Regional morphological adaptations of vastus lateralis muscle in response to different progressive resistance training programs: A randomised controlled trial.

Background: Resistance training often increases muscle size, a phenomenon known as muscle hypertrophy. These morphological adaptations were typically documented to occur in a non-uniform pattern. Investigating the specific morphological adaptations to different training programs was of interest. Objectives: This study aimed to investigate two resistance training programs, a high-intensity program (HI) and a combined high-intensity with low-intensity blood flow restriction program (MIX), on morphological adaptations of vastus lateralis muscle in healthy young men. Methods: Eighteen active participants were recruited and randomly assigned to the HI (n = 10) or MIX (n = 8) groups, undergoing different 6-week resistance training programs. The training volume set was equated and progressively increased from three sets in weeks 1 and 2 to six sets, and eight sets in weeks 3-4 and 5-6, respectively. Three specific regions of vastus lateralis were assessed by magnetic resonance imaging (MRI) and ultrasound imaging (US) during pre-and post-intervention. Results: Statistical analysis revealed statistically significant increases in muscle area at the proximal (HI: Δ12%, MIX: Δ9.2%), middle (HI: Δ8.7%, MIX: Δ9.0%), and distal (HI: Δ14%, MIX: Δ13%) regions. Additionally, both HI and MIX groups showed statistically significant increases in the sum of muscle thickness post-intervention (HI: Δ12%, MIX: Δ19%) and in the sum of fascia thickness post-intervention (HI: Δ27%, MIX: Δ54%). Despite the MIX group training with higher volume load, no statistical differences were observed between groups for any week. Conclusion: These findings suggested that both HI and MIX programs effectively induced increases in muscle area and sums of muscle and fascia thickness in healthy young men, allowing practitioners to choose either program based on individual preferences and constraints.

Burst abdomen: a preventable risk of severe maternal morbidity in a developing country (a case-control study at a university teaching hospital in Tanzania).

Introduction: burst abdomen is a preventable complication of caesarean section that carries an increased risk of maternal death, especially in developing countries including Tanzania. The study aimed to identify the risk factors and high-risk patients for burst abdomen at Muhimbili National Hospital in Tanzania. Methods: a case-control study was performed at Muhimbili National Hospital in Dar es Salaam from 2nd April to 27th December 2019. Characteristics of interest of one case of burst abdomen were compared to three randomly selected controls that consisted of caesarean deliveries either 24 hours before or after the time of delivery of cases. The chi-square test, Fischer´s exact test, and multivariate analysis were used. The level of significance was p < 0.05. Results: a total of 524 women that met the inclusion criteria, comprising 131 cases and 393 controls, delivered by caesarean section in the most recent pregnancy at Muhimbili National Hospital. Cases were independently associated with perioperative illness, including cough (OR 3.8, 95%CI 1.9-7.6), chorioamnionitis (OR 4.5, 95% CI 1.3-14.7), and surgical site infection (OR 3.2, 95% CI 1.7-6.4), and a vertical midline incision wound (OR 1.9, 95% CI 1.2-3.1) compared to control group. Most cases (70%) had intact sutures and loose surgical knots. Conclusion: burst abdomen remains a cause of unnecessary severe maternal morbidity and is independently associated with perioperative illnesses such as cough, chorioamnionitis surgical site infection, and a vertical midline abdominal incision. Thus, there is a need for modifying abdominal fascia closure techniques for patients at risk.

Ultrasound-guided core needle biopsy of deep fascia: A cadaveric study evaluating feasibility, accuracy and reliability.

