scholarly journals Anatomical Study of Periosteal Vascularization of the Forearm: Design of Vascularized Periosteal Flaps

2018 ◽  
Vol 46 (02) ◽  
pp. 106-112
Author(s):  
Sergi Barrera-Ochoa ◽  
David Campillo-Recio ◽  
Jorge Knorr ◽  
Xavier Mir-Bullo ◽  
Alfonso Rodríguez-Baeza ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Osteogenic Potential ◽  
Fresh Frozen ◽  
Pedicle Length ◽  
Mean Size ◽  
Microsurgical Techniques ◽  
The Mean ◽  
Radial Axis

Introduction Vascularized periosteal flaps (VPFs) have proven to be a useful technique for the treatment of unfavorable biological situations in children, with excellent results due to their osteogenic potential. The objective of this work is to present a detailed anatomical description of the periosteal vascularization of the radius and ulna, as well as the design of the forearm VPFs. Methods Anatomical study with 10 fresh-frozen specimens with antegrade injection of green colored latex. Periosteal branches of the radius and ulna, septocutaneous branches, and muscular branches were dissected. The size of the pre and postdissection flaps was measured, as well as the length of the vascular pedicles. Results The four vascular axes studied were the anterior interosseous vascular axis (AIA), radial axis (RA), ulnar axis (UA), and posterior interosseous vascular axis (PIA). The AIA (volar-radial VPF): an average of 16.2 periosteal branches were obtained, with a mean distance of 6.6 mm between them. The mean size of the VPF was 41.3 cm2 pre-dissection and 32.4 cm2 post-dissection. The average pedicle length was 16.1 cm. Vascular RA (radial VPF): an average of 20.8 branches was found, with a mean VPF size of 54.8 cm2predissection, and 39.3 cm2 post-dissection. The average pedicle length was 20.2 cm. Vascular PIA (dorsal-ulnar VPF): an average of 12.8 periosteal branches were obtained, with the mean VPF size being 26.2 cm2 pre-dissection and 20.4 cm2 post-dissection. The average pedicle length 12.6 cm. Vascular UA (ulnar VPF): an average of 10.2 periosteal branches were obtained with a mean VPF size of 37.5 cm2 pre-dissection and 28.2 cm2 post-dissection. of the average pedicle length was 14.8 cm. Conclusions We have described four new VPFs, with the most useful and versatile being the dorsal-ulnar VPF, based on the PIA, and the volar-radial, based on the AIA. The main advantages of these flaps with respect to microsurgical techniques are the simplicity and speed of the technique, its elasticity and adaptability to the recipient bed, as well as its versatility.

ANATOMICAL STUDY OF ARCADE OF STRUTHERS

Hand Surgery ◽  
2010 ◽  
Vol 15 (03) ◽  
pp. 157-159 ◽  
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.

scholarly journals The Anatomy of the Dorsal Capsulo-Scapholunate Septum: A Cadaveric Study

2017 ◽  
Vol 06 (03) ◽  
pp. 244-247 ◽  
Author(s):  
Marina Tommasini Carrara de Sambuy ◽  
Tanya Burgess ◽  
Christophe Mathoulin ◽  
Adeline Cambon-Binder
Keyword(s):  
Dorsal Surface ◽  
Anatomical Study ◽  
Biomechanical Properties ◽  
Scapholunate Ligament ◽  
Maximum Width ◽  
Interosseous Ligament ◽  
Gothic Architecture ◽  
Constant Structure ◽  
Fresh Frozen ◽  
The Mean

