TÜRK POPULASYONUNDA MUSCULUS PALMARİS LONGUS VE MUSCULUS FLEXOR DIGITORUM SUPERFICIALIS’İN GÖSTERİMİNDE KULLANILAN TESTLER ARASINDAKİ UYUMUN İNCELENMESİ

Year 2023, Volume: 24 Issue: 4, 393 - 398, 09.10.2023

Mehmet Demir , Muhammed Furkan Arpacı , Sibel Ateşoğlu Karabaş , Adem Doğaner , Atila Yoldaş

https://doi.org/10.18229/kocatepetip.1179311

Abstract

AMAÇ: Önkolda bulunan musculus palmaris longus (PL); her kişide bulunmayan, palmar fasyanın gerilmesinde rol oynayan ve rekonstruktif cerrahide kullanılan bir kas olup, klinikte bu kasın varlığının belirlenmesinde çeşitli testler kullanılmaktadır. Çalışmamızda, sağlıklı bireylerde PL ve musculus fleksor digitorum superficialis’in (FDS) gösteriminde kullanılan testlerin arasındaki uyumun incelenmesi amaçlanmıştır.
GEREÇ VE YÖNTEM: Araştırmaya 2021 Eylül ile 2022 Temmuz tarihleri arasında Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi çalışanları ile Tıp Fakültesi öğrencileri arasından gönüllülük esasına uygun olarak rastgele seçilmiş 18 yaş üstü toplam 528 kişi katıldı. PL varlığının tespiti için gönüllülere Schaeffer testi, Pushpakumar testi, Thompson testi ve Mishra II testi, FDS kası için ise FDS fonksiyon testi uygulandı. Testler arasındaki uyumların belirlenmesinde Kappa katsayısından yararlanıldı.
BULGULAR: Her iki kolda yapılan testler arasında en uyumlu olan testin Schaeffer testi olduğu ve bu testin de en yüksek oranda Pushpakumar testi ile uyumlu olduğu belirlendi (Sol kolda Kappa: 0,856; p=0.001; Sağ kolda Kappa: 0,832; p=0.001). Sağ ve sol kolda uygulanan FDS fonksiyon testi ile PL’nin belirlenmesinde kullanılan dört test arasındaki ilişkinin istatistiksel olarak anlamlı olmadığı görüldü.
SONUÇ: PL’nin belirlenmesinde en iyi uyumun Schaeffer testi ile Puspakumar testi arasında olduğu belirlendi. Her iki kola uygulanan FDS fonksiyon testi ile PL için kullanılan testler arasında herhangi bir uyumun olmadığı belirlendi. Bulgularımızın PL ve FDS’yi belirleyen klinik uygulamalara yardımcı olacağını düşünmekteyiz.

Keywords

Musculus palmaris longus, Schaeffer testi, musculus fleksor digitorum superficialis, Pushpakumar testi

Supporting Institution

yok

Project Number

Yok

Thanks

yok

INVESTIGATION OF THE COMPATIBILITY BETWEEN THE TESTS USED IN THE DISPLAY OF PALMARIS LONGUS MUSCLE AND FLEXOR DIGITORUM SUPERFICIALIS MUSCLE IN THE TURKISH POPULATION

Abstract

OBJECTIVE: The palmaris longus muscle (PL) in the forearm is a muscle that is not present in all individuals, and plays a role in stretching the palmar fascia and is used in reconstructive surgery, various tests are used to determine the presence of this muscle in the clinic. In this study, we aimed to / it was aimed to examine the compatibility between the tests used in the display of PL and musculus flexor digitorum superficialis (FDS) in healthy individuals.
MATERIAL AND METHODS: The research was carried out with a total of 528 participants over the age of 18 and randomly selected from among the staff of Kahramanmaraş Sütçü Imam University, Medical Faculty, Research and Application Hospital and the students of the Faculty of Medicine between September 2021 and July 2022. Schaeffer’s test, Pushpakumar’s test, Thompson’s test, and Mishra’s II test were applied for PL presence, whilst FDS function test was applied for the presence of the FSD in the volunteers. The Kappa coefficient was used to determine the agreement between the methods.
RESULTS: We determined that the most suitable test among the tests performed on both arms was Schaeffer's test, and this test was the most suitable with Pushpakumar's test (Left arm Kappa: 0.856; p=0.001; Right arm Kappa: 0.832; p=0.001). There was no statistical correlation between the FDS function test applied on the right and left arms and the four tests used to determine PL.
CONCLUSIONS: We determined that the best suitability in the determination of PL was between the Schaeffer test and the Puspakumar’s test, and there was no correlation between the FDS function test applied to both arms and the tests used for PL. We believe that our findings will help clinical applications that determine PL and FDS.

