Median Nerve Compression in the Distal Forearm by a Reversed Palmaris Longus Muscle in a Pediatric Patient

Abstract

Case: A 9-year-old girl presented with a 1-year history of volar wrist and hand pain accompanied by hand paresthesia. Magnetic resonance imaging described a superficial muscle belly in the distal forearm, compatible with a reversed palmaris longus (RPL). An initial trial of conservative treatment was unsuccessful, so the median nerve was explored in the distal forearm, with the release of the flexor retinaculum and resection of the RPL muscle belly. One year after surgery, the child had no symptoms. Conclusion: To the best of our knowledge, there are only 12 reported cases of RPL, and none at such a young age or symptomatic in daily routine activities such as the case presented.