Over the past few decades, researchers and clinicians have dedicated significant attention to fascial tissues. Current interest focuses on their anatomical and pathophysiological features. Breakthroughs in ultrasound (US) and magnetic resonance imaging (MRI) have enhanced our ability to study the dynamics and alterations of the tissue structures. However, a microscopic perspective is also essential for a comprehensive understanding of some pathologies of the fasciae. The aim of this study was to investigate, using a cadaveric study: (1) the ease of visualization of the landmarks used for the US-guided fascial core needle biopsy (CNB); (2) the consistency and accuracy of needle placement inside fascial layers using US guidance and confirmed by histological examination; (3) inter-rater reliability. We assessed the feasibility of US-guided CNB in different topographical regions of human cadavers: the thoracolumbar fascia (TLF), fascia lata (FL), and crural fascia (CF). The results, confirmed by histological examination, revealed no significant difference in needle placements between the in-plane approaches in the long and short axes for all locations and fasciae studied (long axis: 91.88%; short axis: 96.22%); p > 0.05. US-guided core needle biopsy with the in-plane approach is feasible, consistent and reliable. It could provide most or all of high-quality fascial tissue samples required for pathological examination. It could also reveal changes in fascial pathologies, capturing the exact site of pathology thanks to US guidance, in particular in patchy diseases such as eosinophilic fasciitis.

One-Stage Bilateral Severe Trismus Reconstruction: Simultaneous Utilization of Free Anterolateral Thigh and Tensor Fascia Latae Flaps From a Single Donor Thigh: Report of Three Cases.

Bilateral trismus associated with oral cancer was commonly occurred in those who had received surgical intervention and radiotherapy. Complete release of bilateral fibrotic tissues followed by free flaps reconstruction was the main current surgical intervention. However, reconstructions of both defects mostly needed to harvest two flaps from different donor sites were time-consuming and increasing morbidities. Herein, we presented three cases who undergone modified reconstructive method by harvesting the anterolateral thigh (ALT) flap and tensor fascia latae (TFL) flap simultaneously from the same donor site. Trismus release was performed including resection of the buccal part and fibrotic tissue, myotomy of the masticatory and medial pterygoid muscles, and bilateral coronoidectomy. Case 1, a 52 years-old man, with severe trismus as the interincisal distance (IID) was about 0 mm. He undergone a combined 12 × 7.5 cm ALT and 11 × 6 cm TFL flap reconstruction from a single-donor thigh. The IID apparently increased to 37 mm after 1-year follow-up. Case 2, a 64 years-old man, went through a combination of 6 × 7 cm ALT and 6 × 6 cm TFL flap reconstruction from unilateral thigh for severe trismus. The IID significantly improved from 10 mm to 30 mm after one and a half-year follow-up. Case 3, a 53 years-old woman, with IID was around 0 mm before the surgery. A combined 9 × 3 cm ALT and 9 × 3 cm TFL flap reconstruction was performed as the IID enhanced to 20 mm after 6 months follow-up. This reconstruction method using ALT and TFL flaps harvested from a single-donor thigh simultaneously could be suitable for patients with bilateral severe trismus.

Thin Skin in Rhinoplasty: Considerations for Camouflaging Dorsal Nasal Irregularities.

Thin skin presents a challenge for achieving optimal aesthetic outcomes and minimizing complications. The review analyzes various materials and techniques employed to achieve this goal. A comprehensive electronic search was conducted across various medical databases, retrieved 965 studies, from which 15 studies were eligible for inclusion in this review with a total number of 679 patients with thin nasal skin. Techniques that promote graft integration, minimize resorption, and provide a smooth dorsal contour are crucial for thin-skinned patients. Diced cartilage with PRP, fascia lata grafts, and laser-assisted rhinoplasty appear to be particularly effective based on the available evidence. Platelet-rich fibrin (PRF) appears to play a role in some techniques by enhancing healing and tissue regeneration. Natural materials, like fascia lata and ligamentous grafts, offer potential benefits but require further exploration. Fat grafting techniques show promise but necessitate more research. This review provides a comprehensive overview of various techniques for addressing dorsal irregularities in rhinoplasty for patients with thin skin. Surgeons can utilize this information to select the most appropriate approach for achieving optimal aesthetic outcomes while minimizing complications.

