Presence of Multiple Tendinous Insertions of Palmaris Longus: A Unique Variation of a Retrogressive Muscle

Palmaris longus, being the most variable muscle of the upper extremity is generally considered important morphologically rather than functionally. The palmar aponeurosis represents the distal part of the tendon of Palmaris longus.We report here a unique case of palmaris longus presenting variation distally as its tendon divides to gain multiple attachments with the fascia covering the abductor pollicis brevis, flexor retinaculum and the tendon of flexor carpi ulnaris. In addition, it also continues as palmar aponeurosis as its normal course.Presence of this kind of variation might result in compression of the median and ulnar nerves and may aggravate the complications in case of inflammation of palmar aponeurosis thus mimicking the manifestations of Dupuytren's contracture.