Which Approach Is Most Optimal for Needle Electromyographic Examination of the Biceps Femoris Short Head: Medial or Lateral?

Objective To investigate the anatomical characteristics of the biceps femoris short head (BS) and determine the optimal needle placement for BS examination.Methods Twenty-one lower limbs were dissected. The distances from the medial and lateral margins of the biceps femoris long head (BL) tendon to the common fibular nerve (CFN) (M_CFN_VD and L_CFN_VD, respectively) and the distance from the lateral margin of the BL tendon to the lateral margin of the BS (L_BS_HD) were measured 5 cm proximal to the tip of the fibular head (P1), four fingerbreadths proximal to the tip of the fibular head (P2), and at the upper apex of the popliteal fossa (P3).Results The BS was located lateral to the BL tendon. The CFN was located along the medial margin of the BL tendon. The median values were 2.0 (P1), 3.0 (P2), and 0 mm (P3) for M_CFN_VD; and 17.4 (P1), 20.2 (P2), and 21.8 mm (P3) for L_CFN_VD; and 8.1 (P1), 8.8 (P2), and 13.0 mm (P3) for L_BS_VD.Conclusion The lateral approach to the BL tendon was safer than the medial approach for examining the BS. Amore proximal insertion site around the upper apex of the popliteal fossa was more accurate than the distal insertion site. In this study, we propose a safer and more accurate approach for electromyography of the BS.

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Third head of biceps femoris muscle-a case report

International Surgery Journal ◽

10.18203/2349-2902.isj20211322 ◽

2021 ◽

Vol 8 (4) ◽

pp. 1343

Author(s):

Surajit Ghatak ◽

Sonali Adole ◽

Debajani Deka ◽

Muhamed Faizal

Keyword(s):

Insertion Site ◽

Biceps Femoris ◽

Lower Limbs ◽

Medical Sciences ◽

Medial Condyle ◽

Muscle Belly ◽

Biceps Femoris Muscle ◽

Long Head ◽

The Right ◽

Femoris Muscle

Sometimes variations in biceps femoris may be noticed like an accessory head of biceps femoris. Here during routine cadaveric dissection in the department of anatomy. All India institute of medical sciences, Jodhpur we found a case with an accessory head of biceps femoris in both the lower limbs. The muscle belly is originating from the fibers of long head of biceps femoris and going downward medially to get inserted to the medial condyle of tibia on its medial superior aspect. On the right-side insertion site is like a sheath and on half a way it is merging with medial intermuscular septum of thigh. On the left side insertion is first like a thin sheath and then a thin muscle belly. The muscle belly is thin as compared to the long and short head of the main muscle bellies. On the left side thickness is around 3.7 mm in the upper end and thinner in the lower end while on right side also it is around 3.75 mm. On right side length of muscle belly is around 5 cm and on left side it is around 5.5 cm muscle belly, then becomes a sheath with length around 0.5 mm and then again becomes a muscle belly of around 3.5 cm length. Short head is arising high up on the left side while on right side it is as normal.

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Tensor Fasciae Suralis – Prevalence Study and Literature Review

10.1101/19010389 ◽

2019 ◽

Author(s):

Logan S. Bale ◽

Sean O. Herrin

Keyword(s):

