Practical ultrasonographic technique to precisely identify and differentiate tendons and ligaments of the elbow at the level of the humeral epicondyles: anatomical study

Abstract Objectives To develop a practical step-by-step technique to precisely identify and differentiate tendons and ligaments attaching to the humeral epicondyles, to confirm through gross anatomical study the accurate structure identification provided by this technique and to determine the frequency at which each structure can be identified in healthy volunteers. Materials and methods First, ten fresh frozen cadavers (6 men, age at death = 58–92 years) were examined by two musculoskeletal radiologists and a step-by-step technique for the identification of tendons and ligaments at the level of humeral epicondyles was developed. Second, the accurate identification of structures was confirmed through gross anatomical study including anatomical sections on five specimens and layer-by-layer dissection technique on five others. Finally, 12 healthy volunteers (6 men, average age = 36, range = 28–52) were scanned by two radiologists following the same technique. Results An ultrasonographic technique based on the recognition of bony landmarks and the use of ultrasonographic signs to differentiate overlapping structures was developed and validated through gross anatomical study. In healthy volunteers, most tendons and ligaments were identified and well-defined in ≥ 80% of cases, except for the extensor carpi radialis brevis and extensor digiti minimi tendons on the lateral epicondyle (having common attachments with the extensor digitorum communis) and the palmaris longus tendon on the medial epicondyle (absent, or common attachment with the flexor carpi radialis). Conclusion A step-by-step approach to the ultrasonographic assessment of tendons and ligaments at the humeral epicondyles allowed accurate identification of and differentiation among these structures, in particular those relevant to pathological conditions.

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ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽

10.1142/s0218810410004941 ◽

2010 ◽

Vol 15 (03) ◽

pp. 157-159 ◽

Cited By ~ 3

Author(s):

Piyapong Tiyaworanan ◽

Surut Jianmongkol ◽

Tala Thammaroj

Keyword(s):

Ulnar Nerve ◽

Anatomical Study ◽

Medial Epicondyle ◽

Anatomical Location ◽

Greater Tuberosity ◽

Lateral Epicondyle ◽

Surgical Exploration ◽

Fresh Frozen ◽

The Mean ◽

Proximal Border

The incidence and the anatomical location of the arcade of Struthers as related to the arm length were studied in 62 arms of adult fresh-frozen cadavers. The distance between the greater tuberosity and the lateral epicondyle was designated as the arm length. The arcades of Struthers were identified in 85.4%. The mean arm length was 27.85 ± 1.3 cm. The mean of the distance between proximal border of the arcade of Struthers and the medial humeral epicondyle was 8.24 ± 2.06 cm. The mean ratio between the distance from the proximal border of the arcade to the tip of the medial epicondyle and arm length was 0.29 ± 0.07. We concluded that the anatomical location of the arcade as related to the arm length was 29% proximally, from the tip of the medial epicondyle. This report of the anatomical location of the arcade of Struthers related to the arm length can be useful to identify this structure in the arms which have differences in arm length during the surgical exploration and anterior transposition of the ulnar nerve procedures.

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Ulnar footprints of the distal radioulnar ligaments: a detailed topographical study in 21 cadaveric wrists

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193420944705 ◽

2020 ◽

Vol 45 (9) ◽

pp. 931-938

Author(s):

Mauro Maniglio ◽

Charles C. Lin ◽

Remy Flueckiger ◽

Matthias A. Zumstein ◽

Michelle H. McGarry ◽

...

Keyword(s):

Anatomical Study ◽

Coronal Plane ◽

Ulnar Styloid ◽

Bony Landmarks ◽

Fresh Frozen

Understanding of the exact topography of the distal radioulnar ligaments insertions remains limited. An anatomical study was performed in 21 fresh frozen cadaveric wrists, where the superficial and deep ligaments were sequentially transected sharply at their ulnar insertions. The relationships between the distal radioulnar ligament footprints relative to the bony landmarks of the ulnar styloid were digitized. Our study demonstrated that in the coronal plane, the superficial distal radioulnar ligaments inserted at an average of 87% of the styloid height proximally to the styloid tip distally. The deep distal radioulnar ligaments inserted at an average of 81% of the styloid height distally to the fovea proximally. The superficial footprint had an area of 10.6 mm2 on the ulnar styloid. The deep distal radioulnar ligaments attachment was asymmetric and generally had two separate footprints. This study adds important topographical knowledge about the footprint of the distal radioulnar ligaments and may contribute to understanding the consequences of ulnar styloid fractures and distal radioulnar ligaments lesions.

