Vascular Foramina of Dry Human Talus: A Morphological Study.

Background The talus is the second largest tarsal bone and makes the osseous link between the leg and foot region. The branches of the dorsalis pedis, posterior tibial, and peroneal arteries enter vascular foramina (VF) on the various surfaces of the talus and provide intraosseous blood supply. Understanding the morphology and morphometry of VF might be helpful in reducing the risk of vascular injury associated with surgical interventions to the talus.  Aim and objectives The purpose of this study is to contribute reference data for the morphology of VF of talus in a sample from Türkiye. Materials and methods This study was performed on 62 dry talus samples from Türkiye. The number, location, size, and foraminal index of the VF were evaluated on each talus. The total and medial surface lengths, distances of the closest and furthest foramina on the inferior surface, and distances of the closest and furthest foramina on medial surface were measured. Results No VF was detected on articular surfaces and the head of the talus. The majority of VF (1754; 81.17%) were detected on the neck, and 708 (40.36%) were located on the inferior surface of the neck. On the body, VF was mostly detected on the medial surface (233; 57.25%). The mean foraminal indices of the closest and furthest foramina on the inferior surface were 38.85% and 77.89%, respectively. The mean foraminal index of the closest foramina on the medial surface was 33.52%, and the furthest foramina on the medial surface was 63.91%. The total number of VF on 62 tali was determined as 2161. The majority (1521; 70.38%) of the size of VF was ≥0.6 mm. The mean total length was 55.14±4.69 mm, and the medial surface length was 49.18±4.18 mm. Conclusion Knowing the morphologic and morphometric properties of the VF gains importance during surgical interventions to the talus to reduce vascular damage. According to our results, lateral approaches to the talus may be safer than other approaches. To our knowledge, there is no study about the morphology of VF of the talus in Türkiye samples. We believe that the results of this study will provide reference data for morphology and morphometry of VF of talus.

Anatomical features of the proximal end of the radius and its implications for implant design.

PURPOSE: The proximal radio-ulnar joint allows supination and pronation of the forearm and the humeroradial joint allows flexion and extension movements at the elbow joint. Although the proximal end of the radius is less common than other fractures, it is more common nowadays due to the prolongation of life expectancy, increased incidence of osteoporosis. There have been reports in the literature that success has not been achieved due to the lack of anatomical fit of the prosthesis. Knowledge of the morphometric features of the proximal end of the radius is important for the design of anatomically and biomechanically appropriate prostheses. METHODS: In this study, measurements of head and neck of radius, and radial tuberosity were measured in 80 dry radii. Parameters important for prosthesis design were analysed and their correlations examined. RESULTS: The shapes of radial head was found 36% oval and 64% circular. The mean heights of the radial head at anterior, posterior, medial, and lateral sides were 8.52 ± 1.32 mm, 9.02 ± 1.23 mm, 9.20 ± 1.59 mm, 8.05 ± 1.13 mm, respectively. The mean depth of articular facet were 1.85 ± 0.37 mm. It was determined that there was no high correlation between the parameters affecting the prosthesis design. CONCLUSIONS: Morphological and morphometric features of the proximal radius are important for prosthesis design and implantation. The ideal radial head prosthesis design is challenging due to numerous parameters, wide ranges and low correlation, although modular designs facilitate compatibility. The widespread use of 3D printing technologies is expected to reduce the potential complications associated with prosthesis applications.

Sex determination from scapula by volume rendering technique in Turkish population / Determinación del sexo a partir de la escápula mediante la técnica de representación de volumen en la población turca

SUMMARY: The aim of this study is to measure the significant parameters on scapula at computed tomography images and to determine the effects of these parameters for sex determination. The second aim is to find the most effective single and combined parameters to use for sex determination using scapula in Turkish population. In this study, morphometric measurements of scapula on the computed tomography images of 60 male and 60 females were evaluated and their impacts on sex determination were examined via stepwise logistic regression analysis. 10 parameters and 6 indexes calculated via using these parameters were measured. Scapular breadth of the right scapulae (86.7%), maximum scapular length of the left scapulae (85%), scapular breadth of all scapulae (80%) were found to be the most effective single parameters. Combination of the scapular breadth and maximum scapular length were 85%, 90%, 86.7% effective in sex determination on the right scapulae, on the left scapulae and on all of the scapulae, respectively. We believe that the results of this study will contribute to sex determination studies using the scapula in Turkish population for anatomist, anthropologist and forensic scientists.