Literature Review ◽

Classification System ◽

Case Reports ◽

Biceps Femoris ◽

Lower Limbs ◽

Prevalence Study ◽

Accessory Muscle ◽

Anatomical Features ◽

Long Head ◽

Formalin Fixed

SUMMARYTensor fasciae suralis (TFS) is an accessory muscle of the posterior lower extremity. Although TFS has been documented in cadaveric and radiological reports, its prevalence remains unknown. The TFS variant is noteworthy to anatomists, as it may be encountered in the dissection laboratory, and clinicians, as the muscle could potentially cause confusion during physical examination or diagnostic imaging. Multiple variations of TFS have been reported in the literature, suggesting the need for a classification system. We dissected 236 formalin-fixed cadaveric lower limbs to determine the prevalence of TFS. The PubMed and MEDLINE databases were searched to compare the anatomical features of independent TFS case reports. In our prevalence study, the TFS muscle was identified in three lower limbs (1.3%). In total, 35 cases of TFS (31 cadaveric and four radiological) were identified in the literature. Our literature review revealed that the accessory muscle most often arises as a single head from the long head of the biceps femoris, yet many other presentations have been documented. The need for a classification system to distinguish between the subtypes of TFS became apparent during the literature review. Tensor fasciae suralis is a rare muscle, present in only 3 of 236 (1.3%) cadaveric lower limbs dissected in this study. We propose the use of a classification system, based on muscle origin and number of heads, to better organize the subtypes of TFS.

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Partial Tendon Release for Treatment of a Symptomatic Snapping Biceps Femoris Tendon: A Case Report

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738109338360 ◽

2009 ◽

Vol 1 (5) ◽

pp. 435-437 ◽

Cited By ~ 8

Author(s):

Scott A. Crow ◽

Tony Quach ◽

David R. McAllister

Keyword(s):

Case Report ◽

Insertion Site ◽

Biceps Femoris ◽

Fibular Head ◽

Anomalous Insertion ◽

Uncommon Condition ◽

Tendon Insertion ◽

Biceps Femoris Tendon ◽

Partial Release

Snapping of the biceps femoris tendon over the fibular head is an uncommon condition. Reported causes include an anomalous insertion of the tendon, trauma at the insertion site of the tendon, and an abnormality of the fibular head. This article reports a case of a painful snapping biceps femoris tendon in a patient without an anomalous tendon insertion or an abnormality of the fibular head. Partial release of the superior aspect of the tendon resulted in resolution of symptoms.

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Medial Approach to the Sciatic Nerve at the Popliteal Fossa in the Supine Position with Ultrasound Guidance and Nerve Stimulator

ISRN Anesthesiology ◽

10.5402/2012/676823 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3

Author(s):

Tomoaki Yanaru ◽

Kenji Shigematsu ◽

Kazuo Higa ◽

Erisa Nakamori ◽

Keiichi Nitahara

Keyword(s):

Sciatic Nerve ◽

Prone Position ◽

Supine Position ◽

Lower Limb ◽

Ultrasound Guidance ◽

Lateral Approach ◽

Popliteal Fossa ◽

Medial Approach ◽

Medial Side ◽

Transducer Application

Ultrasound guided sciatic nerve block (SNB) at the popliteal fossa is performed with the lateral approach in the supine position or with the lateral or posterior approach in the prone position. When the sciatic nerve (SN) is blocked with the lateral approach in the supine position, the lower limb must be sufficiently elevated to enable adequate space around the knee joint for transducer application. When the SN is blocked in the prone position, the patients’ position needs to be changed. We report a medial approach to the SNB at the popliteal fossa in the supine position with ultrasound guidance. Ten patients scheduled for elective knee or foot surgery participated in this study. Patients were placed in the supine position, with the hip and knee on the operated side flexed and the thigh externally rotated at approximately 45 degrees. A block needle was inserted in-plane with the transducer toward the SN bifurcation from the medial side of the thigh. The block performance time for SNB was min (1.3–3.1 min). All blocks were effective. Our medial approach to the SN in the supine position with ultrasound guidance does not require elevation of the patient’s lower limb or a change in the patient’s position.

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Effects of Diacutaneous Fibrolysis on Passive Neuromuscular Response and Mechanosensitivity in Athletes with Hamstring Shortening: A Randomized Controlled Trial

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126554 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6554

Author(s):

Aida Cadellans-Arróniz ◽

Carlos López-de-Celis ◽

Albert Pérez-Bellmunt ◽

Jacobo Rodríguez-Sanz ◽

Luis Llurda-Almuzara ◽

...

