Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications.

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Morphometric study of the semitendinosus muscle and its neurovascular pedicles in South Indian cadavers.

The purpose of this study was to determine the length of the semitendinosus muscle belly and its tendon in South Indian population and to study the topography and diameter of its neurovascular pedicles. The study included 46 formalin fixed human cadaveric lower limbs. The length of the semitendinosus muscle belly and its tendon were measured. The neurovascular pedicles of the semitendinosus muscle were identified and counted. The diameter of the neurovascular pedicle was measured just before its entrance into the semitendinosus muscle. The topographical distance of the neurovascular pedicles from the origin of the semitendinosus muscle were determined. The mean length of the semitendinosus muscle belly was 332.3±36.1 mm and its tendon measured 154.8±31.9 mm. The mean diameter of the vascular pedicle was measuring 11.4±9.1 mm, just before its entrance into the semitendinosus muscle. The neurovascular pedicles, of the semitendinosus muscle were ranging between 1 and 7. The distance of the entrance of neurovascular pedicle to the semitendinosus muscle from its origin was ranging between 46 and 272 mm. It was observed that the neurovascular pedicles were highest (31%) at the range of 151-200 mm away from the ischial tuberosity. The morphometric data obtained in the present study is enlightening to the orthopedic and plastic surgeons. The topographical knowledge of the neurovascular pedicles has its implications during the harvesting of the grafts and pedicle flaps. The diameter of vessels in the pedicles is enlightening because of new method of anterior cruciate ligament reconstruction.

Morphometric parameters of the human adult kidney: an anatomical study / Parámetros morfométricos del riñon humano adulto: un estudio anatómico

The purpose of this study was to determine the anatomic parameters of the kidney in adults. The Renal lengths, width at superior and inferior poles, thickness at the superior and inferior poles were measured in 151 adult cadaver kidneys. A digital vernier caliper was used for performing the measurements. The data were statistically analyzed. The mean renal length was 8.9 ± 0.9 cm on the right side and 9.1 ± 0.9 cm on the left side. The mean width of the superior pole of the right kidney was 4.9 ± 0.6 cm and the left kidney was 5 ± 0.7 cm. The width of inferior pole of the right and left kidneys were 4.8 ± 0.6 cm and 4.5 ± 0.7 cm respectively. The mean thickness of the superior pole of the right kidney was 3 ± 0.4 cm and left kidney was 3.2 ± 0.5 cm. The mean thickness of the inferior pole of the right and left kidneys were 3.1 ± 0.4 cm and 3.2 ± 0.5 cm respectively. There was no statistical significance with respect to the length of both the kidneys. However there was some data on width and thickness among the right and left side showed the difference which was significant statistically. The present study has provided additional information on the renal morphometry which will be of use to the surgeons and radiologists.

El propósito de este estudio fue determinar los parámetros anatómicos del riñon en los adultos. La longitud renal, ancho de los polos inferior y superior, y grosor de los polos superior e inferior se midieron en riñones de 151 cadáveres adultos. Se utilizó un caliper vernier digital para realizar las mediciones y los datos fueron analizados estadísticamente. La longitud media renal fue 8,9±0,9 cm en el lado derecho y 9,1±0,9 cm en el lado izquierda. El ancho promedio del polo superior del riñón derecho fue 4,9±0,6 cm y del riñón izquierdo fue 5±0,7 cm. El ancho promedio del polo inferior del lado derecho e izquierdo riñones fueron 4,8±0,6 cm y 4,5±0,7 cm, respectivamente. El grosor promedio del polo superior en el riñón del lado derecho fue 3±0,4 cm y el izquierdo 3,2±0,5 cm. El grosor promedio del polo inferior del riñon del lado derecho e izquierdo fueron 3,1±0,4 cm y 3,2±0,5 cm, respectivamente. No hubo diferencia significativa en relación con la longitud de los riñones. Sin embargo hubo algunos datos en ancho y grosor entre el lado derecho e izquierdo que mostraron diferencia significativa. El presente estudio ha proporcionado información adicional sobre la morfometría renal que puede ser de utilidad para los cirujanos y radiólogos.

Anthropometric study of the bicipital groove in Indians and its clinical implications.

