scholarly journals Morphometric analysis of patella and patellar ligament: a cadaveric study to aid patellar tendon grafts

2021 ◽  
Author(s):  
Ashwini Aithal Padur ◽  
Naveen Kumar ◽  
Melissa Glenda Lewis ◽  
Varalakshmi Chandra Sekaran
Keyword(s):  
Acl Reconstruction ◽  
Morphometric Analysis ◽  
Patellofemoral Joint ◽  
Lower Limbs ◽  
Patellar Ligament ◽  
South Indian Population ◽  
Morphometric Data ◽  
Positive Correlation ◽  
Left Limb ◽  
The Right

Abstract Purpose Morphometric analysis of the patella and the patellar ligament is crucial in diagnosing and surgical corrections of knee injuries and patellofemoral joint disorders. Dimensions of the patella and the patellar ligament are frequently used in implant design and ACL reconstruction. This study aims to obtain detailed morphometric data on the patellar ligament and its localization based on gross anatomical dissections in the adult cadavers. Methods The present study consisted of 50 lower limbs from formalin-fixed male adult cadavers aged about 70 years (45–85) belonging to the South Indian population. Total length of the quadriceps tendon, patellar height, patellar ligament height, proximal width, distal width and thickness of the patellar ligament were measured meticulously. Mean, standard deviation, median scores of each parameter were computed for groups using SPSS 16.0. Level of significance was considered as p < 0.05. Wilcoxon signed-rank test was used to compare the various parameters on the right and left limbs. The relationships between all parameters were analyzed using Spearman’s rank correlation test. Results There was no statistically significant difference in the various measurements of the patella and patellar ligament between the right and left lower limbs. Patellar ligament length showed positive correlation with ligament thickness (r = 0.36; p = 0.078 for right limb and r = 0.33; p = 0.104 for left limb). Proximal width of ligament showed significant positive correlation with distal width (r = 0.41; p = 0.041 for right limb and r = 0.54; p = 0.006 for left limb). Conclusion This morphometric data and analysis might be fundamental in understanding various knee conditions in situ and necessary to orthopedic surgeons for successful planning and execution for ACL reconstruction using patellar ligament graft and other patellofemoral joint disorders. Level of evidence I

scholarly journals Estimation of the Humerus Length by its Proximal Segments: A South Indian Anatomical Study

2019 ◽  
Vol 36 (02) ◽  
pp. 067-071
Author(s):  
Kasargod Umesh Prashanth ◽  
Mangala Manohar Pai ◽  
Bukkambudhi Virupakshamurthy Murlimanju ◽  
Latha Venkatraya Prabhu ◽  
Manoor Dass Prameela
Keyword(s):  
Indian Population ◽  
Anatomical Study ◽  
South Indian Population ◽  
Regression Equations ◽  
Morphometric Data ◽  
The South ◽  
South Indian ◽  
Pearson Coefficient ◽  
Best Parameter ◽  
The Right

Introduction To determine the morphometric data of the proximal segments of the humerus in the South Indian population, and to obtain the regression equations that will enable us to predict the whole length of humerus. Materials and Methods The present study included 166 dried adult human humeri. Their lengths were measured by using the osteometric board. The seven proximal segment lengths of the humeri were assessed by using a digital Vernier caliper (Mitutoyo Corporation 150 mm/6 inch, model number 500-196-20, Kawasaki, Japan). Results The mean humerus length in the present study was 30.75 ± 2.03 cm on the right side and 30.27 ± 2.28 cm on the left side. The comparison between the right and left sides of the proximal segments of the humerus did not yield statistically significant results (p > 0.05). The present study observed that the relationship between the dimensions of the proximal segments of the humerus and the length of humerus were strong (p = 0.00). The oblique length between the most proximal and distal points over the anatomical neck was the best parameter to predict the length of humerus (the Pearson coefficient was 0.78 for the right side and 0.77 for the left side). Conclusion The simple regression formulae, which were derived in this study, are helpful in the estimation of the length of the humerus. The formulae can be used in forensic investigations, in which the stature of a person has to be determined and only bone fragments are available. The morphometric data of the present study have implications in archaeological and anthropological studies. The data are enlightening to orthopedicians, when planning reconstructive surgeries of the proximal end of the humerus in the South Indian population.

scholarly journals Successive development of ischemic stroke and hemorrhagic stroke in a patient with essential thrombocythemia: a case report