Keywords

Palmaris longus muscle, Schaeffer, Flexor digitorum superficialis muscle, Pushpakumar

Project Number

Yok

References

• 1.Williams PL, Warwick R, Dyson M, et al. Gray’s Anatomy. 37th Edition, Edinb: Churchill Livingstone, 1989: 406-748.
• 2. Palastanga N, Field D, Soames R. Anatomy and human movement: structure and function. 7th Edition, Elsevier Health Sciences, 2018.
• 3. Alzahrani MT, Almalki MA, Al-Thunayan TA, et al. Clinical assessment of the congenital absence of palmaris longus and flexor digitorum superficialis muscles in young Saudi population. Anat Res Int. 2017; 5342497.
• 4. Yong MW, Yusof N, Rampal L, Arumugam M. Prevalence of Absence of Palmaris Longus and Its Association with Gender, Hand Dominance and Absence of FDS Tendon to Little Finger Among Malay Population. J Hand Surg Asian Pac Vol. 2017;22(4):484-9.
• 5. Chauhan R. Atypical innervation of palmaris longus-A case report. J Anat Soc India. 2003;52(2):171–3.
• 6. Jakubietz MG, Jakubietz DF, Gruenert JG, et al. Adequacy of palmaris longus and plantaris tendons for tendon grafting. J Hand Surg Am. 2011;36(4):695-8.
• 7. Machhindra MV, Garg B, Tiwari V, Kotwal P. AIIMS test: a simple test to look for presence of palmaris longus. Musculoskelet Surg. 2015;99(2):155-8.
• 8. Erić M, Koprivčić I, Vučinić N, et al. Prevalence of the palmaris longus in relation to the hand dominance. Surg Radiol Anat. 2011;33(6):481-4.
• 9. Boltuch AD, Marcotte MA, Treat CM, Marcotte AL. The Palmaris Longus and Its Association with Carpal Tunnel Syndrome. J Wrist Surg. 2020;9(6):493-7.
• 10. Sebastin SJ, Puhaindran ME, Lim AY, Lim IJ, Bee WH. The prevalence of absence of the palmaris longus a study in a Chinese population and a review of the literature. J Hand Surg Br. 2005;30(5):525-7.
• 11. Reimann AF, Daseler EH, Anson BJ, Beaton LE. The palmaris longus muscle and tendon. A study of 1600 extremities. Anat Rec. 1944;(89): 495–505.
• 12. Schaeffer JP. On the variations of the palmaris longus muscle. Anat Rec. 1909;3:275-8.
• 13. Johnson CC, Zusstone E, Miller TT, Nwawka OK, Lee SK, Wolfe SW. Clinical tests for assessing the presence and quality of the palmaris longus tendon: diagnostic accuracy of examination compared with ultrasound. J Hand Surg Eur Vol. 2020;45(3):292-8.
• 14. Thompson JW, McBatts J, Danforth CH. Hereditary and racial variation in the musculus palmaris longus. Am J Phys Anthropol. 1921;(2)4:205-18.
• 15. Mishra S. Alternative tests in demonstrating the presence of palmaris longus. Indian J Plast Surg. 2001;34:12–4.
• 16. Pushpakumar SB, Hanson RP, Carroll S. The 'two finger' sign. Clinical examination of palmaris longus (PL) tendon. Br J Plast Surg. 2004;57(2):184-5.
• 17. RL. Drake, W. Vogl, and AWM. Mitchell (Edited by). Churchill Livingstone/Elsevier, Philadelphia, 3rd edition, USA: Gray’s Anatomy for Students, 2014.
• 18. Austin GJ, Leslie BM, Ruby LK. Variations of the flexor digitorum superficialis of the small finger. J Hand Surg Am. 1989;14(2 Pt 1):262-7.
• 19. Mugalur A, Shahane SM, Samant A, et al. Anatomic variation of palmaris longus and flexor digitorum superficialis of little finger in Indian population. SICOT J. 2015;1:5.
• 20. Katusime A, Kigera JWM. Clinical assessment of the flexor digitorum superficialis muscle to the fifth finger accuracy of common tests. SA Orthopaedic Journal. 2012;11(4):52–4.
• 21. Yammine K. Clinical prevalence of palmaris longus agenesis: a systematic review and meta-analysis. Clin Anat. 2013;26(6):709-18.
• 22. Loannis D, Anastasios K, Konstantinos N, Lazaros K, Georgios N. Palmaris Longus Muscle's Prevalence in Different Nations and Interesting Anatomical Variations: Review of the Literature [published correction appears in J Clin Med Res. 2015;7(11):825-30.
• 23. Kigera JWM, Mukwaya S. Clinical Assessment of the Palmaris Longus–Accuracy of common tests. Ann Afr Surg. 2012;9:104-7.
• 24. Kyung DS, Lee JH, Choi IJ, Kim DK. Different frequency of the absence of the palmaris longus according to assessment methods in a Korean population. Anat Cell Biol. 2012;45(1):53-6.
• 25. Sadeghifar A, Kahani AK, Saied A, Rasayi E. Interobserver and intraobserver reliability of different methods of examination for presence of palmaris longus and examination of fifth superficial flexor function [published correction appears in Anat Cell Biol. Anat Cell Biol. 2018;51(2):79-84.
• 26. Baker DS, Gaul JS, Williams VK, Graves M. The little finger superficialis-clinical investigation of its anatomic and functional shortcomings. J Hand Surg. 1981;(6): 374–8.
• 27. Abhilasha W, Charulata S. A study of absence of Palmaris Longus tendon and its association with other anatomical anomalies-a central Indian population study. IJSR. 2015;4(5):819-22.