Descriptive study of the anatomical and ultrasound correlation at the lumbar spine / Estudio descriptivo de la correlación anatómica y ecográfica en la columna lumbar

No disponible

Anatomía arterial de los colgajos musculares de extensor carpi radialis longus y extensor carpi radialis brevis para su uso en transferencia muscular funcional libre / Arterial anatomy of the extensor carpi radialis longus and extensor carpi radialis brevis muscle flaps related to its use in free functioning muscle transfer

El objetivo de este trabajo es documentar el aporte arterial y el patrón vascular intramuscular de los músculos Extensor Carpi Radialis Longus(ECRL) y Extensor Carpi Radialis Brevis (ECRB) para analizar su utilización como colgajos libres en transferencia muscular funcional para reanimación facial. Realizamos un estudio anatómico en 29 brazos humanos en fresco. Las técnicas de inyección utilizadas fueron la modificada de óxido de plomo y gelatina en 11 cadáveres y la de inyección pulsátil de látex color en 18. Disecamos los músculos ECRL y ECRB y sus pedículos, los fotodocumentamos y radiografiamos valorando los resultados en función del patrón vascular intramuscular, relaciones anatómicas, calibres y longitud de pedículos. Encontramos dos patrones vasculares diferentes en las 29disecciones siguiendo la clasificación de Mathes y Nahai de la anatomía vascular de los músculos (en función del número de pedículos vasculares y su dominancia): Tipo I( 37,9% ECRL y 20,7% ECRB) y Tipo II (62,1%del ECRL y 79,3% del ECRB). El pedículo principal del ECRL (de diámetro medio 1,73 mm y longitud de pedículo media de 32,32 mm) es en el 100% de los casos rama de la arteria recurrente radial y el pedículo principal del ECRB (de diámetro medio 1,11 mm y longitud de pedículo media de 27,77 mm) es rama de la arteria radial en el 68,9% de los casos y de la arteria recurrente radial en el 31,1% de los casos. Concluimos que ElECRL y ECRB presentan dos tipos de patrones vasculares: tipo I y tipo II, siendo más frecuente en nuestro trabajo el tipo II, que hacen que ambos puedan ser transferidos como colgajos libres por su pedículo principal. Ambos músculos presentan un tamaño, contorno, contenido fascial importante para el anclaje de suturas y una longitud de pedículo y calibre vascular adecuados para su transferencia microvascular libre en reanimación facial. De los dos, el más realizable como colgajo libre es el ECRB ya que la relación anatómica del nervio radial con el pedículo del ECRL hace que no sea posible su transferencia como colgajo libre sin sacrificar la ramamotora del nervio radial en la mayor parte de los casos (AU)

The arterial anatomy of the Extensor Carpi Radialis Longus and Brevis(ECRL, ECRB) flaps is herein described in order to provide the vascular basis to be used as free muscle transfer for facial reanimation. Weused 29 fresh above-elbow human arms injected by means of two different techniques. Latex-injection was performed in 18 arms and the modified lead oxide-gelatine injection technique was performed in 11 arms. The ECRL and ECRB with their pedicles were dissected, photodocumented and radiographied. The number, length and calibers of the muscle pedicles were recorded. The intramuscular vascular pattern and the relations of the main pedicles of the muscles with the radial nerve were also noted. Two vascular patterns were found following the Mathes and Nahai Classification of the Vascular Anatomy of the Muscles (number of pedicles and its dominance): Type I (37,9% of ECRL and 20,7% of ECRB dissections) and Type II (62,1% of ECRL and 79,3% of ECRB dissections). The dominant pedicle for the ECRL (with an average caliber of 1,73 mm and an average length of pedicle of 32,32 mm) is a branch of the radial recurrent artery in100% of the dissections and the dominant pedicle for the ECRB (with anaverage caliber of 1,11 mm and an average length of pedicle of 27,77 mm)is a branch of the radial artery in 68,9% of the dissections and a branch of the radial recurrent artery in 31,1% of the cases. As a conclusion, ECR Land ECRB muscle flaps present two types of vascular patterns: type I and type II. Type II pattern is the most common in our study. The anatomical features of both muscles (vascular basis, presence of an important fascial layer, contour and length of the muscle,) make them reliable as free muscles flaps for facial reanimation, however, the relation between the dominant pedicle for the ECRL muscle flap with the posterior interosseous branch of the radial nerve make not possible to free the flap without sacrificing the nerve in most of the cases (AU)

Innervation of biceps brachii and brachialis: Anatomical and surgical approach.

This study describes the anatomy of the musculocutaneous nerve (MCN) in the middle and lower thirds of the arm, with special reference to the motor branches to the biceps and brachialis muscles, given their importance in certain clinical, particularly surgical, procedures. In each dissection (46 upper limbs) we recorded the course of the MCN and its variations, and the number, type of distribution pattern and length of the motor branches to the biceps brachii and brachialis muscles. We also recorded the position at which those branches arose from the MCN trunk. We found three branching patterns for biceps brachii: 1) one branch (60.5%); 2) two branches, one for each biceps head (27.9%); and 3) two branches, one for the two biceps heads and one for the common belly (11.6%). The mean distance between the acromion and the motor branches to biceps brachii was 133.8 mm, 45.3% of the acromion-lateral epicondyle distance. The mean length of those branches was 31.2 mm. We found two branching patterns for brachialis: 1) one branch (72.1%); and 2) two branches (27.9%). These motor nerves to brachialis arose from the MCN at a mean distance of 185.3 mm, 61.5% of the acromion-lateral epicondyle distance, and their average length was 33.0 mm. The data were expressed as the percentage of the distance between the acromion and the lateral epicondyle of the humerus, to make their clinical use easy and to avoid errors caused by anthropometric differences.