS) is usually secondary to compression or irritation of the median nerve in the fibro-osseous canal formed by the flexor retinaculum (transverse carpal ligament) and the carpal bones. The prevalence of CTS in the general population is about 7 to 19%. Several causes both local and systemic have been described, but CTS due to aberrant musculature are rare. Here we report a case of a middle-aged female with paresthesia of the hand and a positive Phalen’s test with nerve conduction study of the median nerve showing sensorimotor neuropathy. The patient underwent surgery for open CTS release where we found a hypertrophied reverse palmaris longus muscle attached to the palmar aponeurosis which was excised along with its proximal tendon. On post-operative follow up all the symptoms of CTS were completely resolved. Muscle abnormalities concern three muscles: the palmaris longus, the flexor digitorum superficialis of index, and the lumbricals. These muscles can be hypertrophied, bifid, duplicated, digastric, inverted or have an abnormal insertion, thus creating a mechanical restriction of the carpal tunnel. Surgical resection of abnormal muscle provides excellent functional recovery. 

Palmaris Profundus of Frohse and Fränkel in Association with Carpal Tunnel Syndrome

1984 ◽  
Vol 9 (2) ◽  
pp. 142-144 ◽  
Author(s):  
M. F. FATAH
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Left Hand ◽  
Palmaris Longus ◽  
Anomalous Muscle ◽  
Longus Muscle ◽  
Palmaris Longus Muscle ◽  
Tunnel Syndrome ◽  
The Right

The occurrence of the anomalous Palmaris Profundus muscle in association with median nerve compression in the wrist in two patients is described. In one of the patients this muscle was a substitute for an absent Palmaris Longus in the left hand. In the right hand, and in the left hand in the second patient, this anomalous muscle was present in addition to the normal Palmaris Longus muscle.

scholarly journals Median Nerve Variation: A Complete Spin before Terminal Branching

2020 ◽  
Vol 15 (01) ◽  
pp. e1-e4
Author(s):  
Amgad S. Hanna ◽  
Zhikui Wei ◽  
Barbara A. Hanna
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Distal Forearm ◽  
Flexor Digitorum Superficialis ◽  
Anatomical Variant ◽  
Motor Branch ◽  
Surgical Interventions ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

AbstractMedian nerve anatomy is of great interest to clinicians and scientists given the importance of this nerve and its association with diseases. A rare anatomical variant of the median nerve in the distal forearm and wrist was discovered during a cadaveric dissection. The median nerve was deep to the flexor digitorum superficialis (FDS) in the carpal tunnel. It underwent a 360-degree spin before emerging at the lateral edge of FDS. The recurrent motor branch moved from medial to lateral on the deep surface of the median nerve, as it approached the distal carpal tunnel. This variant doesn't fall into any of Lanz's four groups of median nerve anomalies. We propose a fifth group that involves variations in the course of the median nerve. This report underscores the importance of recognizing variants of the median nerve anatomy in the forearm and wrist during surgical interventions, such as for carpal tunnel syndrome.

Surgery of the carpal tunnel

1978 ◽  
Vol 49 (2) ◽  
pp. 316-318 ◽  
Author(s):  
Noel Eboh ◽  
Donald H. Wilson
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Modified Technique ◽  
Content Type ◽  
Electrical Studies ◽  
Entrapment Neuropathies ◽  
Palmaris Longus ◽  
Tunnel Syndrome ◽  
Fine Print

✓ 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.

scholarly journals A RARE CASE OF BILATERAL FLEXOR CARPI ULNARIS VARIATION: ANATOMICAL AND CLINICAL CONSIDERATIONS AND LITERATURE REVIEW. Un caso raro de variación bilateral del músculo flexor carpi ulnaris-significado anatómico y clínico y revisión literaria

2016 ◽  
Vol 8 (2) ◽  
pp. 98-103
Author(s):  
Alexandar Iliev ◽  
Georgi P. Georgiev ◽  
Boycho Landzhov
Keyword(s):  
Median Nerve ◽  
Ulnar Artery ◽  
Lateral Side ◽  
Neurovascular Compression ◽  
Palmaris Longus ◽  
Bilateral Absence ◽  
Longus Muscle ◽  
Palmaris Longus Muscle ◽  
Flexor Carpi Ulnaris ◽  
Palmar Aponeurosis

