scholarly journals The suprafascial course of lower leg perforators: An anatomical study

2020 ◽  
Vol 47 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Luca Vaienti ◽  
Giuseppe Cottone ◽  
Francesco De Francesco ◽  
Francesco Borelli ◽  
Giovanna Zaccaria ◽  
...  
Keyword(s):  
Lower Limb ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Lower Leg ◽  
Present Knowledge ◽  
Perforator Flaps ◽  
Surgical Exploration ◽  
Branching Patterns

Background Perforator mapping has been well described in the literature. Once the suprafascial plane is reached, the course of perforators is considered constant. However, the surgeon must be aware of whether an anastomosis exists between perforators superficially to the fascia, in order to choose the best vessel upon which to base the reconstruction. Our retrospective <i>in vivo</i> anatomical study of lower leg perforator flaps presents the first description of variations in the suprafascial path of perforators, which may influence preoperative flap design.Methods An anatomical study of lower limb perforators was performed on 46 nonconsecutive patients who were referred to our department from June 2012 to October 2018. Reconstruction with perforator-based propeller flaps was planned for each of the patients. In total, 72 perforators were preoperatively identified and surgically isolated. The suprafascial course of each perforator was reported.Results During suprafascial surgical exploration, branching patterns were observed in four perforators. These perforators had been classified as single vessels in the preoperative ultrasonographic analysis. However, after surgical dissection, distal converging branches were noted in two of them.Conclusions Our study is the first description in the literature of suprafascial converging perforators, which might constitute an obstacle to planned reconstruction procedures. Despite the accuracy of preoperative evaluations, anatomical variations were present. Knowledge of suprafascial perforator variations may help surgeons to choose the correct perforator upon which to base a planned flap.

Lateral lower leg perforator flaps: An anatomical study to localize and classify lateral lower leg perforators

Microsurgery ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 140-147 ◽  
Author(s):  
Pieter Hupkens ◽  
Wendy Schijns ◽  
Marjolijn Van Abeelen ◽  
Jan G.M. Kooloos ◽  
Nicholas J. Slater ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Lower Leg ◽  
Perforator Flaps

Thin Perforator Flaps for Reconstruction of the Lower Extremity

2019 ◽  
Author(s):  
Peggy J. Ebner ◽  
Daniel J. Gould ◽  
Ketan M. Patel
Keyword(s):  
Lower Limb ◽  
Lower Leg ◽  
Soft Tissue Coverage ◽  
Patient Centered ◽  
Perforator Flaps ◽  
Limb Reconstruction ◽  
Flap Survival ◽  
Flap Transfer ◽  
Viable Solution ◽  
Lower Limb Reconstruction

AbstractThin flaps, a modification of traditional flaps that minimize the need for debulking and revision, offer unique advantages in the field of lower limb reconstruction. Advances in the field of microsurgery have made this streamlined method of reconstruction a viable solution for soft tissue coverage in patients with both trauma and nonhealing wounds. Better understanding of anatomy has allowed for flap harvest above the fascia level and the Scarpal plane. These modifications allow for flap transfer with thicknesses more comparable to the native anatomy of the lower leg, ankle, and foot. Flap survival is comparable to traditional techniques with greater potential for improved patient-centered outcomes.

Digital volumetric measurements based on 3D scans of the lower limb: A valid and reproducible method for evaluation in lymphedema therapy. (Preprint)

2019 ◽  
Author(s):  
Daniel Schiltz ◽  
Natalie Kiermeier ◽  
Dominik Eibl ◽  
Christoph Koch ◽  
Karolina Müller ◽  
...  
Keyword(s):  
Lower Limb ◽  
Lower Leg ◽  
T Test ◽  
Volume Changes ◽  
Quick Method ◽  
Reproducible Method ◽  
The Mean ◽  
3D Scans ◽  
Paired T Test ◽  
Volumetric Measurements

BACKGROUND Exact quantification of volumetric changes of the extremities is difficult. There are several direct and indirect methods to assess extremity volume. As water displacement volumetry is rarely viable in a clinical setting and circumference measurements are prone to errors due to poor reproducibility and high inter- and intra-observer variability, an objective and easily reproducible method is indispensable. OBJECTIVE The aim of this study was to establish a standardized method based on 3D scans with defined caudal and cranial landmarks of the lower leg which allows for measurements of exactly the same body area. Furthermore, this study tests the method in terms of reproducibility and evaluates volume changes after surgical therapy in patients suffering from lymphedema. METHODS 3D-scans of the lower limb were performed with a mobile 3D-scanner. Volumetric calculation was done digitally. “Repeatability“ and “Inter-observer reliability” of digital volumetry were tested. Furthermore, the method was applied on 31 patients suffering from chronic lymphedema. ANOVA (analyses of variance) was conducted to compare the digital volumetric measurements. To assess the sensitivity to changes in digital volumetry, the mean volume of 31 patients before and 3 months after therapy were compared by a paired t-Test. RESULTS Calculations of repeatability of the volume based on 20 3D-scans of the same lower leg showed a mean volume of 2,488 ± 0,011 liters (range: 2,470 – 2,510). The mean volume of the 7 measurements of the 3 examiners did not differ significantly (F(2,18) = 1,579, p = .233). The paired t-Test showed a significant mean volume decrease of 375ml (95% CI = 245/505ml) between pre and post treatment (t (30) =5,892, p < .001). CONCLUSIONS 3D-Volumetry is a noninvasive, easy and quick method to assess volume changes of the lower leg. Other than the costs, it is reproducible and precise and therefore ideal for evolution of therapy in lymphedema.