El objetivo de este estudio fue medir los parámetros significativos en la escápula en imágenes de tomografía computarizada y determinar los efectos de estos parámetros para la determinación del sexo. El segundo objetivo fue encontrar los parámetros individuales y combinados más efectivos para determinar el sexo utilizando la escápula en la población turca. Se evaluaron las medidas morfométricas de la escápula en las imágenes de tomografía computarizada de 60 hombres y 60 mujeres y se examinó su impacto en la determinación del sexo mediante un análisis de regresión logística paso a paso. Se midieron 10 parámetros y 6 índices calculados mediante el uso de estos parámetros. El ancho escapular de la escápula derecha (86,7 %), la longitud escapular máxima de la escápula izquierda (85 %), el ancho escapular de todas las escápulas (80 %) resultaron ser los parámetros individuales más efectivos. La combinación del ancho escapular y la longitud máxima escapular fueron 85%, 90%, 86,7% efectivas en la determinación del sexo en la escápula derecha, en la escápula izquierda y en todas las escápulas, respectivamente. Creemos que los resultados de este estudio contribuirán a los estudios de determinación de sexo utilizando la escápula en la población turca para anatomistas, antropólogos y científicos forenses.

Reappraisal of the proximal tibia anatomy in Turkish population.

OBJECTIVE: Total knee arthroplasty has been popular in recent years. Morphometry of proximal tibia is important for surgeons to perform successful total knee arthroplasty. Aim of this study was to reappraise the proximal tibia morphometry. METHODS: In this study, 57 human dry tibia were evaluated. Anteroposterior and mediolateral dimensions of tibial condyles, maximum width of superior articular surface and length of tibia were measured. Furthermore, morphometric measurements of the intercondylar area and Gerdy's tubercle (infracondylar tibial tubercle) were done. All measurements were performed by two observers using a digital caliper. RESULTS: Mean anteroposterior and mediolateral dimensions of medial tibial condyle were found 39.76 and 23.27 mm, respectively. Mean anteroposterior and mediolateral dimensions of lateral tibial condyle were measured 34.72 and 21.83 mm, respectively. Mean anteroposterior dimension of intercondylar area was 41.62 mm. Shape of the Gerdy's tubercle was oval in 76.8%, irregular in 12.5%, and triangular in 10.7%. Texture of the tubercle was smooth in 85.7% and rough in 14.3%. Mean superoinferior and mediolateral dimensions of Gerdy's tubercle were 12.28 and 10.27 mm, respectively. Anteroposterior and mediolateral dimensions of tibial condyles were significantly higher (p < 0.05) for the medial condyle. Positive and statistically significant correlations were found between the tibial length and the other parameters (p < 0.05, r > 0.40). CONCLUSION: The morphometric data of tibial plateau are important for surgeons during total knee arthroplasty. The superoinferior and mediolateral dimensions of the Gerdy's tubercle, the distance between Gerdy's tubercle and tibial tuberosity, the distance between Gerdy's tubercle and lateral tibial plateau were measured for the first time in our study. The data obtained from this study can be used as a guideline in designing tibial component of the total knee prosthesis in Turkish population. In arthroplasty, patient-specific prosthetic implants may eradicate implant mismatch in the near future.

Sex determination from glenoid cavity by computed tomography in Turkish population / Determinación del sexo de la cavidad glenoidea mediante tomografía computarizada en la población turca

