Indian Journal of Plastic Surgery
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Year : 2008  |  Volume : 41  |  Issue : 1  |  Page : 95-96

Unusual palmaris longus muscle

Department of Anatomy, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka, India

Correspondence Address:
Bhagath Kumar Potu
Department of Anatomy, Kasturba Medical College, Manipal University, Manipal - 576 104, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0970-0358.41125

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How to cite this article:
Thejodhar P, Potu BK, Vasavi RG. Unusual palmaris longus muscle. Indian J Plast Surg 2008;41:95-6

How to cite this URL:
Thejodhar P, Potu BK, Vasavi RG. Unusual palmaris longus muscle. Indian J Plast Surg [serial online] 2008 [cited 2017 Jul 24];41:95-6. Available from:

Dear Sir,

The palmaris longus muscle (PLM) is a slender fusiform muscle, whose short muscle belly arises from the medial epicondyle with a common flexor origin. Its long slender tendon passes palmar to the transverse carpal ligament and is attached to the distal half of its anterior surface and centrally to the Palmar aponeurosis. It is one of the most variable muscles of the human body and is classified as a phylogenetically retrogressive muscle, i.e ., a short belly with a long tendon. [1] In vertebrates, it is found only in mammals and is best developed where the forelimb is used for ambulation. [2] For example, the Palmaris longus is always present in the orangutan [3] but is variably absent in higher apes such as chimpanzees and gorillas. [2] In humans, the absence of Palmaris longus appears to be hereditary but its genetic transmission is not clear. [3]

During a routine dissection of the forearm of a 39 year-old male cadaver in the Department of Anatomy, Kasturba Medical College (K.M.C), Manipal, we observed that the Palmaris longus muscle on the left side was muscular from its origin right up to the wrist and then continued as the Palmar aponeurosis.

Reimann et al , examined 1600 extremities and found incidence rates of 12 and 9% of agenesis and other anomalies respectively. Variations in form constituted 50% of these anomalies. The muscle belly may be central, distal or digastric or it may be completely muscular. [4] Variations also include unilateral absence of the Palmaris longus tendon as well.

Many surgeons agree that the Palmaris longus tendon is the first choice as a donor tendon because it fulfils the necessary requirements of length, diameter and availability, and can be used in reconstructive surgery for a wide variety of procedures including lip augmentation, [5] ptosis correction [6],[7] and in the management of facial paralysis [8] without producing any functional deformity. [9]

The Palmaris longus tendon is often considered the ideal donor for tendon grafts for replacement of the long flexors of the fingers and of the Flexor Pollicis longus tendon [Figure 1]. [10]

PL anomalies are very important for hand surgeons. In spite of being a landmark to the structures of the wrist, the variations of this tendon may confuse even an experienced surgeon. The clinician must consider this possibility if there is any suspicion of an abnormal swelling in the distal forearm.

  References Top

1.Koo CC, Roberts AH. The palmaris longus tendon, another variation in its anatomy. J Hand Surg Br 1991;22:138-9.  Back to cited text no. 1    
2.Vanderhooft E. The frequency and relationship between the palmaris longus and plantaris tendons. Am J Orthop 1996; 25:38-41.  Back to cited text no. 2  [PUBMED]  
3.Wehbe MA, Mawr Bryn. Tendon graft donor sites. J Hand Surg Am 1992;17:1130-2.  Back to cited text no. 3    
4.Reimann AF, Daseler EH, Anson BJ, Beaton LE. The palmaris longus muscle and tendon: A study of 1600 extremeties. Anat Rec 1944;89:495-505.  Back to cited text no. 4    
5.Davidson BA. Lip augmentation using the palmaris longus tendon. Plast Reconstr Surg 1995;95:1108-10.  Back to cited text no. 5  [PUBMED]  
6.Kurihara K, Kojima T, Marumo E. Frontalis suspension for blepharoptosis using palmaris longus tendon. Ann Plast Surg 1984;13:274-8.  Back to cited text no. 6  [PUBMED]  
7.Naugle TC Jr, Faust DC. Autogeneous palmaris longus tendon as frontalis suspension material for ptosis correction in children. Am J Ophthalmol 1999;127:488-9.  Back to cited text no. 7  [PUBMED]  
8.Atiyeh BA, Hashim HA, Hamdan AM, Kayle DI, Musharafieh RS. Lower reconstruction and restoration of oral competence with dynamic palmaris longus vascularised sling. Arch Otolaryngol Head Neck Surg 1998;124:1390-2.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Troha F, Baibak GJ, Kelleher JC. Frequency of the palmaris longus tendon in North American Caucasians. Ann Plast Surg 1990;25:477-8.  Back to cited text no. 9  [PUBMED]  
10.Zeybek A, Giiriinluoglu R, Cavdar S, Bayramigli M. A clinical reminder: A palmaris longus muscle variation. Ann Plast Surg 1998;41:224-5.  Back to cited text no. 10    


  [Figure 1]

This article has been cited by
1 Variation in the insertion of the palmaris longus tendon
V Sunil,S Rajanna,HT Gitanjali,J Kadaba
Singapore Medical Journal. 2015; 56(01): e7
[Pubmed] | [DOI]


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