Reconstruction of the Coracoclavicular Ligament With Palmaris Longus Tendon and Mersilene Tape for Acromioclavicular Dislocations

Background Acromioclavicular (AC) joint dislocation is common among shoulder injuries, and various surgical methods have been introduced for effective ligament reconstruction. Reconstruction of the coracoclavicular (CC) ligament in the anatomical position using autologous tendons is a recent surgical trend. This study is to report clinical and radiologic results of reconstruction of the CC ligament using an autologous palmaris longus tendon interweaved with Mersilene tape (PLMT) with a minimum 2-year follow-up. Methods This retrospective study analyzed 76 patients (mean age, 43.4 ± 11.2 years) with AC joint dislocation treated by reconstruction of the CC ligament with PLMT, from March 2004 to February 2017. The mean follow-up period was 28 ± 6.7 months (range, 24–66 months). The Visual Analog Scale (VAS) for pain assessment, American Shoulder and Elbow Surgeons rating scale (ASES), and Constant Score (CS) were used to evaluate clinical outcomes at the final follow-up. CC and AC distances were measured using anteroposterior (AP) X-ray preoperatively, 6 weeks postoperatively, and at the final follow-up for radiologic outcomes. Complications were also assessed. Results The mean preoperative VAS, ASES, CS were 5.7 ± 0.7, 77.1 ± 6.2, and 61.5 ± 5.2, respectively. These scores at the last follow-up improved to 2.1 ± 0.5, 90.9 ± 4.3, and 94 ± 7.0, respectively (p = 0.043, p < 0.001, p < 0.001). The mean preoperative CC and AC distances were 16.49 ± 3.73 mm and 13.84 ± 3.98 mm, respectively. They were 7.16 ± 1.22 mm and 3.86 ± 2.34 mm at 6 weeks postoperative, and became 9.29 ± 2.72 mm and 5.30 ± 2.09 mm at the final follow-up. The mean CC and AC distances decreased significantly at the final follow-up (p < 0.001, p < 0.001). Although a slight re-widening of the CC distance occurred in 10 patients (13.1%), most patients regained full range of motion of the affected shoulder at the final follow-up. Conclusion The CC ligament reconstruction with PLMT for the treatment of AC joint dislocation showed good clinical and radiological results. This technique could be a good alternative treatment for AC dislocations.

Palmaris profundus in the carpal tunnel

Carpal tunnel release is a routinely performed operation to relieve pressure caused by compression on the median nerve. In the majority of cases, the causation of the compression will be idiopathic. Among the secondary causes of median nerve compression is the palmaris profundus, a rare anatomical variant separate to the palmaris longus tendon. It has been suggested that it may cause carpal tunnel syndrome as it courses underneath the flexor retinaculum with the contents of the carpal tunnel reducing the space available to the median nerve. Several cases have found it intimately associated with the median nerve within the carpal tunnel. Raising awareness of this anatomical variant is therefore important for those undertaking carpal tunnel decompression in order to avoid unintended damage.

Normal reference value of orthodromic and antidromic sensory nerve conduction velocity of median nerve with intact palmaris longus tendon in apparently healthy individuals

Objectives The aim of this study was to determine normative electrophysiological reference values of median sensory nerve conduction studies among security guards with the palmaris longus tendon (PLT). Methods Sensory nerve conduction studies of the median nerve using antidromic and orthodromic methods were conducted in the upper limbs of 101 healthy male security guards between the ages of 21 and 42 years. The presence of the PLT was recorded in both hands using a standard test. A scatter plot was used to determine the correlation between different parameters using the ortho and antidromic methods. Results The mean age (years), weight (kg), height (cm), and BMI (kg/m2) were 28.77 ± 5.14, 70.53 ± 11.28, 171.71 ± 7.12, and 23.91 ± 3.45, respectively. In the median nerve (sensory) by antidromic method, the mean distal latency (DL) was 2.65 ± 0.33 ms and 2.64 ± 0.37, SNCV (sensory nerve conduction velocity) was 53.45 ± 5.28 m/s and 53.84 ± 5.68 and the amplitude was 27.33 ± 12.38 µV and 29.41 ± 12.97 in the left- and right-hand wrist, respectively. By orthodromic method the DL was 2.54 ± 0.53 ms and 2.51 ± 0.44, SNCV was 55.93 ± 6.09 m/s and 55.93 ± 5.24 and the sensory nerve action potential amplitude was 12.00 ± 8.82 µV and 11.72 ± 6.24 in the left and right hand, respectively. Spearman correlations were used to determine the variables influenced by hand sidedness. Conclusions The normative reference parameters of sensory nerve conduction velocity of the median nerve were established by both methods using a standardized technique.