Various aberrant muscles and fibro-tendinous structures have been identified in the anterior wrist, some of them blamed to be possible causes for neurovascular compression syndromes. Herewith, we describe such an intriguing structure related to the flexor carpi ulnaris muscle. During routine dissection of both upper limbs of an adult cadaver, an interesting crescent-shaped fibro-tendinous structure was identified bilaterally, arising broadly from the lateral side of the distal tendon of the flexor carpi ulnaris. This aberrant structure arched over the ulnar artery and nerve before they enter the canal of Guyon and the median nerve just before the carpal tunnel. Further distally, the fibro-tendinous arch narrowed and interlaced with the flexor retinaculum and palmar aponeurosis longitudinal fibres. In this case there was also concomitant bilateral absence of the palmaris longus muscle. Because this aberrant fibro-tendinous arch has very close relations to the median nerve and ulnar nerve and artery in the wrist, it may possibly cause neurovascular compression during some muscle activity.Varios músculos y estructuras fibro-tendinosas aberrantes se han identificado en la parte anterior de la muñeca, muchas de las cuales se considera que pueden causar síndromes de compresión neurovascular. A continuación describimos una tal estructura relacionada con el músculo flexor carpi ulnaris. Durante disecciones de rutina de ambos miembros superiores de cadáveres de adultos fue descubierta una estructura fibro-tendinosa con forma de medialuna en ambos miembros originando de la parte lateral del tendón distal del flexor carpi ulnaris. Esta estructura formaba un arco pasando sobre y cubriendo la arteria y el nervio ulnar antes de que entren en el canal de Guyon, y sobre el nervio mediano justo antes de que entre en el canal carpal. Este arco fibro-tendinoso seguía estrechándose hasta entrelazarse con el ligamento transverso del carpo y las fibras longitudinales de la aponeuorisis palmar .En este mismo caso el músculo palmaris longus estaba ausente en ambas manos. Esta conexión entre el arco fibro-tendinoso y el nervio mediano, la arteria y el nervio ulnar en la muñeca posiblemente puede causar compresión neurovascular durante cierta actividad muscular.

scholarly journals Anomalous Flexor Digitorum Superficialis Muscle Transposition for Vascular Coverage of the Median Nerve in Recurrent Carpal Tunnel Syndrome

2005 ◽  
Vol 13 (1) ◽  
pp. 27-30
Author(s):  
Michael W Neumeister ◽  
Arian Mowlavi ◽  
Robert C Russell ◽  
Bradon J Wilhelmi
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Carpal Tunnel ◽  
Excellent Result ◽  
Vascular Supply ◽  
Flexor Digitorum Superficialis ◽  
Palmar Fascia ◽  
Anomalous Muscle ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

Recurrent carpal tunnel syndrome is uncommon yet troublesome. Significant adhesions and scarring around the median nerve can render it relatively ischemic. A number of vascular flaps have been described to provide vascular coverage in attempts to decrease further cicatricial adhesions and to improve local blood supply around the median nerve. A rare case of an anomalous muscle in the distal forearm used as tissue to provide good vascularized coverage of the median nerve that was severely scarred in its bed is reported. The anomalous muscle was distal to the flexor digitorum superficialis tendon and inserted in the palmar fascia on the ulnar aspect of the hand. Referring branches from the ulnar artery provided vascular supply to the anomalous muscle. The muscle on these vascular pedicles was transposed over the median nerve, providing good, stable, unscarred coverage. The patient had an excellent result with resolution of the carpal tunnel symptoms. The redundant anomalous muscle provided a unique vascularized source for coverage of the median nerve in recurrent carpal tunnel syndrome.

Reversed Palmaris Longus Muscle Causing Effort-Related Median Nerve Compression

1998 ◽  
Vol 23 (1) ◽  
pp. 117-119 ◽  
Author(s):  
K. H. DEPUYDT ◽  
A. H. SCHUURMAN ◽  
M. KON
Keyword(s):  
Median Nerve ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Nerve Compression ◽  
Muscle Belly ◽  
Median Nerve Compression ◽  
Palmaris Longus ◽  
Longus Muscle ◽  
Palmaris Longus Muscle

Two cases of effort-related distal median nerve compression in the dominant forearm caused by a reversed palmaris longus muscle are presented. Simple resection of the muscle belly was performed. Carpal tunnel release was done in one case, but in retrospect this was probably not necessary.

scholarly journals Revision of Carpal Tunnel Release due to Palmaris Longus Profundus

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
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.

scholarly journals Tophaceous Gout Causing the Carpal Tunnel Syndrome and Flexor Digitorum Dysfunction: A Case Report

2021 ◽  
Vol 11 (2) ◽  
pp. 154-160
Author(s):  
D. Y. Kulakov ◽  
V. V. Lyalina ◽  
E. A. Skripnichenko ◽  
S. G. Pripisnova ◽  
A. A. Maksimov ◽  
...  
Keyword(s):  
Case Report ◽  
Carpal Tunnel Syndrome ◽  
Median Nerve ◽  
Male Patient ◽  
Carpal Tunnel ◽  
Review Of Literature ◽  
Tophaceous Gout ◽  
Peripheral Compression ◽  
Tunnel Syndrome ◽  
Flexor Digitorum

Carpal tunnel syndrome is the most common peripheral compression neuropathy and can be caused by many diseases and conditions, including the formation of gouty tophi in various structures of the tunnel. This publication provides a review of literature and a case report on Carpal tunnel syndrome in a 58-year-old male patient with tophaceous gout. The case is characterized by the extremely rare combination of median nerve compression and tendons dysfunction due to the tophi deposits in the flexor tendons of the hand.

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