The palmaris longus is the slender central wrist flexor whose tendon is the most commonly harvested tendon graft in hand surgery, used for zone II flexor tendon reconstruction, MPFL reconstruction, UCL repair, and many other procedures. It is absent in 14% (bilateral absence in 7%), tested by the Schaeffer test (opposing thumb and little finger with wrist slightly flexed, the PL tendon bowstrings visibly). The Z-lengthening harvest technique through two small incisions preserves the palmar fascia while obtaining a 14-16 cm graft.
| Muscle | |
|---|---|
| Attachment | Medial epicondyle (common flexor origin), inserts into the palmar aponeurosis and transverse carpal ligament, not bone |
Tensions the palmar aponeurosis; wrist flexion accessory; the most commonly used autograft tendon in hand and wrist surgery
The palmaris longus is the most superficial tendon at the front of the wrist, visible as a central cord when the wrist is flexed with thumb and little finger opposed. Its presence must be confirmed by the Schaeffer or similar tests before planning a reconstruction, since it is absent in about 14% of people. It is harvested through a small wrist incision, stripping proximally toward the muscle belly, and is used for flexor tendon grafts, ligament reconstruction, suspension arthroplasty and other procedures. Harvest causes no noticeable loss of function.
PL tendon used as autograft for zone II flexor reconstruction, MPFL repair, and ligament reconstruction. Absence in 14% requires preoperative confirmation.
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