Anatomical and safety considerations in establishing portals used for canine elbow arthroscopy

2010 ◽  
Vol 23 (02) ◽  
pp. 75-80 ◽  
Author(s):  
N. Crevier-Denoix ◽  
P. Moissonnier ◽  
V. Viateau ◽  
N. Jardel
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Brachial Artery ◽  
Anatomical Study ◽  
Ligament Injury ◽  
Elbow Arthroscopy ◽  
Cartilage Lesions ◽  
Safety Considerations ◽  
Relationship Of ◽  
Neurovascular Structures

Summary Objectives: To describe the relationship of the major muscular, ligamentous and neurovascular structures in relation to standard medial elbow arthroscopic portals used in dogs, and to evaluate their potential iatrogenic lesions. Design: Anatomical study using 20 canine cadaveric elbows. Methods: Arthroscopic explorations were performed using medial portals. Three 4 mm orthopaedic pins were introduced in place of the arthroscope, egress canula and instrumental portals. Limbs were dissected. Distances between pins and neurovascular structures were measured. Muscle, ligament and cartilage lesions were recorded. Results: Minimal muscular lesions were observed. No ligament injury was evidenced. Superficial iatrogenic cartilage lesions were observed in three joints. The arthroscopic portal was 23.1 mm (range: 16 to 28.5 mm) caudal to the brachial artery, 21.0 mm (13–30.5 mm) caudal to the median nerve, and 4.0 mm (1–7 mm) cranial to the ulnar nerve. The instrumental portal was 16.3 (9–24 mm) caudal to the brachial artery, 13.5 mm (7–24.5 mm) caudal to the median nerve, and 11.8 (8–18 mm) cranial to the ulnar nerve. The egress portal was 21.4 mm (12–37 mm) caudal to the ulnar nerve. Conclusions and clinical relevance: The study confirmed the safety of elbow medial arthroscopic portals. Care must be taken when placing the camera portal so as to avoid injury of the ulnar nerve. Should extensive intra-articular procedures be needed, manipulation of instruments should be done cautiously in the cranio-medial compartment of the joint due to the proximity of the median nerve to the capsule.

scholarly journals Flexor Pollicis Brevis Muscle. Anatomical Study and Clinical Implications

2017 ◽  
Vol 11 (1) ◽  
pp. 1321-1329
Author(s):  
Edie Benedito Caetano ◽  
Yuri da Cunha Nakamichi ◽  
Renato Alves de Andrade ◽  
Maico Minoru Sawada ◽  
Mauricio Tadeu Nakasone ◽  
...  
Keyword(s):  
Medical School ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Sao Paulo ◽  
Clinical Implications ◽  
Normal Pattern ◽  
Anatomical Dissection ◽  
Deep Branch ◽  
Catholic University

Introduction: This paper reports anatomical study of nature, incidence, innervation and clinical implications of Flexor Pollicis Brevis muscle (FPB). Material and Methods: The anatomical dissection of 60 limbs from 30 cadavers were performed in the Department of Anatomy of Medical School of Catholic University of São Paulo. Results: The superficial head of FPB has been innervated by the median nerve in 70% and in 30% it had double innervation. The deep head of FPB were absent in 14%, in 65%, occurred a double innervation. In 17.5% by deep branch of ulnar nerve and in 3.6% by recurrent branch of median nerve. Conclusion: The pattern of innervation more frequent in relationship to the flexor pollicis brevis muscle and should be considered as a normal pattern is that superficial head receives innervation of branches of median nerve and the deep head receives innervation of ulnar and median nerve.

scholarly journals Variant insertion of coracobrachialis muscle-morphological significance, embryological basis and clinical importance

1970 ◽  
Vol 6 (2) ◽  
pp. 42-46 ◽  
Author(s):  
R Guha ◽  
N Satyanarayana ◽  
CK Reddy ◽  
N Jayasri ◽  
V Nitin ◽  
...  
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Brachial Artery ◽  
Clinical Importance ◽  
Proximal Part ◽  
Medial Epicondyle ◽  
Medical Sciences ◽  
Medial Border ◽  
Male Cadaver ◽  
Anomalous Insertion

