Prevalence of Absence of Palmaris Longus tendon
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Prevalence of Absence of Palmaris Longus Tendon
Introduction to Palmaris Longus Tendon Absence
The Palmaris Longus (PL) tendon is a superficial flexor muscle in the forearm, often used in reconstructive surgeries due to its accessibility and minimal impact on hand function when absent. The prevalence of its absence varies significantly across different populations and has been a subject of extensive research.
Global Prevalence Rates
General Findings
The absence of the Palmaris Longus tendon shows considerable variation globally, with reported rates ranging from as low as 1.5% to as high as 63.9%. This wide range is influenced by factors such as ethnicity, gender, and hand dominance.
Ethnic Variations
Studies have documented significant ethnic differences in the prevalence of PL absence. For instance, in the Bahraini population, the absence rate is notably high at 36.8%, with a higher prevalence in females and a tendency for left-sided absence. In contrast, a study among North American Caucasians reported a much lower overall absence rate of 5.5%.
In the Malay population, the absence rate was found to be 11.7%, with a higher prevalence in females and no significant association with hand dominance. Similarly, in the East African population, the overall absence rate was 4.4%, with a higher likelihood of absence in the non-dominant hand.
Gender and Hand Dominance
Gender Differences
Several studies have highlighted gender differences in the prevalence of PL absence. For example, in the Bahraini population, females showed a higher prevalence of PL absence compared to males. This trend was also observed in the Malay population, where females had a higher absence rate. However, in the Nepalese population, the difference between males (14.4%) and females (15.2%) was minimal.
Hand Dominance
Hand dominance also plays a role in the prevalence of PL absence. In right-handed individuals, the absence is more common on the left side, while in left-handed individuals, it is more common on the right side. This pattern was consistent across various studies, indicating a higher likelihood of PL absence in the non-dominant hand .
Age and Bilateral Absence
Age-Related Trends
Age does not appear to significantly influence the prevalence of PL absence. A study involving different age groups found no significant differences, although younger and middle-aged groups showed a slightly lower presence rate compared to the older group.
Bilateral vs. Unilateral Absence
Bilateral absence of the PL tendon is generally less common than unilateral absence. In the Bahraini population, bilateral absence was reported in 19% of subjects, while unilateral absence was 17.9%. Similarly, in the Nepalese population, bilateral absence was observed in 3.7% of subjects, with unilateral absence being more prevalent.
Conclusion
The prevalence of the absence of the Palmaris Longus tendon varies widely across different populations, influenced by factors such as ethnicity, gender, and hand dominance. Understanding these variations is crucial for surgeons, especially when planning tendon graft surgeries. Further research, particularly using imaging assessments, is recommended to provide more accurate prevalence data and to explore the genetic and functional implications of PL absence.
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