2021 ◽  
Vol 49 (1) ◽  
pp. 030006052098771
Author(s):  
Xuhui Chen ◽  
Liming Cao ◽  
Hongye Feng ◽  
Xuming Huang
Keyword(s):  
Ischemic Stroke ◽  
Essential Thrombocythemia ◽  
Sinus Thrombosis ◽  
Stable Condition ◽  
Lower Limbs ◽  
Subdural Hemorrhage ◽  
Vascular Events ◽  
Limb Weakness ◽  
Left Limb ◽  
The Right

Patients with essential thrombocythemia (ET) can experience hemorrhagic or ischemic vascular events. The prevention of these complications is challenging, and the overall risk of vascular events caused by ET is often overlooked. A 34-year-old man was admitted for a 10-day history of weakness and numbness in his right limbs. He had been diagnosed with ET in 2008 but had stopped receiving treatment half a year before admission. Physical examination showed a superficial sense of disturbance in the right limbs and decreased muscle strength in the right upper and lower limbs (4/5). His platelet count (459 × 109/L) was elevated. Magnetic resonance imaging showed acute watershed infarction, and he was treated successfully. However, he was readmitted for headache and left limb weakness 14 months later. A head computed tomography scan revealed spontaneous subdural hemorrhage. He underwent subdural hematoma removal and decompressive craniectomy. Surgery and pathological investigation revealed no venous sinus thrombosis or vascular malformation. His condition improved, and he exhibited a stable condition 1 year after discharge. Successive development of ischemic stroke and spontaneous subdural hemorrhage is rare in a patient with ET. This case suggests that ET is not only a risk factor for stroke but can also cause highly heterogeneous strokes.

scholarly journals Dyke-Davidoff-Masson Syndrome as a rare congenital hemiatrophy: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Azubuike Benjamin Nwako ◽  
Charles Emeka Nwolisa ◽  
Okechukwu Francis Nwako ◽  
Magaret-Lorritta Chidimma Nwako
Keyword(s):  
Facial Asymmetry ◽  
Rare Condition ◽  
Lower Limbs ◽  
Sub Saharan Africa ◽  
Ventricular Dilatation ◽  
Cerebral Hemiatrophy ◽  
Appropriate Treatment ◽  
Left Limb ◽  
Sub Saharan ◽  
The Right

Introduction: Dyke-Davidoff-Masson syndrome (DDMS) is a rare condition in childhood with very few cases reported in sub-Saharan Africa. Typically, the patient presents with facial asymmetry, seizures, and hemiparesis. Radiological findings include cerebral hemiatrophy, ipsilateral lateral ventricular dilatation, and hypertrophy of the calvarium and sinuses. Case presentation: We present the report of a 3-year-old male with weakness of right upper and lower limbs, facial asymmetry, and seizures. Physical examination showed a well-nourished child with a squint of the right eye. There were brisk tendon reflexes with right-sided hemiplegia which is spastic with left limb preference. Computer tomography of the brain showed atrophy of the left cerebral hemisphere, ipsilateral lateral ventricular dilatation, and thickening of the ipsilateral cranium. The diagnosis of Dyke-Davidoff-Masson syndrome was made. He was treated with sodium valproate and lamotrigine and presently physiotherapy and he had remained seizure-free. Conclusion: Dyke-Davidoff-Masson syndrome still affects children despite being a rare condition. There is a need for appropriate clinical and radiological assessment for the diagnosis of DDMS. Early identification and appropriate treatment will improve the general outcome of children with DDMS.

scholarly journals Lateralidad de miembro inferior y su relación con la distribución de las presiones plantares en el equilibrio estático (Laterality of lower limbs and relationship with the plantar pressure distribution in the static balance)

Retos ◽  
2015 ◽  
pp. 5-8
Author(s):  
Carmen Mayolas Pi ◽  
Adoración Villarroya Aparicio ◽  
Joaquín Reverter Masia
Keyword(s):  
Lower Limb ◽  
Dynamic Balance ◽  
Lower Limbs ◽  
Static Balance ◽  
Lateral Preference ◽  
Plantar Pressures ◽  
Left Limb ◽  
The Individual ◽  
The Right ◽  
Sole Of The Foot