Keyword(s):

Gluteus Maximus ◽

Biceps Femoris ◽

Post Treatment ◽

Contractile Properties ◽

Lower Limbs ◽

Injury Incidence ◽

Single Session ◽

Muscle Properties ◽

Neuromuscular Response ◽

Control Limb

Introduction. Diacutaneous Fibrolysis is defined as specific instrumental intervention to normalize function in the musculoskeletal system. It is considered a treatment method for the mechanical alterations of the locomotor system, and it is widely used in sports for therapeutic and preventive purposes. Despite the clinical benefits observed in different musculoskeletal conditions, the action mechanism of diacutaneous fibrolysis remains uncertain. There are no studies evaluating the neuromuscular response on the posterior muscular chain of the lower extremity in athletes, where overload, stiffness, and injury incidence are high. Objective. To evaluate the immediate, and 30 min post treatment effects of a single diacutaneous fibrolysis session on passive neuromuscular response and mechanosensitibity on hamstring and gluteus in athletes with shortening. Design. A randomized within participant clinical trial. Methods. Sixty-six athletes with hamstring shortening were included (PKE < 160). The lower limbs were randomized between the experimental limb and control limb, regardless of dominance. A single session of diacutaneous fibrolysis was applied to the posterior gluteus maximus, biceps femoris, and semitendinosus of the experimental lower limb whereas the control limb was not treated. Viscoelastic muscle properties (myotonometry), contractile muscle properties (tensomiography), and mechanosensitivity (algometry) were tested before treatment (T0), after treatment (T1), and 30 min post treatment (T2). Results. Regarding viscoelastic properties, in the intra-group analysis we found statistically significant differences in the experimental limb at T1, decreasing muscle stiffness in gluteus maximus (p < 0.042), in biceps femoris (p < 0.001) and in semitendinosus (p < 0.032). We also observed statistically significant differences in Tone decrease (p < 0.011) and relaxation increase (p < 0.001) in biceps femoris. At T2, the decrease in stiffness in all tested muscles was maintained (p < 0.05). There were statistically significant inter-groups differences in stiffness on gluteus (p < 0.048) and biceps femoris (p < 0.019) and in tone on biceps femoris (p < 0.009) compared to the control limb. For contractile properties, we only found statistically significant differences on maximal radial displacement (Dm) in gluteus, both control and experimental at T2 (p < 0.05) and in biceps femoris control (p < 0.030). No changes were found in the mechanosensitivity. Conclusions. A single session of diacutaneous fibrolysis produces changes in some parameters related to viscoelasticity properties of the biceps femoris and gluteus. There were no changes on contractile properties on semitendinosus. Only small changes on the contractile properties on the gluteus maximus and biceps femoris were found. No effect was found on the mechanosensitivity of the posterior chain muscles in athletes with hamstring shortening.

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Influence of submaximal isometric contractions of the hamstrings on electromyography activity and force while functioning as hip extensors

Isokinetics and Exercise Science ◽

10.3233/ies-204172 ◽

2020 ◽

pp. 1-8

Author(s):

Dasom Oh ◽

Wootaek Lim

Keyword(s):

Prone Position ◽

Supine Position ◽

Isometric Contraction ◽

Muscle Length ◽

Biceps Femoris ◽

Emg Activity ◽

Isometric Contractions ◽

Significant Difference ◽

Extension Force ◽

Long Head

BACKGROUND: Although the medial and lateral hamstrings are clearly distinct anatomically and have different functions in the transverse plane, they are often considered as one muscle during rehabilitation. OBJECTIVE: The purpose of the study was to compare the electromyographic (EMG) activity between the prone position and the supine position during maximal isometric contraction and to additionally confirm the effect of submaximal isometric contractions on EMG activity of medial and lateral hamstrings, and force. METHODS: In the prone position, EMG activities of the long head of biceps femoris (BFLH) and semitendinosus (ST) were measured during the maximal isometric contraction. In the supine position, hip extension force with EMG activity were measured during the maximal and the submaximal isometric contractions. RESULTS: EMG activity in the prone position was significantly decreased in the supine position. In the supine position, there was a significant difference between the BFLH and ST during the maximal isometric contraction, but not during the submaximal isometric contractions. CONCLUSIONS: The dependence on the hamstrings could be relatively lower during hip extensions. When the medial and lateral hamstrings are considered separately, the lateral hamstrings may show a more active response, with increased muscle length, in clinical practice.