Background Tears of the dorsal radiocarpal capsule at the level of the scapholunate interosseous ligament (SLIL) have recently been described in association with predynamic scapholunate instability. Purpose The aim of this anatomical study of the dorsal capsulo-scapholunate septum (DCSS) was to examine the connection of the dorsal capsule on the SLIL and dorsal intercarpal ligament (DICL). Methods Fourteen fresh frozen wrists from seven adult cadavers were dissected through a dorsal approach. Any dorsal attachment of the DICL on the dorsal surface of the SLIL, that is, the DCSS, was identified and measured (height and width). Results The DCSS was consistently found connecting the DICL, the dorsal radiocarpal capsule, and the dorsal aspect of the SLIL. It was formed by the confluence of three arches like intersecting ribs in gothic architecture. The mean dimensions of the DCSS were 5.8 mm in height and 4.0 mm in maximum width. Conclusion The DCSS that connects the SLIL with the dorsal capsule and DICL could be a constant structure of dorsal wrist. Further investigation is required to study the histology of the DCSS and its biomechanical properties in isolation to know whether the DCSS can be considered a secondary stabilizer of the scapholunate ligament complex. Clinical Relevance A better anatomical knowledge of scapholunate ligament complex could help understand and manage instability of the wrist.

scholarly journals The Vascular Basis of the Pronator Quadratus Muscle Flap and Its Use in Clinical Cases

2020 ◽  
Author(s):  
Binu P. Thomas ◽  
Sasi P. Kiran ◽  
Maolin Tang ◽  
Christopher R. Geddes ◽  
Steven F. Morris
Keyword(s):  
Muscle Flap ◽  
Anatomical Study ◽  
Vascular Supply ◽  
Soft Tissue Reconstruction ◽  
Pronator Quadratus ◽  
India Ink ◽  
Pedicle Length ◽  
Human Cadavers ◽  
The Mean ◽  
Pronator Quadratus Muscle

AbstractBackground Pronator quadratus (PQ) is a deeply situated muscle in the forearm which may occasionally be utilized for soft-tissue reconstruction. The purpose of this anatomical and clinical study was to confirm vascular supply of PQ muscle (PQM) in order to optimize its transfer and confirm its utility in clinical situations. Methods In Part A of the anatomical study, fresh human cadavers (n = 7) were prepared with an intra-arterial injection of lead oxide and gelatin solution, and PQM and neurovascular pedicle were dissected (n = 14). In the anatomical study Part B, isolated limbs of embalmed human cadavers (n = 12) were injected with India ink-gelatin mixture and PQ were dissected.Results PQ is a type II muscle flap, with one major pedicle, the anterior interosseous (AI) vessels and two minor pedicles from the radial and ulnar vessels. The mean dimensions of the muscle were 5.5 × 5.0 × 1.0 cm3, mean pedicle length was 9.6 cm, and the mean diameter of the artery and the vein was 2.3 mm and 2.8 mm, respectively. The dorsal cutaneous perforating branch (DPB) of the artery supplied the skin over the dorsal forearm and wrist. This branch also anastomosed with the 1, 2 intercompartmental supraretinacular artery (ICSRA). Conclusion This study confirms the potential utility and vascular basis of the PQM flap and its associated cutaneous paddle.In the clinical part, two patients with nonhealing wounds exposing the median nerve and flexor tendons in the distal forearm were treated using the PQM flap with good results.

An Anatomical Study of Morton's Interdigital Neuroma: The Relationship Between the Occurring Site and the Deep Transverse Metatarsal Ligament (DTML)

2007 ◽  
Vol 28 (9) ◽  
pp. 1007-1010 ◽  
Author(s):  
J-Young Kim ◽  
Jae Hyuck Choi ◽  
Jungmin Park ◽  
Joonho Wang ◽  
Inmook Lee
Keyword(s):  
Anterior Margin ◽  
Metatarsophalangeal Joint ◽  
Anatomical Study ◽  
Causative Factor ◽  
Metatarsal Head ◽  
Digital Nerve ◽  
Fresh Frozen ◽  
The Common ◽  
The Mean ◽  
The Relationship