SUMMARY: The aim of this study is to contribute to sex determination studies from the scapula in the Turkish population and compare with previous studies. This study was performed with 200 scapulae (100 males and 100 females). The age range of the patients was between 18-93 years old. Computed tomography scans were used and length of glenoid cavity (LGC), breadth of glenoid cavity (BGC), depth of glenoid cavity (DGC), perimeter (PM) and volume (VL) were measured. Randomly selected 20 scapulae were measured three times for examine the intra-rater reliability from those measurements. Gender logistic regression analysis was conducted to find the significant variables at sex determination from the scapula. The most effective parameter in determining sex from scapula was found to be VL (88.5%). The effects of LGC, PM, BGC and DGC at sex determination from scapula were found to be 83%, 82.5%, 79.5%, 66%, respectively. The combination of VL and PM (89.5%) was found to be the most effective combination at sex determination from the scapula. The intraclass correlation values of all measurements were found to be at high reliability. According to the literature, PM and DGC along with the VL in Turkish population, were not used previously for sex determination from the scapula. A combination of the VL and PM was found to be the most effective parameters at sex determination from scapula in the Turkish population. There are few studies on the sex determination from scapula in the Turkish population. This study will guide anthropologists, forensic scientists and anatomists at sex determination studies from scapula and surgeons by morphometrically in clinical situations related to the scapula.

RESUMEN: El objetivo de este estudio fue contribuir a la determinación del sexo a partir de la escápula en la población turca y comparar con estudios previos. Esta investigación se realizó con 200 escápulas (100 hombres y 100 mujeres). El rango de edad de los pacientes estaba entre de 18 años y 93 años. Escaner de tomografía computada se usó para medir en la cavidad glenoidea los siguientes parámetros: longitud (LCG), ancho (ACG), profundidad (PCG), perímetro (PG) y volumen (VCG). Se midieron 20 escápulas seleccionadas tres veces al azar para examinar la confiabilidad intraevaluador de estas mediciones. Se realizó un análisis de regresión logística de género para encontrar las variables significativas en la determinación del sexo a partir de la escápula. El parámetro más eficaz para determinar el sexo a partir de la escápula resultó ser VCG (88,5%). Los efectos de LCG, PG, ACG y PCG en la determinación del sexo a partir de la escápula fueron del 83 %, 82,5 %, 79,5 % y 66 %, respectivamente. La combinación de VCG y PG (89,5%) resultó ser la combinación más efectiva en la determinación del sexo a partir de la escápula. Se encontró que los valores de correlación intraclase de todas las mediciones tenían una alta confiabilidad. De acuerdo con la literatura, PG y PCG junto con el VCG en la población turca, no se han utilizado previamente para la determinación del sexo a partir de la escápula. Se determinó que una combinación de VCG y PG son los parámetros más efectivos en la determinación del sexo a partir de la escápula. Existe escasa información sobre la determinación del sexo a partir de la escápula en la población turca. Este estudio guiará a los antropólogos, forenses y anatomistas en los estudios de determinación del sexo de la escápula y sera útil para los cirujanos en situaciones clínicas relacionadas con la escápula.

A supportive donor nerve for long-term facial paralysis: Anatomical analysis of the posterior auricular nerve and micro-anatomical comparison with zygomatic nerve.

BACKGROUND: The posterior auricular nerve (PAN) is an inspiring candidate for the additional axonal source in long-term facial paralysis to improve the functional results of the cross-facial nerve (FN) graft technique. However, no studies have analyzed the PAN's axonal load and its microscopic anatomy to assess its utilization in facial reanimation. The present study aims to examine the anatomical and microscopic features of the PAN to analyze its feasibility as a donor nerve. METHODS: The bilateral facial side of 14 fresh frozen adult human cadavers was examined for the study. The PAN's anatomical course was recorded, and nerve specimens from the PAN and zygomatic nerve (ZN) were obtained to compare their microscopic anatomy and axon counts using a light microscope and transmission electron microscope. RESULTS: The PAN's average branching distance and its course length were 5.8 ± 2.69 mm and 59.2 ± 5.85, respectively. The mean number of myelinated axons was 600.28 ± 69.97 in the PAN and 728.85 ± 166.31 in the ZN. This difference between the two nerves was statistically significant (p = 0.002). However, considering the gender variable, the mean axon counts of PAN and ZN were statistically similar for face sides and their average. Furthermore, the ultrastructural anatomy of both nerves was similar in electron microscopic evaluation. CONCLUSIONS: The present study confirms that the PAN is a proper candidate to be a supportive donor nerve due to its isolated site, consistent anatomical course, convenient ultrastructural anatomy as well as axonal load.

