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.

A Cephalometric Analysis on Magnitudes and Shape of Sella Turcica.

Familiarity with the shape and dimensions of sella turcica is important to recognize and manage pathological conditions of pituitary gland as well as for orthodontic treatment planning. The present study aims to describe the morphology and dimensions of sella turcica from Indian population, using lateral cephalograms to set a reference data for comparison among different races. The study used 36 lateral skull radiographs of both sexes between age group of 13 to 18 years. Shape of sella turcica was noted by visual inspection. Length, height anterior, height median, height posterior, distance between frontonasal suture and mental spine to midpoint of posterior clinoid process, and tuberculum sella were measured using digital vernier caliper with reference to Frankfort line. The results of the study revealed that mean length, height anterior, height median, height posterior were larger in females than in males. The morphological types identified include pointed posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with rounded hypophyseal fossa, hooked posterior clinoid process with flask-shaped hypophyseal fossa. These observations would be beneficial for the clinicians and orthodontists to design treatment planning in pathology of pituitary gland and in correcting dentofacial anomalies.

Morphological study of styloid process of the temporal bone and its clinical implications.

The objective of this study was to study the morphometry of the styloid process of temporal bone and prevalence of elongated styloid process. The morphology of elongated styloid process along with its embryological and clinical importance are discussed. The present study included 110 human dry skulls which were procured from the bone collections of the department of anatomy. The styloid process was observed macroscopically on both sides of all the skulls, the elongations if any were noted. All the styloids were measured for their length, thickness at different levels and interstyloid distance at various levels. Out of 110 specimens, only 5 skulls (4.5%) exhibited the elongated styloid process. Among them, 3 skulls (2.7%) had unilateral elongation and 2 skulls (1.8%) had bilateral elongation of the styloid process. The mean length of the styloid process was 17.8±9.3 mm and 18.2±5.6 mm for the right and left sides, respectively. The prevalence of elongated styloid process in the present study was 4.5%. The clinical anatomy of this congenital variant is important to the neurosurgeon and radiologist, while interpreting the computed tomogram and magnetic resonance image scans. The morphological knowledge of elongated styloid process is clinically important since the course of the vertebral artery may be distorted in such situations.

Morphometric study of the medial orbital wall emphasizing the ethmoidal foramina.

PURPOSE: Ethmoidal foramina on the medial orbital wall show a higher incidence of variation. Surgeons performing endonasal, anterior cranial fossa and medial orbital wall surgeries must be aware of these variations as they are a source of hemorrhage and also serve as landmark in proximity to the orbital apex. AIM: The present study aims to describe the morphometric distances of various ethmoidal foramina between anterior lacrimal crest to optic canal in south Indian dry human skulls. MATERIALS AND METHOD: The study was done on 44 adult dry human skulls. The occurrence of Ethmoidal foramina was noted by direct inspection. The distance of Ethmoidal foramina from anterior lacrimal crest to optic canal was measured with the help of ruler, probe and magnifying glass. RESULTS: The Posterior ethmoidal foramina were found in all 44 skulls bilaterally. Middle ethmoidal foramen was present in 12 and 13 skulls on right and left, respectively. Anterior ethmoidal foramen was found in 38 and 37 skulls on right and left, respectively. The distance between anterior lacrimal crest (ALC) and posterior lacrimal crest (PLC) was in the range of 3-8 mm and that of ALC to anterior ethmoidal foramen was in the range of 24-30 mm. The range of distance between anterior ethmoidal foramen to posterior ethmoidal foramen was 9-17 mm and that between posterior ethmoidal foramen to optic canal was 5-13 mm. CONCLUSION: These observations would help to predict the anatomical variations in the position of ethmoidal foramina with respect to anterior and posterior lacrimal crest and ensure the safe and precise performance of medial orbital wall surgeries to avoid injuries to the important neurovascular bundles passing through various foramina and fissures.

Mastoid emissary foramina: an anatomical morphological study with discussion on their evolutionary and clinical implications.