Prevalensi Absensi Palmaris Longus Tendon Suku Lampung Pada Civitas Akademika Universitas Malahayati Bandar Lampung

ABSTRAK Latar Belakang : Perkembangan tendon Palmaris Longus sudah lengkap saat dilahirkan. Tendon Palmaris Longus tidak akan berkembang lagi sesudah itu. tendon Palmaris Longus sering digunakan untuk operasi rekonstruksi. Absensi pada satu atau ke dua sisi dari tendon Palmaris Longus sangat bervariasi. Hingga saat ini belum ada penelitian tentang Absensi Palmaris Longus di Lampung.Tujuan penelitian: Mengetahui Prevalensi Absensi Palmaris Longus Tendon Suku Lampung pada Civitas Akademika Universitas Malahayati Bandar Lampung.Metode Penelitian : Jenis penelitian kuantitatif, dengan rancangan observasional. Populasi penelitian ini seluruh Civitas Akademika Universitas Malahayati Bandar Lampung yang bersuku Lampung. Data diambil menggunakan teknik Total Sampling. Pemeriksaan fisik menggunakan tes Schaeffer dan dikonfirmasi dengan pemeriksaan fisik lainnya yakni Tes Mishra I, Tes Mishra II, Tes Thompson, Pushpakumar’s two fingers sign. Hasil penelitian : Dari 104 responden Absensi Palmaris Longus Tendon sebanyak 6 orang (5,8%). Absensi Palmaris Longus Tendon unilateral sebanyak 3 orang (2,9%), Absensi Palmaris Longus Tendon Bilateral sebanyak 3 orang (2,9%), dengan jenis kelamin laki-laki sebanyak 3 orang (2,9%), dan jenis kelamin Perempuan sebanyak 3 orang (2,9%).Kesimpulan : Prevalensi Absensi Palmaris Longus Tendon Suku Lampung pada Civitas Akademika Universitas Malahayati Bandar Lampung sebanyak 6 orang (5,8%). Saran untuk penelitian lebih lanjut agar mendapatkan hasil yang lebih akurat mewakili populasi Indonesia perlu subjek yang lebih homogen dan lebih banyak. Kata Kunci : Absensi Palmaris Longus Tendon, Suku Lampung ABSTRACT Background: The development of the Palmaris Longus tendon is complete at birth. The Palmaris Longus tendon will not develop again after that. The Palmaris Longus tendon is often used for reconstructive surgery. The absence on one or both sides of the Palmaris longus tendon varies widely. Until now there has been no research on Palmaris Longus Absence in Lampung.Objective: To determine the prevalence of the Palmaris Longus Tendon Absence of Lampung Tribe in the Academic Community of Malahayati University, Bandar Lampung.Methodology: This type of research is quantitative, with an observational design. The population of this research is the entire academic community of Malahayati University in Bandar Lampung, who are of Lampung ethnicity. Data were collected using the total sampling technique. The physical examination used the Schaeffer test and confirmed by other physical examinations, namely the Mishra I test, Mishra II test, Thompson's test, Pushpakumar's two fingers sign.Results: Of the 104 respondents, there were 6 Palmaris Longus Tendon attendances (5.8%). Absence of unilateral palmaris longus tendons as many as 3 people (2.9%), absence of bilateral palmaris longus tendons as many as 3 people (2.9%), with male gender as many as 3 people (2.9%), and female gender as many as 3 people (2.9%).Conclusion: The prevalence of Palmaris Longus Tendon Absence of the Lampung Tribe in the Academic Community of Malahayati University in Bandar Lampung is 6 people (5.8%). Suggestions for further research in order to get results that more accurately represent the Indonesian population need more homogeneous and more subjects. Keywords: Absence of Palmaris Longus Tendon, Lampung Tribe