Vestibular landmarks to minimize injury to the mental nerve during transoral endoscopic thyroidectomy-vestibular approach (TOETVA) procedure: an anatomical study / Puntos de referencia vestibulares para minimizar la lesión del nervio mentoniano durante el procemiento de abordaje vestibular de tiroidectomía endoscópica transoral (TOETVA): un estudio anatómico

SUMMARY: The aim of this study is to reveal the morphometry of the mental nerve to describe a safe zone for minimizing mental nerve damage during transoral endoscopic thyroidectomy-vestibular approach (TOETVA). This study was performed on 12 cadavers. Localization of mental foramen according to teeth, distances of buccogingival sulcus-lip (BG-L), mental foramen-midline (MF-Midline), mental foramen - buccogingival sulcus (MF - BG), commissure - branching point (Cm - Br), branching point - vertical projection of branching point on lower lip (Br - LVP), vertical projection of branching point on lower lip - commissure (LVP - Cm), commissure - midline (Cm - midline), angles of mental (AM), angular (AA) and labial branches (AL) and branching patterns were recorded. Type 1 was mostly found as branching pattern in this study (45.8 %). A new branching pattern (type 9) was found on one cadaver. Mental foramen was mostly located at level of second premolar teeth. According to morphometric results of this study; supero- lateral to course of angular branch and infero-medial to course of mental branch of mental nerve on lower lip after exiting the mental foramen were described as safe zones during surgery for preserving mental nerve and its branches.

RESUMEN: El objetivo de este estudio fue revelar la morfometría del nervio mental o mentoniano para describir una zona segura y de esta manera, minimizar el daño de este nervio durante la tiroidectomía endoscópica transoral-abordaje vestibular (TOETVA). Este estudio se realizó en 12 cadáveres. Se realizó la localización del foramen mentoniano según los dientes, distancias surco gingival-labio (BG-L), foramen mentoniano-línea mediana (MF-Midline), foramen mentoniano-surco gingival (MF-BG), comisura-punto de ramificación (Cm-Br), punto de bifurcación - pro- yección vertical del punto de bifurcación en el labio inferior (Br - LVP), proyección vertical del punto de bifurcación en el labio inferior - comisura (LVP - Cm), comisura - línea mediana (Cm - línea mediana), ángulos del mentón (AM). Se registraron ramos angulares (AA) y labiales (AL) y patrones de ramificación. El tipo 1 se encontró principalmente como patrón de ramificación en el 45,8 %. Se describe un nuevo patrón de ramificación (tipo 9) encontrado en un cadáver. El foramen mentoniano se localizaba mayoritariamente a nivel de los segundos premolares. Según los resultados morfométricos, supero-lateral al curso de la rama angular e infero-medial al curso de la rama mentoniana del nervio mentoniano en el labio inferior, después de salir del foramen mentoniano, se describieron las zonas seguras, para la cirugía y preservación del nervio mentoniano y de sus ramos.

Defining a Preauricular Safe Zone: A Cadaveric Study of the Frontotemporal Branch of the Facial Nerve.

BACKGROUND: In the preauricular region, the frontotemporal branch of the facial nerve is vulnerable to injury, which can result in facial palsy and poor cosmesis after surgical interventions. OBJECTIVES: The purpose of this study was to describe variations in the branching patterns of the frontotemporal branch of the facial nerve and the relation between this branch and the surrounding anatomic landmarks. Based on our findings, we propose a Danger Zone and Safe Zones for preauricular interventions to avoid frontal branch injury. METHODS: Twenty cadaveric half-heads, 10 freshly frozen and 10 embalmed, were dissected. The anatomy of the auriculotemporal nerve, facial nerve, and variations of its branching pattern in the preauricular region were investigated. RESULTS: The mean [standard deviation] number of frontotemporal branches crossing the zygomatic arch was 2.05 [0.6]. Beginning from the X point at the apex of the intertragal notch, frontal branches ran over the zygomatic arch at a distance extending from 10 to 31 mm anterior to the tragus, which can be defined as the Danger Zone for frontal branches. Safe Zones A and B are triangular regions located behind and in front of the Danger Zone, respectively. CONCLUSIONS: Mapping of these Safety and Danger Zones is a reliable and simple approach in preauricular interventions to avoid frontal branch injury because the facial nerve typically has multiple frontal branches. This approach provides practical information for surgeons rather than estimating the trajectory of a single frontal branch from Pitanuy's line.