Background: Using clinical and cadaver studies, we examined the relationship between the location of Morton interdigital neuromas and the surrounding structures, including the deep transverse metatarsal ligament (DTML), which has been suspected as a major causative factor in neuroma formation. Methods: Seventeen fresh-frozen cadavers were evaluated to determine the relationship between the location of Morton interdigital neuromas and the DTML at two phases of the gait cycle with 60 degrees of metatarsophalangeal dorsiflexion and with 15 degrees of ankle dorsiflexion. We measured the distance from the bifurcation of the common digital nerve in the foot to the anterior margin of the DTML and also measured the length of the DTML itself. Clinically, we checked the location of the Morton interdigital neuroma and its length during surgery in 32 feet. Results: In the second and third webspace, the mean distance from the bifurcation of the common digital nerve of the foot to the anterior margin of the DTML was 16.7 mm, 15.1 mm in the mid-stance position, and 15.9 mm and 14.6 mm in the heel-off position. The length of the second and third DTML averaged 12.8 mm and 10.6 mm. Clinically, all of the cases of Morton interdigital neuroma started at the bifurcation area of the common digital nerve, and the mean neuroma length was 7.5 mm (6 to 11). Conclusions: Morton interdigital neuromas were located more distally than the DTML in both the mid-stance and the heel-off stage during walking. The main lesion was located between the metatarsal head and the metatarsophalangeal joint and more distal than the DTML, questioning previous studies suggesting that the DTML is the major causative factor in development of Morton interdigital neuroma.

scholarly journals Anatomical study of anterior supramalleolar artery and its potential application to design a bi-foliate fasciocutaneous flap

2015 ◽  
Vol 48 (01) ◽  
pp. 017-021
Author(s):  
Ji-Yin He ◽  
Shih-Heng Chen ◽  
Kannan Karuppiah Kumar ◽  
Zhi-Hong Fan ◽  
Jie Lao ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Type A ◽  
Fasciocutaneous Flap ◽  
Lower Limbs ◽  
Anterior Tibial Artery ◽  
Medial Branch ◽  
Flap Transfer ◽  
Type D ◽  
Pedicle Length ◽  
The Mean

ABSTRACT Purpose: A further understanding of the anterior supramalleolar artery (ASMA) and its potential applications in reconstructive surgery. Materials and Methods: A total of 24 fresh lower limbs from fresh cadavers were injected with red latex for dissection. The type of origin, course, diameter of the pedicle, and the distance between the origin of the ASMA from the anterior tibial artery to the extensor retinaculum (O-R) were recorded. Bi-foliate fasciocutaneous flaps were harvested using the branches of the ASMA. Results: We found four types of origin of the ASMA, and we have accordingly classified them into four types. 10 of them were type A, 7 were type B, 6 were type C and 1 was type D. The mean O-R (origin of ASMA to retinaculum) distance was 2.0 ± 0.8 cm. The diameter of the medial branch (D1), the diameter of the lateral branch (D2), and the diameter of artery stem (D3) (only in type A) were 1.0 ± 0.2 mm, 0.8 ± 0.3 mm, 1.1 ± 0.2 mm, respectively. The mean pedicle length of the lateral flap (L1) and medial flap (L2) were 5.1 ± 1.0 cm and 3.7 ± 0.6 cm, respectively. Conclusions: The ASMA exists constantly with four different types of origin. Its sizable diameter and lengthy pedicle make it suitable for bi-foliate fasciocutaneous flap transfer.

scholarly journals Anatomical study of the teres major muscle: description of an additional distal muscle slip

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lukas Ernstbrunner ◽  
Malik Jessen ◽  
Marco Rohner ◽  
Manuel Dreu ◽  
Samy Bouaicha ◽  
...  
Keyword(s):  
Latissimus Dorsi ◽  
Anatomical Study ◽  
Macroscopic Description ◽  
Distal Muscle ◽  
Mean Width ◽  
Fresh Frozen ◽  
Teres Major ◽  
Tremendous Importance ◽  
The Mean ◽  
Deltopectoral Approach