La distribución de las cargas durante la marcha se ha valorado en muchos estudios, en algunos de los cuales se ha observado la influencia de la lateralidad del individuo en esta distribución. Sin embargo, en estático se han realizado pocos estudios que valoran las posibles causas de una distribución no equitativa de las cargas, algunos según la visión o no del espacio colindante y según la influencia de la lateralidad visual. En nuestro estudio vamos a observar si influye la preferencia lateral del miembro inferior en la distribución de la carga en la planta del pie, utilizando tres pruebas para valorar la dominancia lateral: chute con precisión, equilibrio dinámico y equilibrio estático (Maupas y cols., 2002). Según nuestros resultados, la preferencia lateral de miembro inferior no influye de forma significativa en la distribución de las cargas en la planta del pie, sin embargo, observamos una tendencia a que aumente la carga del miembro izquierdo en los diestros (según las pruebas de equilibrio dinámico y chute con precisión) y en el miembro derecho en los zurdos.Palabra clave: lateralidad, presiones plantares, equilibrio estático, test lateralidad.Abstract: The distribution of loads during gait has been evaluated in many studies, some of which have been seen to influence the handedness of the individual in this distribution. However, in the static pool, several studies have been carried out which assess the possible causes of inequitable distribution of the charges, some according to the vision or adjoining space and according to influence of visual laterality. In our study we will observe the influence of the lateral lower limb preference in the distribution of the load on the sole of the foot, using three tests to assess the lateral dominance: shoot with precision, dynamic balance and static balance (Maupas et al. 2002). According to our results, lower limb lateral preference does not influence significantly the distribution of charges in the sole of the foot, however, we observe a tendency to increase the load/weight on the left limb in righthanded people (according to tests of balance dynamic and precision shot) and on the right limb in left handed people.Key words: laterality, plantar pressures, static balance, laterality test.

scholarly journals Biomechanical Assessment of the Strength of Volleyball Players in Different Stages of the Training Macrocycle

2015 ◽  
Vol 22 (3) ◽  
pp. 148-152
Author(s):  
Marcin Śliwa ◽  
Tomasz Sacewicz
Keyword(s):  
Lower Limbs ◽  
Training Methods ◽  
Lower Velocity ◽  
Locomotor System ◽  
Strength Capacity ◽  
Extensor Muscles ◽  
Left Limb ◽  
Volleyball Players ◽  
Torque Values ◽  
The Right

Abstract Introduction. In order to help volleyball players achieve superior results, their coaches are constantly seeking new training methods. One of the methods used to improve the effectiveness of the training that is being implemented is conducting tests which make it possible to assess the player’s locomotor system in terms of its motor and biomechanical functions. The aim of the study was to determine the torque of the knee flexor and extensor muscles of volleyball players in three stages of the annual macrocycle. Material and methods. The study involved 14 volleyball players. Torque was assessed using the BIODEX System 4 Pro at the angular velocities of 60°/s and 180°/s, in three periods of the annual training macrocycle. Results. After the preparatory training period, there was a statistically significant increase in the torque of the flexor and extensor muscles of the lower limbs, both for the lower velocity (p ≤ 0.02 for the right limb and p ≤ 0.024 for the left limb) and the higher one (p ≤ 0.03 for the right limb and p ≤ 0.034 for the left limb). After the preliminary round, statistically insignificant changes were found for the torque values obtained at both velocities. Conclusions. The study showed that frequent monitoring of players can help assess their strength capacity in a more reliable way. The results of such measurements carried out in different periods of the volleyball season can help evaluate the players’ strength at a given moment, verify and modify the training methods which are being used, and approach each player individually.

scholarly journals Prevalence of the additional head of quadriceps femoris in the South Indian population: a cadaveric and radiological study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Femina Sam ◽  
Madhavi Kandagaddala ◽  
Ivan James Prithishkumar ◽  
Koyeli Mary Mahata ◽  
Mahasampath Gowri ◽  
...  
Keyword(s):  
Indian Population ◽  
Vastus Lateralis ◽  
Femoral Nerve ◽  
Quadriceps Femoris ◽  
Lower Limbs ◽  
South Indian Population ◽  
The South ◽  
South Indian ◽  
Circumflex Femoral Artery ◽  
Vastus Intermedius

AbstractQuadriceps femoris is an extensor muscle in the anterior compartment of thigh and is traditionally taught to be composed of four heads. Recently, there is an increased interest in the occurrence of an additional muscle head of quadriceps femoris. But scientific knowledge regarding its incidence is lacking in the South Indian population. This study was done to confirm the presence of the additional head by routine anatomic dissection and radiological imaging techniques. Forty-one formalin fixed human cadaveric lower limbs were dissected and the morphology of the additional head was noted. Retrospective analysis of 88 MRI images of patients was done. The additional muscle head was present in 43.9% of the cadaveric lower limbs and was consistently located between the vastus lateralis and vastus intermedius. It originated from variable portions of the greater trochanter, intertrochanteric line, lateral lip of linea aspera and lateral surface of the shaft of femur and inserted either as a muscle belly or as an aponeurosis into the vastus intermedius (55.6%), vastus lateralis (22.2%) or directly into the base of the patella. It received its vascular supply from branches of the lateral circumflex femoral artery and was innervated by branches from the posterior division of the femoral nerve. In addition, the additional muscle head was identified by MRI and its incidence was reported to be 30.68% for the first time in living subjects. The result of this study provides additional information in understanding the morphology of the quadriceps femoris muscle.

