Palmaris profundus and carpal tunnel syndrome: is it really a palmaris muscle?

The palmaris profundus (PP) is a variable muscle present in the flexor muscle region of the forearms. Its implication in the etiopathogenesis of carpal tunnel syndrome has been discussed in the literature. We present a case of a PP with a characteristic morphology, associated with a bifid median ner...

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Bibliographic Details
Authors: Ortiz, Alejandro, Aranda, Eduvigis, Sañudo Tejero, José Ramón, Aragonés Maza, Paloma
Format: article
Publication Date:2022
Country:España
Institution:Universidad Complutense de Madrid (UCM)
Repository:Docta Complutense
Language:English
OAI Identifier:oai:docta.ucm.es:20.500.14352/107201
Online Access:https://hdl.handle.net/20.500.14352/107201
Access Level:Open access
Keyword:611
Palmaris profundus
Median nerve
Carpal tunel
Palmaris longus
Radio-carpian muscle
Ciencias Biomédicas
32 Ciencias Médicas
Description
Summary:The palmaris profundus (PP) is a variable muscle present in the flexor muscle region of the forearms. Its implication in the etiopathogenesis of carpal tunnel syndrome has been discussed in the literature. We present a case of a PP with a characteristic morphology, associated with a bifid median nerve (MN), found during surgery for a recurrence of carpal tunnel syndrome in a 51-year-old female patient. The PP muscle was first described with this morphology by Frohse in 1908. Initially, this muscle was considered an anatomical variation of the palmaris longus, but since 1984 the existence of both muscles has been observed in the same forearm, so the PP is considered an accessory muscle. Some authors associate the existence of a PP with compression of the median nerve in the carpal tunnel. Others, however, argue that it may be an aggravating factor but not the primary cause, or simply a casual finding during surgery. We believe that this tendon is not the primary cause of compression of the MN, but it can aggravate the situation in case of a reduced canal due to any other cause, so we recommend surgeons to resect it if it is found. Furthermore, based on the embryological origin of the forearm muscles, we believe that this PP could actually be the radio-carpal, radio-palmar or short radial forearm muscle described as early as the 19th century.