scholarly journals Use of Gracile and semi-tendinosus tendons (GRAST) for the reconstruction of irreparable rotator cuff tears

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marie Protais ◽  
Maxime Laurent-Perrot ◽  
Mickaël Artuso ◽  
M. Christian Moody ◽  
Alain Sautet ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Donor Site ◽  
Anatomical Study ◽  
Donor Site Morbidity ◽  
Rotator Cuff Tears ◽  
Subacromial Space ◽  
Greater Tuberosity ◽  
Working Zone ◽  
Superior Capsular Reconstruction

Abstract Background Irreparable rotator cuff tears are common and difficult to treat. Techniques for “filling the loss of substance” require fixation to the rotator cuff stump (tendon augmentation) or to the glenoid (superior capsular reconstruction), which are complicated by the narrow working zone of the subacromial space. The main objective of this study was to determine whether a braided graft of gracilis (GR) and semitendinosus (ST) could fill a loss of tendon substance from an irreparable rupture of the supra- and infraspinatus, by fixing the graft to the greater tuberosity and the spine of the scapula. Methods This was a cadaveric study with the use of ten specimens. The GRA and ST tendons were harvested, braided and reinforced with suture. An experimental tear of the supraspinatus (SS) and upper infraspinatus (IS) retracted at the glenoid was made. The GRAST transplant was positioned over the tear. The transplant was attached to the greater tuberosity by two anchors and then attached to the medial third of the scapular spine by trans-osseous stitching. The percentage of filling obtained was then measured and passive mobility of the shoulder was assessed. We proceeded to the same technique under arthroscopy for a 73 years old patient whom we treated for a painful shoulder with irreparable cuff tear. We inserted a GRAST graft using arthroscopy. Results The Braided-GRAST allowed a 100% filling of the loss of tendon substance. Mobility was complete in all cases. Conclusion This technique simplifies the medial fixation and restores the musculo-tendinous chain where current grafting techniques only fill a tendinous defect. The transplant could have a subacromial “spacer” effect and lower the humeral head. The donor site morbidity and the fate of the transplant in-vivo are two limits to be discussed. This anatomical study paves the way for clinical experimentation.

Anatomical variations of clivus: a descriptive anatomical study

2021 ◽  
Author(s):  
Bhavana Murjani ◽  
Rohini Bhosale ◽  
Easwaran Ramaswami ◽  
Sonali Kadam ◽  
Amit Ramchandani
Keyword(s):  
Anatomical Study ◽  
Anatomical Variations

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.

Accessory museulus soleus

1926 ◽  
Vol 22 (5-6) ◽  
pp. 511-513
Author(s):  
V. N. Ternovsky ◽  
M. Sadykova
Keyword(s):  
Lower Limb ◽  
Lower Leg ◽  
Flexor Hallucis Longus ◽  
Posterior Surface ◽  
Flexor Digitorum Longus ◽  
Accessory Muscle ◽  
Peroneus Brevis ◽  
The Right ◽  
Flexor Digitorum

Dissecting the muscles of the right lower limb of an unknown corpse, we found an accessory muscle on the posterior surface of the lower leg. This muscle (see Fig.) Was bordered behind in. soleus and with the tendon m. plantaris, in front - with in. flexor hallucis longus, medially - c m. flexor digitorum longus and laterally - c m. peroneus brevis.

Stren. A case of melorheostosis. (Acta Chirurgica Scandinavica Vol. LXXVIII, Fasc. I-III, S. 94-102)

1937 ◽  
Vol 33 (1) ◽  
pp. 111-111
Author(s):  
V. S. Mayat
Keyword(s):  
Lower Limb ◽  
Lower Leg ◽  
The Right ◽  
Entire Limb

The author reports a case of melorheostosis (osteosclerotic process) in the right lower limb in a 13-year-old girl. The case of the author. fourteenth in literature. With this disease, a significant shortening of the entire limb is found, and 3/4 of the shortening refers to the lower leg, the damaged part of which is more affected.

COMPREHENSIVE ANATOMICAL STUDY OF VARIATIONS IN LINGUAL AND FACIAL ARTERIES IN ADULT CADAVERS FOR SURGICAL PRACTICE

2021 ◽  
pp. 69-70
Author(s):  
Ramitha Enakshi Kumar. S ◽  
P. Vahini
Keyword(s):  
Carotid Endarterectomy ◽  
Plastic Surgery ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Malignant Tumours ◽  
Surgical Practice ◽  
Hospital Acquired Infections ◽  
The Face ◽  
Human Cadavers ◽  
Hospital Acquired

Objective: The objective of this study is to comprehensively put forth the anatomical variations in the origin and course of lingual and facial arteries found in adult cadavers. Methods: Ten human cadavers were dissected and studied for variations from the norm regarding facial and lingual arteries . Results: 80% of the cadavers displayed classical origin and course of the arteries. There was a deviation from normal regarding origin of the arteries in 20% of the cadavers. Meanwhile, abnormality in the course amounted to 10%. Conclusion: In 20% of cadavers, there were variations in origin of facial and lingual arteries , meanwhile, changes in the course of the stated arteries is 10%. These variations prove to be of signicance to surgeons to prevent mishaps and hospital acquired infections, while performing carotid endarterectomy, intra-arterial catheterizations, plastic surgery of the face and resection of malignant tumours.

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