Linburg–Comstock variation and syndrome. A meta-analysis
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Linburg–Comstock variation often connecting the flexor pollicis longus and flexor digitorum profundus of the index finger at a different level with significant discrepancy between clinical and cadaveric frequencies reported in the literature. Although this variation is quite prevalent, it is yet frequently unrecognized. The aim of this meta-analysis is to generate more accurate weighted frequency values of the Linburg–Comstock variation and to look for possible association with ethnicity, laterality, gender and side.
A systematic literature search identified 14 studies, including 4132 forearms/hands, which met the inclusion criteria.
While no significant difference was found for laterality, we found significantly higher Linburg–Comstock variation rate in females compared to males. Turkish population demonstrated a significantly higher crude frequency when compared to Europeans (22.2 vs. 15.2%). Hispanic population showed the highest crude frequency (34.5%), whereas the African ancestry showed the least one (8.8%).
Linburg–Comstock variation could cause career-threatening disabilities and could complicate some hand injuries as well. This review invites future researchers to use a single nomenclature; the term “Linburg–Comstock variation” is to be used when no symptoms are present, and the term “Linburg–Comstock syndrome” in cases where the variation is symptomatic.
KeywordsLinburg–Comstock variation Flexor pollicis longus Flexor digitorum profundus Hand Meta-analysis
Both authors contributed equally to this manuscript. Yammine K. was involved in protocol/project development, data collection or management, data analysis, manuscript writing/editing. Erić M. was involved in protocol/project development, data collection or management, data analysis, manuscript writing/editing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
No funding was received for this study.
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