RESUMO
El propósito del presente estudio fue conocer la distribución de los ramos motores del nervio fibular superficial (NFS) y de sus respectivas penetraciones en los músculos fibulares en relación al ápice de la cabeza de la fíbula, dividiendo el compartimiento lateral de la pierna en tres regiones a fin de hacer posible una visión más segura de sus correlaciones clínicas y quirúrgicas. A través de disección, se estudiaron 60 piernas pareadas de 30 cadáveres adultos, de ambos sexos, Brasileños, con edad promedio de 44,9 años, siendo 8 de sexo femenino y 22 del masculino. Después de la disección se registraron las distancias de los puntos de penetración de los ramos del NFS en los músculos fibular largo (mFL) y corto (mFC), localizándolos en los tercios proximal, medio o distal, según fuere el caso. Se observó que el mayor número de ramos penetraron en el mFL a nivel de la parte distal del tercio proximal de la pierna, mientras que en el mFC lo hicieron en las partes proximal y distal del tercio medio de la pierna. Los ramos motores para el mFL penetraban en el vientre muscular entre 48,06 y 141,56 mm, y los ramos para el mFC lo hicieron entre 163,34 y 209,67 mm del origen del nervio. No hubo diferencias estadísticamente significativas ni entre los lados derecho e izquierdo ni entre genéros. Independiente de las diferencias metodológicas entre los estudios disponibles, el detalle de la distribución nerviosa en este compartimiento, permitirá una mayor precisión en el momento de elegirse un área para colgajo de injerto autólogo y una menor chance de lesiones iatrogénicas durante cirugías de la región.
The purpose of the present study was to know the distribution of the motor branches of the superficial fibular nerve (SFN) and their respective motor points in the fibular muscles in relation to the apex of the head of the fibula, dividing the lateral compartment of the leg in three regions in order to make possible a safer view of your clinical and surgical correlations. Through dissection, 60 paired legs of 30 adult cadavers, of both sexes, Brazilians, with an average age of 44.9 years, 8 being female and 22 male, were studied. After the dissection, the distances of the motor points of the NFS branches in the fibularis longus (FLm) and brevis (FBm) muscles were recorded, locating them in the proximal, middle or distal thirds. It was observed that the largest number of branches penetrated the FLm at the level of the distal part of the proximal third of the leg, while in the FBm they did so in the proximal and distal parts of the middle third of the leg. The motor branches for the FLm penetrated into the muscular belly between 48.06 and 141.56 mm, and the branches for the FBm did between 163.34 and 209.67 mm of the origin of the nerve. There were no statistically significant differences between the right and left sides or between genres. Regardless of the methodological differences between the available studies, the detail of the nervous distribution in this compartment will allow a greater precision at the time of choosing an area for autologous graft flap and a lower chance of iatrogenic injuries during surgeries of the region.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Nervo Fibular/anatomia & histologia , Músculo Esquelético/inervação , Fíbula/inervação , Variação Anatômica , Cadáver , Perna (Membro)/inervaçãoRESUMO
PURPOSE: The purpose of this study was to determine clinical importance and morphology of the fibularis longus, brevis, tertius muscles (presented as fibular muscles in this study), and prevalence of accessory fibular muscles (AFM) on fetal cadavers. MATERIALS AND METHODS: In this study, 200 limbs from 100 embalmed fetuses (54 male and 46 female) were studied. Morphology of fibular muscles and the presence of AFM were observed through dissection on fetal legs bilaterally. The absence of fibularis tertius muscle (FT) and the presence of AFM were identified. Length and length of the tendon of AFM were measured. Insertion of AFM was also identified. RESULTS: Mean values and standard deviations of all parameters according to trimesters were calculated. All parameters were increased with age during the fetal period. We determined the absence of FT; no FT was observed in 40 legs of 200 extremities (20%). The AFM was present in 7 of 200 specimens (3.5%). AFM muscles were classified into two types according to their site of origin. CONCLUSION: The present study has revealed the morphology of the fibular muscles and prevalence of the presence of AFM on fetal cadavers. In addition, it has revealed the morphometric development and prevalence of the absence of FT in a large series, and their clinical importance was discussed.
