Palmaris longus absence in six largest Indonesian ethnicities and its relationship with gender, ethnicity, and hand dominance
Background: Palmaris longus (PL) tendon is often used as graft in tendon or ligament reconstruction. PL absence is a normal variation in human body. Its prevalence was different in various population. Serbian population had an absence rate of 42.4%, but in the Korean population it was only 4.0%. This study aimed to determine the prevalence of PL absence in various ethnic of Indonesian population and its relationship with gender and side of hand dominance.
Methods: We conducted a cross-sectional study in 1230 people from six ethnicities in Indonesia. The absence of PL was determined by Schaeffer test and confirmed with Mishra and Thompson test. Data collection was performed by a single examiner in various cities in Indonesia. The relationship between PL absence with ethnicity, gender, and hand dominance were determined by Chi-square test.
Results: Prevalence of PL absence in overall Indonesian population was 10.4% (bilateral 37.5% and unilateral 62.5%). The highest were in Batak and Madura ethnicities (15.5%), followed by Sunda (11.8%), Java (10.0%), Betawi (6.0%), and the lowest was Minang ethnicity (4.1%) (p = 0.008). Prevalence of PL absence in female and male were 10.7% 10.2%, respectively, p > 0.05).
Conclusion: Compared to range of prevalence in other countries in the world, prevalence of PL absence in Indonesian population was moderate (10.4%). There was significant difference found between ethnicity, but not in gender. Surgeon should consider this data when planning for reconstruction procedures using PL graft in Indonesian population.
Thompson JC. Netter’s concise orthopaedic anatomy. 2nd ed. O’Grady E, editor. Philadelphia: Saunders Elsevier; 2010.
Erić M1, Koprivčić I, Vučinić N, Radić R, Krivokuća D, Lekšan I , et al. Prevalence of the palmaris longus in relation to the hand dominance. Surg Radiol Anat. 2011;33(6):481-4. http://dx.doi.org/10.1007/s00276-010-0751-0
Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 5th edition. Toronto: Lippincott; 2006.
Thompson NW, Mockford BJ, Cran GW. Absence of the palmaris longus muscle: a population study. Ulster Med J. 2001;70(1):22-4.
Davidson BA. Lip augmentation using the palmaris longus tendon. Plast Reconstr Surg. 1995;95(6):1108-10. http://dx.doi.org/10.1097/00006534-199505000-00026
Naugle TC Jr, Faust DC. Autogenous palmaris longus tendon as frontalis suspension material for ptosis correction in children. Am J Ophthalmol. 1999;127(4):488-9. http://dx.doi.org10.1016/S0002-9394(98)00072-5
Atiyeh BA, Hashim HA, Hamdan AM, Kayle DI, Moucharafieh RS. Lower reconstruction and restoration of oral competence with dynamic palmaris longus vascularized sling. Arch Otolaryngol Head Neck Surg. 1998;124(12):1390-2. http://dx.doi.org/10.1001/archotol.124.12.1388
Wehbé MA. Tendon graft donor sites. J Hand Surg Am. 1992;17(6):1130-2. http://dx.doi.org/10.1016/S0363-5023(09)91079-6
Weber RV, Mackinnon SE. Median nerve mistaken for palmaris longus tendon: restoration of function with sensory nerve transfers. Hand. 2007;2(1):1-4. http://dx.doi.org/10.1007/s11552-006-9011-5
Toros T, Vatansever A, Ada S. Accidental use of the median nerve as an interposition material in first carpometacarpal joint arthroplasty. J Hand Surg Br. 2006;31(5):574-5. http://dx.doi.org/10.1016/j.jhsb.2006.05.001
Vastamäki M. Median nerve as free tendon graft. J Hand Surg Br. 1987;12(2):187-8. http://dx.doi.org/10.1016/0266-7681(87)90010-6
Geldmacher J. Median nerve as free tendon graft. Hand. 1972;4(1):56. http://dx.doi.org/10.1016/0072-968X(72)90012-5
Kovácsy A. [Removal of the median nerve instead of the palmaris longus tendon]. Magy Traumatol Orthop Helyreallito Seb. 1980;23(2):156-8. Hungarian.
Dahlan MS. Statistik untuk kedokteran dan kesehatan. 3rd ed. Jakarta: Salemba Medika; 2009. Indonesian.
Sastroasmoro S, Ismael S. Dasar-dasar metodologi penelitian klinis. 5th ed. Jakarta: Sagung Seto; 2010. Indonesian.
Dahlan MS. Besar sampel dan cara pengambilan sampel. 2nd ed. Jakarta: Salemba Medika; 2009.
Roohi SA, Choon-Sian L, Shalimar A, Tan GH, Naicker AS. A study on the absence of palmaris longus in a multiracial population. Malay Orthop J. 2007;1(1):26-8. http://dx.doi.org/10.5704/MOJ.0705.007
Na'im A, Syaputra H. Kewarganegaraan, suku bangsa, agama, dan bahasa sehari-hari penduduk Indonesia: hasil sensus penduduk 2010. Jakarta: Badan Pusat Statistik; 2011. Indonesian.
Agarwal P. Absence of the palmaris longus tendon in Indian population. Indian J Orthop. 2010;44(2):212-5. http://dx.doi.org/10.4103/0019-5413.61863
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. http://dx.doi.org/10.5115/acb.2012.45.1.53
Kigera JWM, Mukwaya S. Frequency of agenesis palmaris longus through clinical examination - an East African study. PLoS One. 2011;6(12):e28997. http://dx.doi.org/10.1371/journal.pone.0028997
Enye LA, Saalu LC, Osinubi AA. The prevalence of agenesis of palmaris longus muscle amongst students in two Lagos-based Medical Schools. Int J Morphol. 2010;28(3):849-54. http://dx.doi.org/10.4067/S0717-95022010000300029
Mbaka GO, Ejiwunmi AB. Prevalence of palmaris longus absence - a study in the Yoruba population. Ulster Med J. 2009;78(2):90-3.
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