The coracobrachialis muscle in the arm is morphologically the sole representative of adductor group muscle in the arm, but such function during the process of evolution became insignificant in man. It is more important morphologically than functionally. Variant insertion of the coracobrachialis muscle was found during routine dissection of an adult male cadaver in the Department of Anatomy, College of Medical Sciences, and Bharatpur, Nepal. Normally the coracobrachialis muscle is inserted into the middle of the medial border of the humerus. In the present case an additional slender tendon passed inferiorly, crossing anterior to the median nerve and brachial artery, before attaching to the medial epicondyle of the humerus. Most of the proximal part of the tendon gave rise to an aponeurotic expansion that inserted into the distal medial border of the humerus. The tendinous insertion and aponeurotic expansion may represent a variant of the coracobrachialis longus (Wood's) muscle and the internal brachial ligament or the ligament of Struthers. The ulnar nerve was found to be traversing below the aponeurotic expansion. This type of anomalous insertion of coracobrachialis muscle may lead to compression of median nerve, brachial artery and ulnar nerve. Key words: Coracobrachialis muscle; ligament of Struthers; median nerve; brachial artery; ulnar nerve. DOI: 10.3126/jcmsn.v6i2.3616 Journal of college of Medical Sciences-Nepal, 2010, Vol.6, No-2, 42-46

scholarly journals The Incidence and Characteristics of Marinacci Anastomosis: An Anatomical Study

2020 ◽  
Vol 5 (03) ◽  
Author(s):  
Renata Hodzic ◽  
Mirsad Hodzic ◽  
Ermina Iljazovic ◽  
Nermina Piric ◽  
Sanela Zukic
Keyword(s):  
Median Nerve ◽  
Ulnar Nerve ◽  
Anatomical Study ◽  
Ulnar Artery ◽  
Hand Muscles ◽  
Time Period ◽  
Clinical Centre ◽  
Fresh Frozen ◽  
The Right ◽  
Anatomical Research

Marinacci anastomosis, also known as Ulnar-Median anastomosis, is an anastomosis in which the branch anastomotic originates proximally in the ulnar nerve and unites distally with the median nerve. A purpose of this study was to determine the incidence and  the characteristics of Marinacci anastomosis in the Bosnian population. The 60 anterior forearms of fresh frozen adult cadavers were dissected in the Department of Pathology,  University Clinical Centre Tuzla and the morgue of Tuzla during a time period of two years. The Marinacci anastomosis was evidenced in one male forearm in the right side behind the ulnar artery, following an transversal course of 5.2 cm until its connection with the median nerve in only one branch. The incidence of Marinacci anastomosis was 1.67%. Since this anastomosis can expalin some cases where injuries in the forearm nerves are not reflected in the hand muscles, it is important to study. Our study contributes to a limited research on the Marinacci anastomosis, a condition that is rarely found and reported in anatomical research.

scholarly journals Pattern study of union of two heads of biceps and its clinical significance

2017 ◽  
Vol 5 (4) ◽  
pp. 1646
Author(s):  
Jyoti Rohilla ◽  
Aarti Rohilla ◽  
Kamal Singh ◽  
Suresh Kanta Rathee
Keyword(s):  
Median Nerve ◽  
Clinical Significance ◽  
Brachial Artery ◽  
Elbow Joint ◽  
Biceps Brachii ◽  
Diagnostic Procedures ◽  
Close Relationship ◽  
Long Head ◽  
Neurovascular Structures

Background: Biceps brachii derives its name from its two proximally attached parts or ‘heads’ that is known as long head and short head. Two tendons form elongated bellies that though closely applied get fused within 7cm or so above the elbow joint. These variations should be kept in mind during surgical and diagnostic procedures done by clinicians.Methods: A total of 18 cadavers were dissected for two successive years during undergraduate and were observed for different patterns of fusion of two heads of biceps brachii.Results: The present study showed that frequency of fusion of heads of biceps brachii in its upper one-third part was observed less commonly while it was frequently observed in its middle one-third part.Conclusions: Variation in union of heads might be significant in causing compression of neurovascular structures because of their close relationship to the brachial artery and median nerve.

scholarly journals STRUTHERS’ LIGAMENT AND SUPRACONDYLAR HUMERAL PROCESS: AN ANATOMICAL STUDY AND CLINICAL IMPLICATIONS

2017 ◽  
Vol 25 (4) ◽  
pp. 137-142 ◽  
Author(s):  
Edie Benedito Caetano ◽  
João José Sabongi Neto ◽  
Luiz Angelo Vieira ◽  
Maurício Ferreira Caetano ◽  
José Eduardo de Bona ◽  
...  
Keyword(s):  
Median Nerve ◽  
Brachial Artery ◽  
Case Series ◽  
Anatomical Study ◽  
Nerve Compression ◽  
Clinical Implications ◽  
Level Of Evidence ◽  
Pronator Teres ◽  
Compressive Neuropathy ◽  
Anatomy Laboratory

ABSTRACT Objective: The objective of this study was to determine the frequency and anatomical characteristics of Struthers’ ligament and the supracondylar humeral process and evaluate the clinical implications in compressive neuropathy of the median nerve . Method: We dissected 60 arms from 30 cadavers (26 males and 4 females): 15 were previously preserved in formalin and glycerin and 15 were dissected fresh in the Anatomy Laboratory for this paper. The relationships between Struthers’ ligament and the median nerve and brachial artery and veins were documented with drawings and photos . Results: The supracondylar humeral process was not found in any of the 60 dissected arms. Struthers’ ligament was identified in six arms (two bilateral); in all cases high insertion of the pronator teres muscle was observed . Conclusion: Struthers’ ligament is an aponeurotic structure that may or may not be associated with the supracondylar humeral process, and is an important potential site of median nerve compression in the lower third of the arm. Level of Evidence IV, Case Series.