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Comparison of Outcome of Three Different Approaches for Supracondylar Humerus Fractures in Children

10.53350/pjmhs2115103482 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3482-3484

Author(s):

Syed Usman Shah ◽

Mohammad Younas ◽

Naseer Ullah Khattak ◽

Amina Gul Shehzar Khan ◽

Sultan Shah ◽

...

Keyword(s):

Posterior Approach ◽

Lateral Approach ◽

Supracondylar Fractures ◽

Medial Approach ◽

Fractures In Children ◽

Supracondylar Humerus Fractures ◽

Significant Difference ◽

Group A ◽

Humerus Fractures ◽

Group B

Objective: The aim of this study is compare the outcomes among three different approaches (lateral approach, medial approach and posterior approach) for supracondylar humerus fractures in children. Study Design: Retrospective cohort study Place and Duration: The study was conducted at Orthopedics department of Ayub Teaching Hospital, Abbottabad for duration of one year from January 2020 to December 2020. Methods: There were one hundred and thirty five children had supracondylar humerus fracture were presented. Patients were aged between 3-12 years. Informed written consent was taken from authorities for detailed demographics age, sex, cause of fracture and side of fracture. Patients were categorized into three equal groups, group A had 45 patients and received lateral approach, group B had 45 patients and received medial approach and group C received posterior approach with 45 cases. Shaft Condylar Angle (SCA) and Baumann angle were used to analyze the radiological result. All children were assessed using Flynn's criteria for functional outcomes, and the results were divided into Excellent, Good, Fair and Poor. Post-operative outcomes among all the three groups were calculated and compared. SPSS 23.0 version was used to analyze complete data. Results: There were 90 (66.7%) males (30 in each group and 45 (33.3%) females (15 in each group). In group A mean age was 6.88±5.45 years, mean age in group B was 7.11±5.33 years and in group C mean age was 7.17±5.66 years. Sports 85 (62.9%) was the most common cause of fracture followed by traffic accidents 30 (22.2%) and the rest were 20 (14.8%) fall from the height. According to radiological outcomes, Mean shaft condylar Angle in group A was 41.5±6.3, in group B was 41.8±1.9 and in group C was 40.1±3.8 respectively (P>0.05). Mean Bauman angle in group A was 18.8±6.11, group B was 19.4±7.5 and in group C 20.4±5.3 with (P>0.05). According to Flynn’s criteria, excellent outcomes were observed in 33 (73.3%) in LA group, 24 (53.3%) in MA group and 22 (48.9%) in PA group, good results were observed in 11(24.4%), 19 (42.2%) and 21 (46.7%), fair outcomes in 1 (2.2%), 2 (4.4%) and 2 (4.4%). Conclusion: As a result of this research, we have concluded that the lateral technique for supracondylar fractures is superior to the medial or posterior approaches in terms of radiological and functional results. However, there was no statistically significant difference between the three groups. Keywords: Supracondylar fractures, Flynn’s criteria, Functional outcome, Open reduction

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Poor agreement between ultrasound and inbuilt diffusion tensor MRI measures of biceps femoris long head fascicle length

Translational Sports Medicine ◽

10.1002/tsm2.58 ◽

2018 ◽

Vol 2 (2) ◽

pp. 58-63 ◽

Cited By ~ 3

Author(s):

Fearghal P. Behan ◽

Robin Vermeulen ◽

Tessa Smith ◽

Javier Arnaiz ◽

Rodney Whiteley ◽

...