The identification of mastoidal emissary veins is of importance in the neurosurgical practice to diagnose abnormal and normal structures. In the present study, the objectives were to estimate the prevalence rate of mastoidal emissary foramina in the temporal bones of the adult skull and to study their number and morphology. The present study included 48 adult human skulls which were obtained from the gross anatomy laboratory of our institution. The mastoid parts of 96 temporal bones were macroscopically observed for the prevalence, number and morphology of the emissary foramina. It is observed that, the mastoidal emissary foramen was present in 88 temporal bones (91.7%) of our specimens. The foramen was observed single in 60 temporal bones (62.5%), double in 22 bones (22.9%), and triple in 6 temporal bones (6.2%). The mastoidal emissary foramen was absent in 8 (8.3%) temporal bones. The foramen was bilaterally absent in 3 (3.1%) skulls. It was unilaterally absent in 2 (2.1%) skulls and both were on the left side. The mastoidal emissary vein is prevalent in a large number (91.7%) of cases. It was observed that the accessory mastoidal emissary foramina were present in 29.1% of cases. Recognition of the mastoid emissary veins and accessory mastoid emissary veins during the otologic surgery is critical to avoid the significant bleeding. In the neurosurgical practice, the knowledge is important due to variability in the number of mastoidal emissary veins and their connection to the venous sinuses.

Superficial palmar arch completion at the first interdigital cleft: a case report.

Knowledge of variations in the formation of superficial palmar arch is beneficial for successful vascular surgery in the hand as well as for plastic surgeons. The authors describe an unusual completion of superficial palmar arch by first dorsal metacarpal branch of radial artery at the first interdigital cleft which was encountered during routine upper limb dissection for undergraduates. The arteria princeps pollicis and arteria radialis indicis also were the branches of first dorsal metacarpal artery at the first interdigital cleft.

Double superior vena cavae with bilaterally symmetrical azygos veins and incomplete left circumflex artery

Vascular variations should be considered seriously, since the majority of these are incidental findings during surgeries or catheterization. A prior knowledge of the possible existence of variations in the veins, especially in the vena cava, is necessary for surgeons, radiologists, or anaesthesiologists, since central catheterization procedures have been increased over the years. We are presenting double superior vena cavae, bilaterally symmetrical azygos veins, and an incomplete left circumflex coronary artery, which were noted during routine dissection of a 65-year-old male cadaver. Knowledge of the combination of these variations makes this case significant during cardiothoracic surgeries. The embryological basis and clinical significance of the abovementioned vascular aberrations have been discussed (AU)

No disponible

Occipital condyle morphometry and incidence of condylus tertius: phylogenetic and clinical significance.

PURPOSE: The objectives were to study the morphometry of occipital condyles and to find the incidence of third occipital condyle in Indian skulls. MATERIALS AND METHODS: In the present study, 140 occipital condyles from 70 dry skulls were analysed. The length, width, height of occipital condyles, the anterior and posterior intercondylar distances was measured. RESULTS: The average length, width and height of occipital condyle were 21.9 mm, 11.26 mm and 10.2 mm respectively. The average anterior and posterior intercondylar distances were 18.7 mm and 38.7 mm respectively. Among our specimens, 2 skulls (2.86%) had a third occipital condyle. CONCLUSION: We believe that the data of the present study may provide anatomical reference to neurosurgeons and thus help in surgical procedures around the craniovertebral junction. The clinical and phylogenetic significance of the third occipital condyle has been discussed.

Bilateral incomplete discoid lateral meniscus in a 14 weeks fetus: a case report and review of literature.

Discoid lateral meniscus is a rare condition that unilateral is more common than bilateral, here we report a case of bilateral discoid lateral meniscus which was observed in the knee joints of a female fetal cadaver of 14 weeks gestation (92 mm crown-rump length). It was an incomplete type of discoid meniscus, occupying about three fourth of the tibial plateau area. The embryological basis of this anomaly is discussed with emphasize on its clinical implications. This finding support the opinion that discoid lateral meniscus as a true congenital malformation that is not found in normal development.

Occipital emissary foramina in human skulls: an anatomical investigation with reference to surgical anatomy of emissary veins.

AIM: The objectives were to find the incidence and topography of the occipital emissary foramina in skulls of South Indian Region. MATERIAL AND METHODS: In the present study, 78 dried adult human skulls were examined. They were analyzed for the gross incidence and position of the occipital emissary foramen. The observations were made in the squamous part of the occipital bone from the posterior margin of the foramen magnum to the external occipital protuberance. RESULTS: From our observations, the occipital emissary foramen was present in 11 (14.1%) skulls. Left sided foramen was observed in 5 cases (6.4%), right-sided foramen in 4 (5.1%) and the median foramen was seen in 2 (2.6%) of the cases. CONCLUSION: The occipital emissary vein is present in a small percentage (14.1%) of cases. It was also demonstrated that its location is variable as to left, right or midline. Its location was closer to the foramen magnum than to the external occipital protuberance in all the specimens. The morphology of this subject is important to the neurosurgeons and plastic surgeons. The knowledge is of importance in suboccipital craniotomies as this foramen transmits the occipital emissary vein and will keep awareness among the surgeons to avoid the excessive bleeding.