Abstract Background Understanding muscle and tendon anatomy is of tremendous importance to achieve optimal surgical execution and results in tendon transfers around the shoulder. The aim of this study was to introduce and describe an additional distal muscle slip of the teres major (TM). Methods Sixteen fresh-frozen cadaver shoulders were dissected with the deltopectoral approach. The ventral latissimus dorsi (LD) tendon was harvested, and the shoulders were analyzed for the presence/absence of a distal teres major slip (dTMs) and its dimensions and relationship with the TM and LD tendons. Results The dTMs was identified in 12 shoulders (75%). It was always distal to the TM tendon and visible during the deltopectoral approach. There was a clear separation between the TM proximally and dTMs tendon distally. At the humeral insertion, both tendons had a common epimyseal sheet around the teres major and inserted continuously at the humerus. The mean width of the dTMs tendon at the insertion was 13 ± 4 mm (range, 7–22 mm). The total lengths of the dTMs tendon and LD tendon were 40 ± 7 mm (range, 25–57 mm) and 69 ± 7 mm (range, 57–79 mm), respectively (p < 0.001). The dTMs muscle showed direct adhesions in ten shoulders (83%) with the LD muscle. Conclusions This is the first macroscopic description of an additional distal slip of the teres major muscle. The dTMs has a separate (distal) but continuous (mediolateral) insertion at the humerus within a common epimyseal sheet around the TM. The dTMs tendon is visible during the deltopectoral approach and can therefore provide a lead structure, particularly in ventral LD transfers with the deltopectoral approach.

Batch Precipitation of Lead Iodide

1994 ◽  
Vol 59 (6) ◽  
pp. 1301-1304
Author(s):  
Jaroslav Nývlt ◽  
Stanislav Žáček
Keyword(s):  
Aqueous Solution ◽  
Particle Size ◽  
Particle Size Distribution ◽  
Size Distribution ◽  
Crystal Size ◽  
Lead Nitrate ◽  
Lead Iodide ◽  
Constant Rate ◽  
Mean Size ◽  
The Mean

Lead iodide was precipitated by a procedure in which an aqueous solution of potassium iodide at a concentration of 0.03, 0.10 or 0.20 mol l-1 was stirred while an aqueous solution of lead nitrate at one-half concentration was added at a constant rate. The mean size of the PbI2 crystals was determined by evaluating the particle size distribution, which was measured sedimentometrically. The dependence of the mean crystal size on the duration of the experiment exhibited a minimum for any of the concentrations applied. The reason for this is discussed.

The Hallux Metatarsophalangeal Capsule: An Anatomic Study With Respect to Percutaneous Hallux Valgus Correction

2021 ◽  
pp. 107110072110272
Author(s):  
Kenneth M. Chin ◽  
Nicholas S. Richardson ◽  
John T. Campbell ◽  
Clifford L. Jeng ◽  
Matthew W. Christian ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Metatarsal Head ◽  
Cadaveric Study ◽  
Anatomic Study ◽  
Orthopedic Surgeons ◽  
Popular Knowledge ◽  
Fresh Frozen ◽  
The Mean ◽  
Anatomic Relationship

Background: Minimally invasive surgery for the treatment of hallux valgus deformities has become increasingly popular. Knowledge of the location of the hallux metatarsophalangeal (MTP) proximal capsular origin on the metatarsal neck is essential for surgeons in planning and executing extracapsular corrective osteotomies. A cadaveric study was undertaken to further study this anatomic relationship. Methods: Ten nonpaired fresh-frozen frozen cadaveric specimens were used for this study. Careful dissection was performed, and the capsular origin of the hallux MTP joint was measured from the central portion of the metatarsal head in the medial, lateral, dorsal, plantarmedial, and plantarlateral dimensions. Results: The ten specimens had a mean age of 77 years, with 5 female and 5 male. The mean distances from the central hallux metatarsal head to the MTP capsular origin were 15.2 mm dorsally, 8.4 mm medially, 9.6 mm laterally, 19.3 mm plantarmedially, and 21.0 mm plantarlaterally. Conclusion: The MTP capsular origin at the hallux metatarsal varies at different anatomic positions. Knowledge of this capsular anatomy is critical for orthopedic surgeons when planning and performing minimally invasive distal metatarsal osteotomies for the correction of hallux valgus. Type of Study: Cadaveric Study.

scholarly journals Effects of topical gel formulation of Ficus carica latex on cutaneous leishmaniasis induced by Leishmania major in BALB/c mice