Plantar Fascia Thickness and Stiffness in Healthy Individuals vs Patients With Plantar Fasciitis.

BACKGROUND: Plantar fasciitis is a major cause of heel pain, resulting from repetitive trauma to the plantar fascia and leading to structural changes within the fascia. It has been observed that plantar fascia thickness in plantar fasciitis patients exceeds that of normal individuals. However, the biomechanical properties of the plantar fascia in patients with plantar fasciitis remain unclear. Therefore, this study aimed to compare plantar fascia stiffness between healthy individuals and patients with plantar fasciitis across different areas. METHODS: Fifty-eight participants were divided into 2 groups: 29 healthy individuals and 29 individuals with plantar fasciitis. B-mode ultrasonography was used to assess plantar fascia thickness, whereas shear wave elastography was employed to measure plantar fascia stiffness. The study focused on 3 distinct areas: calcaneal insertion, 1-cm distal area, and 2-cm distal area. Additionally, the most painful area reported by patients was marked in the plantar fasciitis group. RESULTS: The findings showed that the plantar fasciitis group exhibited significantly greater plantar fascia stiffness in almost all areas compared to the healthy group (P < .05). Moreover, the stiffness of the plantar fascia in the most painful area demonstrated the highest value compared with other areas within the plantar fasciitis group (P < .05). CONCLUSION: This study suggests structural and mechanical changes in the plantar fascia in patients with plantar fasciitis.

Spontaneous rupture of the plantar fascia: a case report.

Introduction: The rupture of the plantar fascia is a rare but significant injury that predominantly affects athletes and individuals engaged in high-impact activities. Sudden increases in physical activity, direct trauma, corticosteroid injections, and chronic degeneration from plantar fasciitis can predispose individuals to rupture. It can involve a complete or partial tear of the plantar fascia fibers, leading to a loss of structural integrity and functional support. The tear may occur at the origin, mid-portion, or insertion of the fascia. Spontaneous ruptures of the plantar fascia (occurring without any predisposing factors) are rarely observed in clinical practice. No guidelines or other unequivocal recommendations are available for this pathological condition. Method: A healthy 35-year-old male who works in an office setting and is a recreational cyclist with a silent clinical anamnesis experienced a spontaneous rupture of the plantar fascia of the left foot with no history of trauma. He exhibited significant localized tenderness and swelling in the medial arch of the left foot with difficulty bearing weight on the affected foot. An MRI confirmed a partial rupture of the medial cord of the plantar fascia accompanied by surrounding inflammation. The patient underwent conservative treatment, which included rest, immobilization, physiotherapy (ultrasound therapy, high-power laser therapy, and transcutaneous electrical nerve stimulation), rehabilitation, and a gradual return to activity. Results: At the 12-week follow-up, the patient reported a significant reduction in pain and marked improvement in functional mobility (as confirmed by VAS and Foot Function Index scores). Physical examination showed no tenderness, and the patient could bear full weight on the foot without discomfort. A follow-up ultrasound demonstrated complete resolution of the plantar fascia rupture and no residual inflammation. Discussion: This case underscores the effectiveness of an integrated rehabilitative approach and provides a framework for managing similar cases in clinical practice.

Fixation of Superolateral Platysma Flap to the Mastoid Fascia: A Novel Isolated Neck Lift Technique.

