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Clinical assessment of absence of the Palmaris longus muscle in African Antiguan population.
Abstract
Background: The knowledge of the prevalence of the palmaris longus (PL) tendon according to gender and ethnicity is important for surgeons planning to use its tendon for transfer and transplant. Unfortunately, there is no information related to the prevalence of PL agenesis in the African Antiguan population. This study aimed to determine the prevalence of PL agenesis and its association with gender, body side and hand dominance in the African Antiguan population by using the Chi-square test.
Methods: In this random cross-sectional study, six hundred African Antiguan subjects (300- males and 300- females; age range 18-62 years) were tested for the absence of PL tendon, using Schaffer’s test. In subjects with negative Schaffer's test, Thompson's test, Mishra's test I, Mishra's test II, and Pushpakumar's "two-finger sign" method were used to confirm its absence.
Results: Overall agenesis of PL in the present study reached 12.8%, unilateral agenesis (7%) was more common than bilateral absence (5.8%). The PL agenesis was found significantly greater (p=0.037) in females (15.6%) than the males (10%). The muscle agenesis was significantly more often on the left side than the right (p=0.02). In both right-hand (p>0.05) and left-hand (p<0.05) dominant subjects, the left-sided agenesis was greater.
Conclusions: This study reaffirms the existence of ethnic differences in the prevalence of PL agenesis. The prevalence of PL agenesis in the African Antiguan population is lesser than the reported incidence of 15% in standard textbooks, and much higher than the black and Asian population. The PM tendon is prevalent in vast majority (87.2%) of African Antiguans, and it is not diminishing rapidly like in middle eastern populations. Hence the surgeons can still harvest the tendon for various reconstructive and tendon graft surgery in African Antiguans.
