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Remove the skin from the palmar surface of the hand and fingers. Be careful to remove only the skin so that the deeper structures are not injured. Beneath the superficial fascia, identify the tendon of the palmaris longus muscle, which inserts into the palmar aponeurosis. Proximal to this insertion, the tendon of palmaris longus muscle pierces the fascia of the forearm (or antebrachial fascia) and passes superficial to the flexor retinaculum. The palmaris longus muscle is absent approximately 10% of the time.
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