BACKGROUND: This study aimed to evaluate the utility of a novel neck lift technique based on fixation of superolateral platysma flap to the mastoid fascia in terms of postoperative aesthetic outcome and patient satisfaction within an 18-month follow-up period. METHODS: A total of 145 female patients who underwent isolated neck lift operation with the superolateral platysma flap technique were included. Global Aesthetic Improvement Scale (GAIS) scores (by the investigator) and the patient reported outcomes were recorded in terms of improvement in the cervicofacial angle, jowls, platysmal bands and malpositioned cervical fats, at 6 and 18 months, postoperatively. The complications were recorded at early postoperative period and at 1, 6 and 18 months, postoperatively. RESULTS: The median duration of follow-up was 18 months (range, 6-48 months). GAIS scores at 18th months, revealed exceptional improvement in the cervicofacial angle (82.8%), the jowls (93.1%), platysmal bands (93.1%) and malpositioned cervical fat (97.2%). Majority of patients were very satisfied with the treatment in terms of the aesthetic improvement. Complications involved the minor ecchymosis (17.2%) and minor skin circulatory problem (11.7%) in the early postoperative period, suture exposure (12.4%) in the postoperative 1st month, and cervical band reformation in the 6th (0.7%) and 18th (1.4%) months. CONCLUSION: In conclusion, lateral displacement and fixation of superolateral platysma flap to the mastoid fascia seems to be a useful neck lift technique for correction of platysma- and skin-derived aging sings with minor and manageable complications, immediate return to everyday activities and a high patient satisfaction. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The evaluation of risk factors in fascia dehiscence after abdominal surgeries.

Background: Despite the advances in surgical techniques and risk control practices in recent years, open wounds following abdominal laparotomy still have a high prevalence. The purpose of this study is to investigate the risk factors of fascia dehiscence (FD) in abdominal surgery patients. Methods: In this observational study, a total of 60 emergency and elective laparotomy patients were enrolled. For all patients, with (treatment) or without (control) wound dehiscence, a checklist was used to extract data from medical records regarding underlying diseases, suturing method, emergency or elective surgical procedure, duration of surgery less than 180 min, intraoperative bleeding, wound closure method, hernia repair, age, sex, smoking history, comorbidities, type of surgery, colostomy placement, wound complications, re-operation, mortality, wound complications including wound infection, wound dehiscence, incisional hernia, and anastomotic leak, and preoperative readiness assessments such as laboratory tests including C-reactive protein (CRP), Albumin (Alb), etc., were completed, and then comparisons were made. Results: Patients were examined in two groups: 14 patients (70%) in wound dehiscence with age 40-60 and 6 patients (30%) in non-wound dehiscence with age 60-75. Eight patients (40%) underwent elective surgery, and 12 patients (60%) underwent emergency surgery (P=0.2). Fourteen patients (70%) experienced mortality (P<0.001) and 13 patients (65%) had Alb less than 3 (P<0.001). Fourteen patients (70%) had drain installation (P=0.02). It was determined that the increase in CRP levels (compared to pre-dehiscence levels) was observed in 17 out of 20 cases, with the highest difference being CRP=91 and an average increase of 30. None of the patients suspected of anastomotic leakage were confirmed to have it. Dehiscence was typically diagnosed between the 4th and 7th days post-surgery. The colon and rectum were significantly more associated with dehiscence, while the stomach had the lowest association among surgical sites. Conclusion: Based on this study, FD is more common in patients treated in the emergency room than in elective procedures. Mortality occurred more in patients with FD, and there is a significant relationship between FD with albumin less than 3 and drain placement.

The deltotrapezial fascia stabilizes the AC-Joint and its reconstruction restores the horizontal stability in AC-joint separations-a biomechanical comparison.

BACKGROUND: Various techniques are available for the reconstruction of acromioclavicular joint (ACJ) dislocations, with the main focus being on restoration of the AC capsule or coracoclavicular (CC) ligaments. Recent research has underlined the significance of the deltotrapezial fascia (DTF) and related muscles as dynamic stabilizers of the ACJ. HYPOTHESIS: Reconstruction of the DTF increases the stability of the ACJ in the horizontal plane more than a complete transection of the fascia, while not restoring the stability of the native state. METHODS: Five pairs of human cadaveric shoulders including the torsos were included in the study and underwent cyclic anterior-posterior loading using an electromechanical testing machine. The shoulders were put into three groups: group N (n = 10): native ACJ; group T (n = 10): ACJ with transected DTF; group R (n = 10): ACJ with reconstruction of the DTF after transection. The dislocation was recorded with an 3D optical measuring system. RESULTS: Group N showed a mean horizontal displacement of 2.94 mm (± 1.26), group T showed a mean anterior displacement of 3.33 mm (± 1.37) and group R showed a mean anterior displacement of 2.95 mm (± 1.08). The mean anterior displacement for group T was significantly higher after every measured number of cycles compared with groups N and R. There was no significant difference in mean anterior displacement between groups N and R. CONCLUSION: The transection of the DTF results in significantly reduced stability in the horizontal plane of the ACJ. A reconstruction of the DTF restores the stability of the native ACJ in the horizontal plane. Further clinical and biomechanical investigations should focus on reconstruction techniques of the DTF.

