Variations of Plantaris, Palmaris Longus, and Fifth Superficial Flexor Tendons: a Cadaver Study

Background & Aims: The Plantaris muscle is located in the superficial posterior compartment of the leg and is absent in some individuals. The present study was undertaken to evaluate the absence variation of Plantaris muscle and its possible relation with Palmaris longus and fifth superficial flexor digitorum of the hand. Methods: 83 fresh cadavers, referred to legal medicine center, Kerman, Iran from April 2010 to November 2011 were enrolled in the study. Dissection was performed using mini incisions and the results were recorded in a questionnaire including presence or absence, length and width of the Plantaris and Palmaris longus tendons, and the presence or absence of the fifth superficial flexor. The suitability of the Palmaris and Plantaris tendons was assessed using the previously described criteria and according to the criteria that are proposed by us. Results: 8 of the 83 cadavers showed variations. Plantaris tendon was present in 80 (96.3%) and absent in 3 (3.7%), of which was absent bilaterally in two (2.3%) and unilaterally in one (1.2%). 6 cadavers (7.2%) were deficient in Palmaris longus tendon, 4 bilateral (4.8%) and 2 (2.3%) unilateral. Bilateral absence of fifth flexor digitorum superficialis was observed in 2 cadavers (2.3%) and one showed unilateral absence (1.2%). There was no statistically significant relationship (p<0.05) among the presence of Palmaris longus, plantaris and fifth superficial flexor. The plantaris tendon by far showed better characteristics for graft than the Palmaris tendon. Conclusion: According to the results of the present study, considering the Plantaris tendon for graft harvest seems logic, noting its high percentage of presence and better characteristics.