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Bony landmarks of the medial orbital wall: An anatomical study of ethmoidal foramina

Clinical Anatomy ◽

10.1002/ca.22303 ◽

2013 ◽

Vol 27 (4) ◽

pp. 570-577 ◽

Cited By ~ 8

Author(s):

Maria Piagkou ◽

Georgia Skotsimara ◽

Aspasia Dalaka ◽

Eftychia Kanioura ◽

Vasiliki Korentzelou ◽

...

Keyword(s):

Anatomical Study ◽

Bony Landmarks ◽

Orbital Wall ◽

Medial Orbital Wall

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Research Paper DNA barcode identification of fish products from Guiyang markets in southwest China

Journal of Food Protection ◽

10.4315/jfp-21-258 ◽

2022 ◽

Author(s):

Qian Tang ◽

Qi Luo ◽

Qian Duan ◽

Lei Deng ◽

Renyi Zhang

Keyword(s):

Dna Barcoding ◽

Molecular Identification ◽

Fish Consumption ◽

Southwest China ◽

Dna Barcode ◽

Guizhou Province ◽

Accurate Identification ◽

Continuous Growth ◽

Fish Products ◽

Fresh Frozen

Nowadays, the global fish consumption continues to rise along with the continuous growth of the population, which has led to the dilemma of overfishing of fishery resources. Especially high-value fish that are overfished are often replaced by other fish. Therefore, the accurate identification of fish products in the market is a problem worthy of attention. In this study, full-DNA barcoding (FDB) and mini-DNA barcoding (MDB) used to detect the fraud of fish products in Guiyang, Guizhou province in China. The molecular identification results showed that 39 of the 191 samples were not consistent with the labels. The mislabelling of fish products for fresh, frozen, cooked and canned were 11.70%, 20.00%, 34.09% and 50.00%, respectively. The average kimura 2 parameter distances of MDB within species and genera were 0.27% and 5.41%, respectively; while average distances of FDB were 0.17% within species and 6.17% within genera. In this study, commercial fraud is noticeable, most of the high-priced fish were replaced of low-priced fish with a similar feature. Our study indicated that DNA barcoding is a valid tool for the identification of fish products and that it allows an idea of conservation and monitoring efforts, while confirming the MDB as a reliable tool for fish products.

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Safe Zone for Percutaneous Screw Fixation - Talonavicular Fusion

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00430 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0043

Author(s):

Ashish Shah ◽

Sung Lee ◽

Sameer Naranje ◽

Zachariah Pinter ◽

Robert Stibolt ◽

...

Keyword(s):

Medial Branch ◽

Screw Insertion ◽

Anterior Branch ◽

Bony Landmarks ◽

Medial Plane ◽

Extensor Hallucis Longus ◽

Hindfoot Deformities ◽

Fresh Frozen ◽

Optimal Fusion ◽

Neurovascular Structures

Category: Hindfoot Introduction/Purpose: Talonavicular fusion has been established as a reliable intervention for degenerative, inflammatory, and traumatic joint lesions as well as hindfoot deformities. In order to achieve optimal fusion, various versions of the procedure have been introduced in literature and have remained a topic of contention, with the most common variation involving the insertion of 1 to 3 screws dorsomedially and dorsolaterally. Dorsolateral screw placements commonly cause neurovasculature injury. The purpose of our cadaveric study was first to establish the safety of the dorsolateral percutaneous screw insertion in relation to these dorsal neurovascular structures, and then subsequently to standardize the ideal placement of the dorsolateral screw by comparing two insertion sites based on consistent bony landmarks. Methods: Ten fresh-frozen cadaver legs amputated at the knee were used for this study. Percutaneous cannulated screws were inserted to perform isolated talonavicular arthrodesis. The screws were inserted at 3 consistent sites: “medial screw” at dorsomedial navicular where it intersected at the medial plane of the first cuneiform, “central screw” at the edge of dorsal navicular between medial and intermediate cuneiforms, and “lateral screw” at the edge of dorsal navicular between intermediate and lateral cuneiforms. Superficial and deep dissections were carried out to identify any injured nerves, arteries, and tendons. Results: The mean age at death in our sample of cadavers was 80.1 ± 7.5 years (range 68 to 92) and had the BMI of 21.8 ± 2.4 (range 18.1 to 25.1). There were 5 males (50.0%) and 5 females (50.0%). The medial screw injured the anterior tibialis tendon in 2 cases (20.0%), the central screw injured the extensor hallucis longus tendon in 3 cases (30.0%), and the lateral screw injured the anterior branch of SPN, lateral branch of SPN, and medial branch of DPN once each in a total of 3 cases (30.0%). Conclusion: TN fusion with central screw placement at the interspace between the medial and intermediate cuneiforms protects the neurovasculatures of the foot to a superior extent than lateral screws between the intermediate and lateral cuneiforms.

