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Case Reports
. 2022 May 5;4(5):303-305.
doi: 10.1016/j.jhsg.2022.04.005. eCollection 2022 Sep.

Persistent Median Artery With a Reversed Palmaris Longus and Volar Ganglion

Jack Sudduth  1 , Laura Galarza  1 , John Sullivan  1 , Marc E Walker  1
Affiliations
Case Reports

Persistent Median Artery With a Reversed Palmaris Longus and Volar Ganglion

Jack Sudduth et al. J Hand Surg Glob Online. .

Abstract

Being aware of the variants of upper extremity anatomy is of utmost importance to a surgeon. This case report describes a patient who presented with two separate wrist masses. Operative exploration was planned, and both the structures were investigated. The distal mass was identified as a volar wrist ganglion, and the more proximal mass was identified as the muscle belly of a reversed palmaris longus muscle. Incidentally, it was noted that the patient had a patent, persistent median artery. Although many variants of the palmaris longus have been described, as have been cases of a persistent median artery, both have not been previously documented in a single patient. Although this is rare, having knowledge of possible anatomic variations is valuable for any surgeon operating on the upper extremity.

Keywords: Anatomical variants; Palmaris longus; Persistent median artery; Volar ganglion; Wrist mass.

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Figures

Figure 1
Figure 1
Preoperative preparation demonstrating 2 adjacent volar wrist masses.
Figure 2
Figure 2
Sagittal and coronal magnetic resonance images demonstrating the muscle belly of the reversed palmaris longus (white arrows).
Figure 3
Figure 3
Dissection revealed the presence of the muscle belly of the reversed palmaris longus at the location of the larger mass.
Figure 4
Figure 4
The presence of a persistent median artery was found adjacent to the muscle belly of the reversed palmaris longus (white arrow).
See this image and copyright information in PMC

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