The Tricellufuse Technique for Closing Nasal Septal Perforations.

Objective: Nasal septal perforation (NSP) is a structural anomaly that affects the mucosa, cartilage, and bone of the nasal septum, often stemming from septoplasty as the primary cause. Spontaneous healing of a perforated septum is rare, and typically the healing process is observed until it is determined that the condition is stable and no longer deteriorating, at which point surgical intervention is considered. Numerous surgical techniques have been proposed for NSP repair. This study introduces a novel approach incorporating a fascia lata graft with fat tissue and diced septal cartilage to reconstruct medium-sized NSP. Methods: The researchers conducted a retrospective analysis involving 22 patients who underwent repair for NSP from January 2021 to January 2023. Grafts were obtained, and the perforation was addressed using an open rhinoplasty technique, followed by the insertion and suturing of the graft. Results: The mean size of the septal perforations was 12 mm horizontally and 13 mm vertically. All patients with NSPs were chosen as medium size (within 0.5-2 cm). The mean follow-up period was 12 months. Complete closure of NSP was achieved in 19 out of 22 patients (86.3%). Among the cases, 15 were male (68%), and the ages ranged from 25 to 45 years with a mean of 35. Eight cases (36%) were smokers. After 12 months postoperatively, closure was not achieved in 3 medium-sized NSPs due to smoking. . The analysis revealed that the failure rate in the smoker group was statistically significant (P = .036). Conclusion: The TriCelluFuse technique, combining fascia lata, fat tissue, and diced septal cartilage, is a secure and reliable method for closing NSPs. It has a significant success rate and should be considered a viable option for individuals with NSPs.

Fascia lata allograft: a suitable alternative in ligamentous reconstruction for chronic elbow instability?

Background: Up to now, there is no gold standard concerning the optimal graft choice in the surgical therapy of chronic elbow instability. As donor site morbidity represents a rare (1%-4%) but severe complication of graft harvest, using an allograft seems favorable. Fascia lata mimics the anatomy through its fan-shaped configuration of the ligamentous complex of the elbow joint, making it questionable for use as a graft. The aims of the study are (1) to evaluate the biomechanical suitability of fascia lata allograft and (2) to compare clinical and radiological outcome between ligament reconstruction of the lateral collateral ligament complex using either FiberTape augmented triceps autograft or FibreTape augmented fascia lata allograft. Methods: Biomechanical testing of fascia lata was performed using a 10 kN uniaxial test system with a 1 kN load cell. The retrospective cohort study evaluated all patients who received a ligament reconstruction of the elbow due to chronic instability with allogenic fascia lata or autologous triceps tendon. Exclusion criteria were any type of coexisting fracture or nerval injury. Demographic parameters, patient-reported outcome parameters and radiological stability parameters (sonography and fluoroscopy) were evaluated. Results: Tensile testing of 39 fascia lata allografts revealed an ultimate load of 234.8 ± 23.1 N and ultimate strength of 33.4 ± 4.4 MPa. Twenty one patients were included in the clinical substudy (57.1% men, 42.9% women, age 41.0 ± 12.2 years, body mass index 24.9 ± 4.1 kg/m2) with average follow-up of 21.6 ± 17.1 months. No significant differences were found concerning pain level, patient-reported outcome measures, or range of motion, between fascia lata and triceps group. There was also no difference concerning sonographic stability of lateral ulnar collateral ligament between the 2 groups (P = .14). One revision occurred in fascia lata allograft group and 2 in triceps autograft group due to graft elongation. Conclusion: Currently, there is no clinical evidence demonstrating the superiority of either autograft or allograft tissue. Due to its demonstration of sufficient biomechanical properties, fascia lata allograft seems an appropriate treatment option for ligamentous reconstruction of chronic elbow instability.