BACKGROUND: Since morphometric data on the upper end of the humerus from Indian anatomical samples are scarce, this study was undertaken with reference to orthopedic surgery. The aim was to determine the length, width and depth of the bicipital groove and to find the incidence of a supratubercular ridge of Meyer in an Indian population. METHODS: The study included 104 unpaired dry humeri (48 right side and 56 left) which belonged to the anatomy laboratory of our institution. The length, width and depth of the bicipital groove were measured with a digital vernier caliper. The data were tabulated as mean ± SD and statistically compared between the right and left sides. RESULTS: The mean length, width and depth of the bicipital groove were 84.6 ± 10.9 mm, 8.5 ± 2.3 mm and 4.4 ± 1.8 mm, respectively, which corresponded to 27.8% of the total length, 32.2% of the transverse width and 17% of the anteroposterior widh of the humerus, respectively. There was no statistically significant difference in these parameters between the left and right sides (p > 0.05). A supratubercular ridge of Meyer was seen in 24 (23.1%) of the humeri. CONCLUSION: The study determined the morphometric parameters of the bicipital groove in an Indian population. We believe that this study will be an important reference for scientific research, and the details are also important for anthropologists and clinical anatomists.

Pulmonary fissures and lobes: a cadaveric study with emphasis on surgical and radiological implications.

PURPOSE: The objective was to study the morphology of fissures and lobes of the lung in South Indian population. MATERIALS AND METHODS: The study included 60 adult cadaveric lungs which were obtained from the human anatomy laboratory. The specimens were macroscopically observed for gross morphology of fissures and lobes. RESULTS: Only 32 (53.3%) lungs showed the fissures and lobes as described in the standard anatomy texts. Among the right lungs, 15 (46.9%) had incomplete horizontal fissure, 6 lungs (18.7%) had absence of the horizontal fissure and one lung (3.1%) had the azygous lobe. The remaining 10 right lungs (31.3%) showed the usual morphology. In the left lungs, normal morphology was observed in 22 cases (78.6%), 2 lungs had incomplete oblique fissure (7.1%), one lung had (3.6%) absence of the oblique fissure, one lung showed an accessory fissure and lobe (3.6%). The anomalous multiple fissures and lobar pattern was observed in 2 cases (7.1%). CONCLUSION: Morphological knowledge of fissures and lobes of the lung is of importance to the thoracic surgeons in performing lobectomies and segmental resection. The radiologists should have an idea about these variations in interpreting the MRI and CT scans. We believe that the data from the present study certainly adds an important reference in the medical literature.

Morphological investigation of cranial sutures in Indian human adult skulls.

OBJECTIVES: The goal of the study was to evaluate the gross morphology of the coronal, sagittal and lambdoid sutures in human adult dried skulls and to determine if any difference exists in terms of patency. MATERIALS AND METHODS: The study included 78 human dry skulls of Indian population. The coronal, sagittal and lambdoid sutures were analyzed using the modified grading scale (Sabini RC and Elkowitz DE, 2006) for quantifying the sutural patency. An open suture was graded as 0, a fused suture as 1 and an obliterated suture as 2, 3 or 4, depending on the extent of obliteration. RESULTS: In coronal suture, the grade 1 suture was seen in 3.9%, grade 2 in 55.1%, grade 3 in 33.3%, and grade 4 in 7.7% of the cases. The sagittal sutures had grade 1 in 2.6%, grade 2 in 46.1%, grade 3 in 37.2%, and grade 4 in 14.1% of the cases. In contrast, the lambdoid suture showed 23.1% grade 1, 55.1% grade 2, 16.7% grade 3, and 5.1% grade 4 sutures. The grade 0 suture morphology was not observed in any of the skulls. CONCLUSIONS: When compared with the coronal and sagittal sutures, the lambdoid suture was more likely to be patent. The prolonged patency of the lambdoid suture may be due to external forces acting on it. The greater number of muscles acting on the lambdoid suture compared to coronal and sagittal sutures may be considered as the cause. We believe that, these findings may be helpful to the researchers who are interested in biomedical science and osteopathic manipulative medicine. The findings are also enlightening for the neuroscientists, morphologists, anthropologists and clinicians.