Morphometric analysis of the actions of angiotensin II on renal arterioles and glomeruli

1992 ◽  
Vol 262 (3) ◽  
pp. F367-F372 ◽  
Author(s):  
K. M. Denton ◽  
P. A. Fennessy ◽  
D. Alcorn ◽  
W. P. Anderson
Keyword(s):  
Electron Microscopy ◽  
Angiotensin Ii ◽  
Vascular Resistance ◽  
Morphometric Analysis ◽  
Unit Length ◽  
Average Difference ◽  
Outer Cortex ◽  
Efferent Arteriole ◽  
Transmission Electron ◽  
The Right

To study the effects of angiotensin II on afferent and efferent arteriole diameters and on intraglomerular dimensions, angiotensin II (20 ng.kg-1.min-1) or saline vehicle was infused intravenously for 20 min into anesthetized rabbits pretreated with enalapril. Both kidneys were perfusion fixed (glutaraldehyde), and vascular casts were made of the right kidneys using methacrylate. Morphometric analysis of the left kidneys using transmission electron microscopy revealed no significant effects of angiotensin II within the glomerulus, including the degree of mesangial contraction. The diameters of the afferent and efferent arteriole casts from the right kidneys were measured at 20, 50, and 75 microns from the glomerulus by scanning electron microscopy. In the outer cortex the mean diameters of the afferent and efferent arterioles were 14.1 +/- 0.8 and 9.7 +/- 0.5 microns, respectively, in the angiotensin II-infused rabbits, significantly less than in the control (vehicle) rabbits, 17.0 +/- 0.7 microns (P less than 0.001) and 10.7 +/- 0.4 microns (P less than 0.005), respectively. Calculation of the relative changes in vascular resistance, however, indicated that the effects of angiotensin II on efferent arteriole resistance (average difference 2.4 +/- 1.2 units/microns) were significantly greater per unit length than the effects on afferent arteriole resistance (average difference 0.9 +/- 0.3 units/microns). Thus infused angiotensin II caused greater reduction in afferent arteriolar diameter than in efferent, but the calculated increase in vascular resistance per micron was greater in efferent vessels due to their smaller resting diameter.

Foix-Chavany-Marie syndrome caused by a disconnection between the right pars opercularis of the inferior frontal gyrus and the supplementary motor area

2012 ◽  
Vol 117 (5) ◽  
pp. 844-850 ◽  
Author(s):  
Juan Martino ◽  
Enrique Marco de Lucas ◽  
Francisco Javier Ibáñez-Plágaro ◽  
José Manuel Valle-Folgueral ◽  
Alfonso Vázquez-Barquero
Keyword(s):  
Supplementary Motor Area ◽  
Diffusion Tensor ◽  
Anterior Part ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Lower Limbs ◽  
Rare Type ◽  
Orofacial Movement ◽  
Pars Opercularis ◽  
The Right

Foix-Chavany-Marie syndrome (FCMS) is a rare type of suprabulbar palsy characterized by an automaticvoluntary dissociation of the orofacial musculature. Here, the authors report an original case of FCMS that occurred intraoperatively while resecting the pars opercularis of the inferior frontal gyrus. This 25-year-old right-handed man with an incidentally diagnosed right frontotemporoinsular tumor underwent surgery using an asleep-awake-asleep technique with direct cortical and subcortical electrical stimulation and a transopercular approach to the insula. While resecting the anterior part of the pars opercularis the patient suffered sudden anarthria and bilateral facial weakness. He was unable to speak or show his teeth on command, but he was able to voluntarily move his upper and lower limbs. This syndrome lasted for 8 days. Postoperative diffusion tensor imaging tractography revealed that connections of the pars opercularis of the right inferior frontal gyrus with the frontal aslant tract (FAT) and arcuate fasciculus (AF) were damaged. This case supplies evidence for localizing the structural substrate of FCMS. It was possible, for the first time in the literature, to accurately correlate the occurrence of FCMS to the resection of connections between the FAT and AF, and the right pars opercularis of the inferior frontal gyrus. The FAT has been recently described, but it may be an important connection to mediate supplementary motor area control of orofacial movement. The present case also contributes to our knowledge of complication avoidance in operculoinsular surgery. A transopercular approach to insuloopercular gliomas can generate FCMS, especially in cases of previous contralateral lesions. The prognosis is favorable, but the patient should be informed of this particular hazard, and the surgeon should anticipate the surgical strategy in case the syndrome occurs intraoperatively in an awake patient.