High hydrostatic pressure treatment for advanced tissue grafts in reconstructive head and neck surgery.

The increasing importance of regenerative medicine has resulted in a growing need for advanced tissue replacement materials in head and neck surgery. Allo- and xenogenic graft processing is often time-consuming and can deteriorate the extracellular matrix (ECM). High hydrostatic pressure (HHP)-treatment could allow specific devitalization while retaining the essential properties of the ECM. Porcine connective tissue and cartilage were HHP-treated at 100-400 MPa for 10 min. Structural modifications following HHP-exposure were examined using electron microscopy, while devitalization was assessed through metabolism and cell death analyses. Furthermore, ECM alterations and decellularization were evaluated by histology, biomechanical testing, and DNA content analysis. Additionally, the inflammatory potential of HHP-treated tissue was evaluated in vivo using a dorsal skinfold chamber in a mouse model. The devitalization effects of HHP were dose-dependent, with a threshold identified at 200 MPa for fibroblasts and chondrocytes. At this pressure level, HHP induced structural alterations in cells, with a shift toward late-stage apoptosis. HHP-treatment preserved ECM structure and biomechanical properties, but did not remove cell debris from the tissue. This study observed a pressure-dependent increase of markers suggesting the occurrence of immunogenic cell death. In vivo investigations revealed an absence of inflammatory responses to HHP-treated tissue, indicating a favorable biological response to HHP. In conclusion, application of HHP devitalizes fibroblasts and chondrocytes at 200 MPa while retaining the essential properties of the ECM. Prospectively, HHP may simplify the preparation of allo- and xenogenic tissue replacement materials and increase the availability of grafts in head and neck surgery.

Comparison of Dye Spread Pattern and Nerve Involvement between Suprainguinal and Infrainguinal Fascia Iliaca Blocks with Different Injectate Volumes: A Cadaveric Evaluation.

Background and Objectives: Fascia iliaca compartment block (FICB) is an effective and relatively safe technique in perioperative pain management for hip surgery. However, blockade of the obturator nerve (ON) using this technique remains controversial. This study aimed to compare dye spread patterns and nerve involvement in the suprainguinal FICB (S-FICB) and infrainguinal FICB (I-FICB) approaches using different volumes of dye. Materials and Methods: Following randomization, 6 S-FICBs and 6 I-FICBs were performed on the left or right sides of 6 unembalmed cadavers. For each block, 30 mL or 60 mL of dye solution was injected. The extent of dye spreading and the staining pattern in the lumbar plexus branches were investigated using anatomical dissection. Results: Twelve injections were successfully completed. The lateral femoral cutaneous nerve (LFCN) and femoral nerve (FN) were consistently stained in all injections. Extended dye spread toward lumbar plexus branches was observed volume-dependently in S-FICBs. However, I-FICBs with an increased volume only showed dye spreading in the caudad direction limited to within the fascia iliaca. When 30 mL of dye was used, the ON was not stained with either approach. A stained ON was only observed in S-FICBs when 60 mL of dye was used. Conclusions: In this cadaveric evaluation, the ON was not stained in either FICB approach with the volume of injectate commonly used in clinical practice. The S-FICBs but not I-FICBs using a high volume of injectate resulted in extended spreading to the lumbar plexus branches.

Excision of a nasal dermoid sinus cyst and primary reconstruction using an autologous fascia lata graft in a cat.

