Demir Can İlker, Yaşar Emrah Kağan, Dursun Buket, Alagöz Murat Şahin
From the Department of Plastic, Reconstructive and Aesthetic Surgery, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
Ann Plast Surg. 2021 Feb 1;86(2):237-241. doi: 10.1097/SAP.0000000000002535.
The palmaris longus (PL) is one of the most anatomically variable muscles in the body. Although these variations are often asymptomatic, symptoms related to nerve compression can sometimes be encountered. If treatment is indicated, correct diagnosis is important for successful management. In cases of upper extremity nerve compression, variations of the PL should be included in the differential diagnosis. We report a case of reversed PL (RPL) with symptoms of median nerve compression and review the literature, emphasizing the rare and challenging character of these lesions.
The literature review was performed using Google Scholar and PubMed databases. Keywords were "reversed palmaris longus," "reversed palmaris longus median nerve compression," "anomolous palmaris longus muscle," and "symptomatic palmaris longus." Only clinical RPL muscle cases with at least one of the symptoms of paresthesia and pain in the median nerve sensory area or swelling on the wrist were included.
In the literature review, 21 publications including 30 patients, matched the search criteria between 1973 and 2018 and were evaluated.
In carpal tunnel syndrome, in cases with atypical presentation, RPL should be considered in the differential diagnosis.
掌长肌（PL）是人体解剖结构变异最多的肌肉之一。虽然这些变异通常无症状，但有时会出现与神经受压相关的症状。如果需要治疗，正确诊断对于成功治疗至关重要。在上肢神经受压的病例中，PL的变异应纳入鉴别诊断。我们报告一例伴有正中神经受压症状的反向掌长肌（RPL）病例，并复习文献，强调这些病变的罕见性和挑战性。
使用谷歌学术和PubMed数据库进行文献综述。关键词为“反向掌长肌”、“反向掌长肌正中神经受压”、“异常掌长肌”和“有症状的掌长肌”。仅纳入在正中神经感觉区有感觉异常和疼痛症状之一或腕部肿胀的临床RPL肌肉病例。
在文献综述中，对1973年至2018年间符合检索标准的21篇出版物（包括30例患者）进行了评估。
在腕管综合征中，对于非典型表现的病例，鉴别诊断时应考虑RPL。