scholarly journals BLADDER RECONSTRUCTION DURING SEPARATION OF A CONJOINT TWIN ISCHIOPAGUS TRIPUS

2019 ◽  
Vol 26 (2) ◽  
Author(s):  
Fajar Effendi ◽  
Safendra Siregar ◽  
Jupiter Sibarani
Keyword(s):  
Urinary Tract ◽  
Pelvic Floor ◽  
Conjoined Twins ◽  
Team Work ◽  
Lower Limbs ◽  
Pelvic Floor Reconstruction ◽  
Unique Challenge ◽  
Left Ureter ◽  
Ischiopagus Tripus ◽  
The Right

Objective: Conjoined twins represent one of the rarest congenital anomalies occurring with a varying incidence of about approximately 1 : 50.000 - 1 : 200.000 births. Ischiopagus conjoined  twinning (Fuse at the hip region) is even rare representing only 6% of all conjoined  twins. Here we report our experience in lower urinary tract reconstruction during separation of a conjoined twin ischiopagus tripus in Hasan Sadikin Hospital, Bandung. Case(s) Presentation: Two years old female conjoined twins, weighing in total of 8 kilograms, were brought to our hospital. The twins were fused  at  the lower  halves of  their bodies with two separate lower limbs at the right side and a fused left lower limb. External genitalia were absent. From CT Angiography we found four kidneys, two in each child with two separate bladders, with right ureter of baby A and left ureter of  baby B enter the  right bladder, while left ureter of  baby A and  right ureter of  baby B enter the left bladder. There was one cloaca that drains urine and feces. During the separation surgery, we performed ureteroneocystostomy and temporary ureteral stenting, followed by cystostomy. The pediatric surgeon performed bowel separation by stapling technique, pelvic wall separation, ileostomy, and pelvic floor reconstruction. The orthopedic surgeon performed femur separation, pelvic floor reconstruction, reconstruction of the pelvic ring, and femur reconstruction. The patients underwent defect closure, which performed by plastic surgeon. The operation was successful, without any complication to the kidney and the urinary tract of both babies. Discussion: Ischiopagus conjoined twins are the most complex conjoined twins and occur in only 6% of all conjoined twin cases. Ischiopagus is usually located along the axis with the head located on the opposite side. This case usually has one umbilicus and the two bodies are fused below this level, the union occurs in the lower abdomen and the pelvis. The internal organs that usually coalesce in cases of ischiopagus conjoined twins are liver, lower gastrointestinal, and genitourinary. The fused gastrointestinal part is the ileo-colic part of terminal ileum (Meckel's diverticulum). Conclusion: The separation of conjoined twin is a unique challenge due to its complex anatomy and physiology. Although advancement in imaging and monitoring has improved the survival rate separation can be successfully achieved only with meticulous planning and team work.

scholarly journals Muscle strength and inflammatory response to the training load in rowers

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10355
Author(s):  
Tomasz Podgórski ◽  
Alicja Nowak ◽  
Katarzyna Domaszewska ◽  
Jacek Mączyński ◽  
Magdalena Jabłońska ◽  
...  
Keyword(s):  
Muscle Metabolism ◽  
Creatine Kinase Activity ◽  
Lower Limbs ◽  
Total Testosterone ◽  
Blood Biochemical ◽  
Global Force ◽  
Significant Difference ◽  
Muscle Groups ◽  
Torque Values ◽  
The Right

Background Regular exercise leads to changes in muscle metabolism. The consequence of this is the adaptation to higher training loads.The aim of this study was to evaluate biomechanical and biochemical parameters describing the functions of skeletal muscles in periods when changes in training forms were introduced. Methods Seventeen male sweep-oar rowers, members of the Polish national rowing team, participated. The study was carried out at the beginning and at the end of the preparatory period. In the first and second examination measurements of torques of selected muscle groups and blood biochemical analysis were performed. Results There was observed a statistically significant decrease in the relative global force of the right lower limb between both terms of examination. A statistically significant increase in maximum torque was found for torso flexors. In the case of muscles responsible for torso rotation, a statistically significant decrease in the torque values of right torso rotators was observed. A significant difference was found with respect to creatine kinase activity, total testosterone concentration, total testosterone to cortisol ratio and total phenolics concentration (p < 0.05). Conclusion The study shows that the rowers’ training should be more focused on building the strength of lower limbs to prevent the overload of lumbar spine and that the amount of force developed may be significantly affected by the antioxidant potential of rowers.

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