Case summary: A 6-year-old female spayed domestic shorthair cat was presented with a 7-month history of a subcutaneous mass on the dorsal nasal surface. A CT examination revealed the presence of a nasal dermoid sinus cyst with a nasal bone defect. The cyst was excised and an autologous fascia lata graft was used for reconstruction. The dorsal nasal bone was reconstituted and no compromise of respiratory function was reported in the long-term outcome. No short-term complications were observed at the 2-week follow-up. No long-term complications or recurrence were observed at the 2- and 12-month follow-ups. Fascia lata grafting appears to be an effective method for repairing a nasal bone defect after surgical excision of a nasal dermoid sinus cyst in cats. It is inexpensive and the tissue is easily harvested and provides good functional and cosmetic results. Relevance and novel information: To the authors' knowledge, this is the first report that evaluates the effectiveness of repairing a nasal bone defect after dermoid sinus cyst excision in a cat using an autologous fascia lata graft.

Retrocolic Fascia-An Anatomical and Multidetector Computed Tomographic Angiography (MDCTA) Morphometric Analysis in Patients with Right Colon Cancer.

BACKGROUND: This study aims to delineate anatomical landmarks crucial for complete mesocolic excision, focusing on Gerota's fascia, which guides surgical dissection in right-sided colon cancer, forming the posterior limit. Employing a multimodal approach, the research aims to understand the fascial anatomy and its variations under pathological conditions. METHODS: Three methods were applied: a pilot dissection on an embalmed cadaver for clear anatomical presentation of prerenal fascia, Mimics segmentation of the fascia and its relationship with the colon, and a retrospective analysis of MDCTA scans from 196 patients (mean age 65.73 y, 118 F/78 M). Systematic measurements of fascial thickness were taken at key renal levels-upper pole, hilum, lower pole, and infra-renal. Covariates analyzed included Body Mass Index, age, and sex. RESULTS: The pilot dissection revealed the renal fascia of Gerota as the only true retrocolic compact connective tissue and the fusion fascia of Toldt as a mesh of strands of loose connective tissue and fat lobules. MDCTA showed clearer visualization of Gerota's fascia at the hilum and inferior renal pole, predominantly on the left. There were significant differences in fascial thickness between sides (1.30 mm on the right and 1.34 mm on the left) and a positive correlation with BMI, whereas age and sex showed no significant effects. CONCLUSION: Gerota's fascia is a critical anatomical landmark in CME for right colon cancer. This study highlights the fascia's structural integrity, unaffected by the tumor, underscoring its importance in surgical navigation.

The Impact of Fascial Manipulation® on Posterior Shoulder Tightness in Asymptomatic Handball Players: A Randomized Controlled Trial.

This prospective study aimed to determine the impact of Fascial Manipulation® by Stecco (FM) on the range of motion (ROM) of internal rotation (IR) and horizontal adduction (HADD) in asymptomatic handball players, representing significant risk factors for shoulder injuries. A randomized controlled trial was conducted, with participants randomly assigned to either the investigated group (N = 29) receiving a single session of FM or the control group (N = 27) receiving no treatment. The ROM for IR and HADD were measured before, immediately after, and one month after the FM session. The investigated group experienced a statistically significant acute increase in glenohumeral IR (14 degrees, p < 0.001) and HADD (14 degrees, p < 0.001) compared to the control group (p < 0.001). The positive effects of FM persisted one month post-treatment, with increased IR ROM by 12 degrees (p < 0.001) and HADD ROM by 11 degrees (p < 0.001). Participants in the investigated group reported lower subjective tightness/stiffness immediately after (p < 0.001) and one month after treatment (p = 0.002) compared to the control group. This study demonstrates that a single application of FM effectively improves glenohumeral ROM in the dominant throwing shoulder of asymptomatic handball players. It highlights the immediate and sustained positive effects of FM on IR and HADD. These findings support the use of FM as an effective method for enhancing shoulder ROM and reducing subjective tightness/stiffness. The study was registered at ClinicalTrials.gov (NCT06009367).