Keyword(s):

Diffusion Tensor ◽

Biceps Femoris ◽

Diffusion Tensor Mri ◽

Poor Agreement ◽

Fascicle Length ◽

Long Head ◽

Biceps Femoris Long Head

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Difference of Hamstring Activity Between Bilateral and Unilateral Nordic Hamstring Exercises With a Sloped Platform

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0249 ◽

2021 ◽

pp. 1-6

Author(s):

Toshiaki Soga ◽

Taspol Keerasomboon ◽

Kei Akiyama ◽

Norikazu Hirose

Keyword(s):

High Speed ◽

Biceps Femoris ◽

Break Point ◽

Hamstring Injury ◽

Emg Activity ◽

Maximum Voluntary Isometric Contraction ◽

Mean Values ◽

Significant Difference ◽

Long Head ◽

Control Study

Context: This study aimed to examine the differences in electromyographic (EMG) activity of the biceps femoris long head (BFlh) and semitendinosus (ST) muscles, break-point angle (BPA), and the angle at peak BFlh EMG activity between bilateral and unilateral Nordic hamstring exercise (NHE) on a sloped platform. Design: This study was designed as a case-control study. Methods: Fourteen men participated in the study. The participants initially performed maximum voluntary isometric contraction (MVIC) on the prone leg curl to normalize the peak hamstring EMG amplitude as the %MVIC. Then, participants were randomized to perform the following 3 variations of NHE: bilateral (N40) or unilateral (N40U) NHE with a platform angle of 40°, and unilateral NHE with a platform angle of 50° (N50U). The EMG activities of the BFlh and ST and the knee flexion angle during the NHE variations were recorded to calculate the EMG activity of the BFlh and ST in terms of the %MVIC, the angle at peak BFlh EMG, and BPA. Results: The BFlh %MVIC was significantly higher in N40U (P < .05) and N50U (P < .05) than in N40. A significant difference in BFlh %MVIC and ST %MVIC was observed between N40U (P < .05) and N50U (P < .05). The mean values of BPA and the angle at peak BFlh EMG were <30° for all NHE variations. Conclusions: In the late swing phase of high-speed running, BFlh showed higher EMG activity; thus, unilateral NHE may be a specific hamstring exercise for hamstring injury prevention.

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Muscle- and Region-Specific Associations Between Muscle Size and Muscular Strength During Hip Extension and Knee Flexion in the Hamstrings

Journal of Sport Rehabilitation ◽

10.1123/jsr.2021-0007 ◽

2021 ◽

pp. 1-6

Author(s):

Raki Kawama ◽

Masamichi Okudaira ◽

Hirohiko Maemura ◽

Satoru Tanigawa

Keyword(s):

Knee Flexion ◽

Muscular Strength ◽

Sports Injuries ◽

Biceps Femoris ◽

Muscle Size ◽

Cross Sectional ◽

Long Head ◽

Hip Extension ◽

Flexion Strength ◽

Biceps Femoris Long Head

Context: Strength deficits of the hamstrings following sports injuries decrease athletic performance and increase the risk of injury recurrence. Previous studies have shown a high correlation between the muscular strength during hip-extension and knee-flexion and total muscle size of the hamstrings. However, it remains unclear which region of the individual hamstring muscles is closely associated with muscular strength. Objective: To investigate the relationship between the size of each region of the individual hamstring muscles and muscular strength during hip extension and knee flexion. Design: Within-subject repeated measures. Setting: University laboratory. Participants: Twenty healthy young male volunteers who regularly engaged in sports activities. Outcome Measures: Anatomical cross-sectional areas were acquired from the proximal, middle, and distal regions of the biceps femoris long head, biceps femoris short head, semitendinosus, and semimembranosus. Hip-extension and knee-flexion strength were measured during maximal voluntary isometric and concentric contractions (angular velocities of 60°/s and 180°/s). Results: The anatomical cross-sectional area of the distal regions in biceps femoris long head (r = .525–.642) and semitendinosus (r = .567) were significantly correlated with hip-extension strength under all conditions and only at an angular velocity of 180°/s, respectively. Meanwhile, anatomical cross-sectional areas of the distal regions in biceps femoris short head (r = .587–.684) and semimembranosus (r = .569–.576) were closely associated with knee-flexion strength under all conditions. Conclusion: These results suggest that muscle size in the distal regions of biceps femoris long head and semitendinosus greatly contributes to the production of hip-extension strength, whereas that of biceps femoris short head and semimembranosus significantly contributes to the generation of knee-flexion strength. These findings could be useful for designing training and rehabilitation programs to efficiently improve strength deficits following sports injuries such as strain injury and anterior cruciate ligament tears.

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