Endoscopic Plantar Fascia Release: An Anatomical Study

1995 ◽  
Vol 16 (11) ◽  
pp. 719-723 ◽  
Author(s):  
Eric P. Hofmeister ◽  
Michael J. Elliott ◽  
Paul J. Juliano
Keyword(s):  
Average Distance ◽  
Anatomical Study ◽  
Plantar Fascia ◽  
Average Amount ◽  
Lateral Plantar Nerve ◽  
Flexor Digitorum Brevis ◽  
Fresh Frozen ◽  
Abductor Digiti Minimi ◽  
Relationship Of ◽  
Neurovascular Structures

The anatomical relationship of neurovascular structures to the plantar fascia after endoscopic fasciotomy was studied in 13 adult fresh-frozen cadaver feet. Using a single portal technique, an endoscopic system was placed into the plantar compartment through a 1-cm medial incision. Under direct endoscopic visualization, the plantar fascia was released. The feet were then dissected and the anatomic relationship of the neurovascular structures to the area of release was studied. The average amount of plantar fascia released was 81%. The average distance of the release to the lateral plantar nerve, and the nerve to the abductor digiti minimi was 10.5 and 12.3 mm, respectively. The flexor digitorum brevis muscle was partially transected in 46% of the cases, and the average amount of muscle transected was 0.8 mm. The endoscopic approach to the release of the plantar fascia provides adequate release and does not appear to pose any danger to underlying neurovascular structures.

Gantzer’s Muscle

1996 ◽  
Vol 21 (2) ◽  
pp. 269-270 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Median Nerve ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Nerve Supply ◽  
Flexor Pollicis Longus ◽  
Pronator Syndrome ◽  
Anterior Interosseous Nerve ◽  
Dual Origin ◽  
Relationship Of ◽  
The Relationship

The relationship of Gantzer’s muscle (the accessory head of flexor pollicis longus; FPL) to the median nerve and its anterior interosseous branch is debated. In an anatomical study of 25 limbs, the incidence, origin, insertion, nerve supply and relations of Gantzer’s muscle have been documented. The muscle was found in 13 of the 25 (52%) limbs and was supplied by the anterior interosseous nerve. It arose from the medial humeral epicondyle in 85% and had a dual origin from the epicondyle and coronoid process in the rest. Its insertion was to the ulnar part of FPL and its tendon. Gantzer’s muscle always lay posterior to both the median and anterior interosseous nerves. Anatomical variations in which Gantzer’s muscle may contribute to median nerve compression in pronator syndrome are discussed.

Macrovascular decompression of the median nerve for posttraumatic neuralgic limb pain

2013 ◽  
Vol 12 (3) ◽  
pp. 270-273 ◽  
Author(s):  
Aqueel Pabaney ◽  
Shawn L. Hervey-Jumper ◽  
Joseph Domino ◽  
Cormac O. Maher ◽  
Lynda J. S. Yang
Keyword(s):  
Neuropathic Pain ◽  
Median Nerve ◽  
Brachial Artery ◽  
Motor Neuropathy ◽  
Tissue Mass ◽  
Anatomical Relationship ◽  
Lancinating Pain ◽  
Outcomes For Children ◽  
Pain Recognition ◽  
Relationship Of

Neuropathic pain is rare in children, and few reports provide adequate guidelines for treatment. The authors describe the successful treatment of tardy neuropathic pain via macrovascular decompression in a 15-year-old boy who presented with progressive pain 11 years following trauma to the upper extremity that had required surgical repair of the brachial artery. Examination revealed mild chronic median and ulnar motor neuropathy as well as recent progressive lancinating pain and a Tinel sign at the prior scar. A soft tissue mass in the neurovascular bundle at the site of previous injury was noted on MRI. Surgical exploration demonstrated an altered anatomical relationship of the previously repaired brachial artery and the median nerve, resulting in pulsatile compression of the median nerve by the brachial artery. Neurolysis and decompression of the median nerve with physical separation from the brachial artery resulted in immediate pain relief. This is the first report of macrovascular decompression of a major peripheral nerve with complete symptom resolution. Noninvasive imaging together with a thorough history and physical examination can support identification of this potential etiology of peripheral neuralgic pain. Recognition and treatment of this uncommon problem may yield improved outcomes for children with neuropathic pain.

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