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Ali Pouryousef ◽  
Erfan Eslami ◽  
Sepehr Shahriarirad ◽  
Sina Zoghi ◽  
Mehdi Emami ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Murine Model ◽  
Leishmania Major ◽  
Considerable Effect ◽  
Ficus Carica ◽  
Control Group ◽  
Topical Gel ◽  
The Third ◽  
Mean Size ◽  
The Mean

Abstract Objectives The current study aimed to evaluate the effects of Ficus carica latex on the treatment of cutaneous leishmaniasis (CL), induced by Leishmania major. A 5% topical gel with F. carica latex was prepared. BALB/c mice were infected by inoculation of amastigotes form of L. major. Thirty BALB/c mice were divided into five groups, where the first group was treated daily, the second group twice per day, and the third group every other day with the 5% topical gel, for 3 weeks. The sizes of the lesions were measured before and during the course of treatment. Results Although the mean size of lesions in the mice group treated with the 5% F. carica gel, especially in the group receiving daily treatment, was less than the mean size of the lesions in the control group, yet, the differences was not statistically significant (p > 0.05). The findings of the current study demonstrated that the 5% F. carica latex with a 3-week course of treatment had no considerable effect in recovery or control of CL induced by L. major in the murine model. Using higher concentration of F. carica latex and with longer treatment lengths may increase its efficacy in the treatment of CL.

scholarly journals Comparative Study of Flexor Hallicus Longus Tendon Length through Single Incision or Accessory Plantar Medial Incision: A Cadaver Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0018
Author(s):  
Caitlin Curtis Crocker ◽  
Eildar Abyar ◽  
Sean Young ◽  
Fatemah Razaghi ◽  
Gerald McGwin ◽  
...  
Keyword(s):  
Single Incision ◽  
Plantar Flexion ◽  
Cadaver Study ◽  
Tendon Graft ◽  
Interference Screw ◽  
Flexor Hallucis Longus ◽  
Tunnel Length ◽  
Exact Test ◽  
Fresh Frozen ◽  
The Mean

Category: Ankle; Hindfoot Introduction/Purpose: Flexor Hallucis Longus (FHL) tendon transfer to the calcaneus is a common adjuvant procedure in the treatment of Achilles pathology. The FHL tendon can be harvested using a posterior incision where the tendon is dissected along its course into the fibroosseous tunnel. Alternatively, the FHL may be harvested through a separate plantar medial incision as it crosses the flexor digitorium longus at the Knot of Henry. This study aims to quantify FHL tendon lengths achieved through the two common approaches utilizing pair matched cadavers. Methods: Seven pair matched fresh-frozen cadaver legs without signs of musculoskeletal abnormalities were used for this assessment. One leg in each pairing underwent a single incision harvest while the contralateral leg underwent an accessory medial plantar harvest. After dissecting the tendon, a calcaneus tunnel was prepared from dorsal to plantar in both calcanei in standard fashion. Two measurements were obtained. The first measurement was taken from the distal aspect of the muscle belly to the distal end of the tendon. The tendon was then pulled through the calcaneus, and the foot was held in tension at 20 degrees of plantar flexion. The second measurement was taken from site where tendon entered the calcaneous to the distal end of the tendon graft. The measurements were analyzed using Wilcoxon Signed Ranks Test and Fischer Exact Test. Results: Using a posterior incision, the mean tendon measurement from calcaneous tunnel to the distal end of the tendon was 4.0 cm. Using an accessory plantar medial incision, the mean tendon measurement from the calcaneous tunnel to the distal end of the tendon was 7.2 cm. The average tunnel length obtained using an accessory medial incision was significantly greater than the length obtained using the single incision approach (p= 0.0003, p=0.0022, and p=0.0016). The accessory plantar medial incision obtained an FHL tendon tunnel length that was an average of 2.9 cm greater than the posterior incision. Conclusion: The single incision approach provided sufficient length to safely anchor the FHL into the calcaneus which suggests that the accessory plantar medial approach is not necessary for routine FHL transfers to the calcaneus with interference screw fixation. However, if additional length is needed for other applications such as posterior tibialis tendon dysfunction or peritoneal tendon tears, the accessory incision does provide an average of 2.9 cm of additional length.

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