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The Plantar Plate of the Lesser Toes: An Anatomical Study in Human Cadavers

Foot & Ankle International ◽

10.1177/107110079401500508 ◽

1994 ◽

Vol 15 (5) ◽

pp. 276-282 ◽

Cited By ~ 112

Author(s):

Richard B. Johnston ◽

Judith Smith ◽

Timothy Daniels

Keyword(s):

Metatarsophalangeal Joint ◽

Anatomical Study ◽

Volar Plate ◽

Anatomic Structure ◽

Joint Dislocation ◽

Plantar Plate ◽

Adjacent Structures ◽

Fresh Frozen ◽

Human Cadavers ◽

Second Toe

The purpose of this study was to evaluate the anatomic structure and biochemical composition of the plantar plate of the lesser toes. Fresh frozen-human cadaveric feet were used to study 20 metatarsophalangeal and proximal interphalangeal plantar plates. The observations of foot dissections were compared with the finger volar plate. The plantar plate of the toe is a rectangular structure with a stout distal insertion and relatively flimsy proximal origin. The anatomic relationships to adjacent structures and composition are similar between the volar plates of the fingers and plantar plates of the toes. The plantar plate is known to experience extension forces that the volar plate does not experience. The weightbearing nature of the foot and forces imposed by toe-off may create chronic hyperextension of the metatarsophalangeal joint and predispose the plantar plate to attenuation or rupture, thus leading to instability of the metatarsophalangeal joint. These findings may explain in part the clinical condition of spontaneous metatarsophalangeal joint dislocation, most commonly found in the second toe.

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Monoclonal and Polyclonal Antibodies for Immunohistochemical Detection of Bovine Parainfluenza Type 3 Virus in Frozen and Formalin-Fixed Paraffin-Embedded Tissues

Journal of Veterinary Diagnostic Investigation ◽

10.1177/104063879200400404 ◽

1992 ◽

Vol 4 (4) ◽

pp. 393-399 ◽

Cited By ~ 8

Author(s):

Deborah M. Haines ◽

Jane C. Kendall ◽

Brad W. Remenda ◽

Michelle M. Breker-Klassen ◽

Edward G. Clark

Keyword(s):

Polyclonal Antibodies ◽

Accurate Identification ◽

Formalin Fixed Paraffin ◽

Formalin Fixed Paraffin Embedded ◽

Fresh Frozen ◽

Type 3 ◽

Murine Monoclonal Antibodies ◽

Formalin Fixed ◽

Immunohistochemical Testing

Accurate identification of bovine Parainfluenza type 3 virus in bovine respiratory disease requires dependable, sensitive, and specific techniques for detection in affected animals. Immunohistochemical testing can be a rapid and reliable means of demonstration of virus in tissues from suspect cases; however, this procedure is dependent upon the quality of the antisera directed against the viral antigens. The production of rabbit polyclonal and murine monoclonal antibodies directed against bovine Parainfluenza type 3 virus and techniques for their use in fresh-frozen and formalin-fixed paraffin-embedded tissues in immunofluorescence and immunoperoxidase-based immunohistochemical tests are described.

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The Accuracy of Common Hand Injections With and Without Ultrasound: An Anatomical Study

Hand ◽

10.1177/1558944717692086 ◽

2017 ◽

Vol 12 (6) ◽

pp. 591-596 ◽

Cited By ~ 5

Author(s):

Philip To ◽

Kaylan N. McClary ◽

Micah K. Sinclair ◽

Brittany A. Stout ◽

Mohab Foad ◽

...

