A Meta-Analysis of the Surgical Availability and Morphology of the Plantaris Tendon

Abstract

Background: The tendon of the plantaris muscle (PM) is highly relevant in surgical practice. It is used as a graft for tendon/ligament repair or reconstruction in hand surgery whenever palmaris longus (PL) is lacking. Its occurrence in humans is reported to be high. Methods: A meta-analysis based on cadaveric studies was conducted to quantitatively assess PM frequency and size. Results: Data from 41 studies including 10062 leg specimens yielded the following: overall true prevalence ≈ 93%, overall crude prevalence = 90.6%, bilateral prevalence ≈ 92%, significantly more frequent on the right side, no gender significance, and no significant differences between ethnicities except that of Brazilian populations. The pooled mean length (± SD) of the PM tendon (PT) was 30.63 ± 5.87 cm and that of its width was 3.68 ± 1.37 mm. Pooled frequencies of the types of PT insertion are reported. Conclusions: This meta-analysis demonstrated a higher prevalence of PM when compared to clinical PL frequency in the literature with a tendon length double than that of PL along with an acceptable width. The surgical availability of the PM tendon was found stable across human populations; a clinical advantage when compared to the high variability of PL ethnicity-based frequency. Our results indicate that the PT is of high clinical relevance as a reliable and suitable resource for tendon grafting and reconstruction.