Keyword(s):

Carpal Tunnel ◽

Anatomical Study ◽

Blue Dye ◽

Success Rates ◽

Additional Information ◽

Lower Accuracy ◽

Significant Difference ◽

Fresh Frozen ◽

Thumb Carpometacarpal ◽

Cmc Joint

Background: The aim of the study is to determine the accuracy of hand injections with and without the aid of ultrasound (U/S) into the carpal tunnel, thumb carpometacarpal (CMC) joint, first dorsal compartment (DC) and the radiocarpal (RC) joint. Methods: Four participants of various level of experience injected the carpal tunnel, thumb CMC, first DC, and RC joint into 40 fresh frozen cadaver specimens with blue dye and radiographic contrast. Participants 1 and 2 were injected without U/S guidance, and participants 3 and 4 were injected with U/S guidance. A successful injection was determined by both fluoroscopy and dissection/direct observation. Additional information was recorded for each injection such as median nerve infiltration and evidence of thumb CMC arthrosis. Results: The overall accuracy for carpal tunnel, thumb CMC, first DC, and RC injections were 95%, 63%, 90%, and 90%, respectively. Success was compared with and without U/S guidance. Success rates were similar for each injection site, except the thumb CMC joint, where U/S participants had 25% higher accuracy. In the setting of thumb CMC arthrosis, the incidence of success was 38% for participants with no U/S aid and 72% for participants with U/S aid. There was a significant difference between participants who used U/S with the participant with more U/S experience being more successful. Conclusion: Carpal tunnel, first DC, and RC injections had an accuracy of greater than 90%. Thumb CMC injections have a lower accuracy (63%) and one can improve accuracy with U/S. The accuracy of U/S-guided injections is dependent on the user and their experience.

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Quantitative Anatomic Analysis of the Medial Ulnar Collateral Ligament Complex of the Elbow

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118762751 ◽

2018 ◽

Vol 6 (3) ◽

pp. 232596711876275 ◽

Cited By ~ 13

Author(s):

Christopher L. Camp ◽

Hamidreza Jahandar ◽

Alec M. Sinatro ◽

Carl W. Imhauser ◽

David W. Altchek ◽

...

Keyword(s):

Surface Area ◽

Ulnar Collateral Ligament ◽

Surgical Reconstruction ◽

Collateral Ligament ◽

3 Dimensional ◽

Visual Center ◽

Bony Landmarks ◽

Fresh Frozen ◽

Detailed Assessment ◽

The Mean

Background: A more detailed assessment of the anatomy of the entire medial ulnar collateral ligament complex (MUCLC) is desired as the rate of medial elbow reconstruction surgery continues to rise. Purpose: To quantify the anatomy of the MUCLC, including the anterior bundle (AB), posterior bundle (PB), and transverse ligament (TL). Study Design: Descriptive laboratory study. Methods: Ten unpaired, fresh-frozen cadaveric elbows underwent 3-dimensional (3D) digitization and computed tomography with 3D reconstruction. Ligament footprint areas and geometries, distances to key bony landmarks, and isometry were determined. A surgeon digitized the visual center of each footprint, and this location was compared with the geometric centroid calculated from the outline of the digitized footprint. Results: The mean surface area of the AB was 324.2 mm2, with an origin footprint of 32.3 mm2 and an elongated insertional footprint of 187.6 mm2 (length, 29.7 mm). The mean area of the PB was 116.6 mm2 (origin, 25.9 mm2; insertion, 15.8 mm2), and the mean surface area of the TL was 134.5 mm2 (origin, 21.2 mm2; insertion, 16.7 mm2). The geometric centroids of all footprints could be predicted within 0.8 to 1.3 mm, with the exception of the AB insertion centroid, which was 7.6 mm distal to the perceived center at the apex of the sublime tubercle. While the PB remained relatively isometric from 0° to 90° of flexion ( P = .606), the AB lengthened by 2.2 mm ( P < .001). Conclusion: Contrary to several historical reports, the insertional footprint of the AB was larger, elongated, and tapered. The TL demonstrated a previously unrecognized expansive soft tissue insertion directly onto the AB, and additional analysis of the biomechanical contribution of this structure is needed. Clinical Relevance: These findings may serve as a foundation for future study of the MUCLC and help refine current surgical reconstruction techniques.

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