Anatomical variations of the calcaneofibular ligament in human foetuses.

Ligaments anatomy often show a huge anatomy variations between species and individuals. For example calcaneofibular ligaments (CFL) characterize the great variability of morphological shape or presence of additional bands. The aim of this study was to propose first anatomical classification of CFL concerning on human fetuses. We investigated thirty spontaneously-aborted human fetuses aged 18-38 weeks of gestation at death. Sixty lower limbs (30 left and 30 right) fixed in 10% formalin solution were examined. The morphological variability of CFL was assessed. Four types of CFL morphology were observed. Type I was characterized by a band shape. This was the most common type, occurring in 53% of all cases. Based on our study we are proposing a classification based on four morphological types of CFL. Types 2 and 4 are further divided into subtypes. Present classification may be useful to better understand the anatomical development of ankle joint.

Branching pattern of the internal iliac artery accompanied by a venous anastomosis: rare vascular variations.

The ability to navigate the complex and often deceptive branching patterns of the internal iliac artery can be decisive in planning and performing surgeries within the lesser pelvis. The following case report presents a peculiar quadruple division of the internal iliac artery, accompanied by a venous anastomotic structure. Apart from the posterior and anterior trunks, the superior vesicle and iliolumbar arteries arose independently from the internal iliac artery. The division was surrounded by a venous oval, compressing certain branches and potentially complicating surgical access. Due to the uncommon course of the internal iliac artery and the presence of the anastomosis, a possible nerve root compression has been identified. Both clinical significance and classification method of the case are discussed. Knowledge of this anatomical variation is valuable for both diagnosis and surgery, especially within the specialties of urology, gynaecology and general surgery.

Five-headed superior omohyoid.

The omohyoid is an infrahyoid muscle with two bellies. It is responsible for lowering and positioning of the hyoid bone. It is morphologically variable in the origin, insertion and morphology of its bellies. Quantitative variations of the superior belly of the omohyoid muscle are not common. We present a case of a five-headed superior omohyoid, and a short clinical review related to this muscle. All the bellies had their origin in an intermediate tendon and were attached to the hyoid bone. The volume of its superior part was greater than usual. Knowledge of the anatomy of this muscle is important, especially for surgeons operating in the anterolateral neck region.

Case report of the double-headed extensor hallucis longus.

BACKGROUND: We present a case report of double-headed extensor hallucis longus (EHL) with potential clinical significance. MATERIALS AND METHODS: Cadaveric dissection of the right lower limb of a 70-year- -old at death female was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The limb was dissected using standard techniques according to a strictly specified protocol. Each head and tendon of the muscle was photographed and subjected to further measurements. RESULTS: During dissection, an unusual type of EHL muscle was observed. It consisted of two muscle bellies, a main tendon and an accessory tendon. Both muscle bellies were located on anterior surface of the fibula and the interosseous membrane. The main tendon insertion was located on the dorsal aspect of the base of the distal phalanx of the big toe, while the accessory tendon insertion was located medially. CONCLUSIONS: The EHL muscle is highly morphologically variable at both the point of origin and the insertion. Knowledge of its variations is connected to several pathologies such as foot drop, tendonitis, tendon rupture, and anterior compartment syndrome.

Anatomical variation of co-existing bilaminar tensor of the vastus intermedius muscle and new type of sixth head of the quadriceps femoris.

BACKGROUND: We present a case report of quadriceps femoris (QF) with co-existing bilaminar tensor of the vastus intermedius (TVI) muscle and new type of sixth head. MATERIALS AND METHODS: Cadaveric dissection of left thigh of a 72-year-old man was performed for research and teaching purposes at the Department of Anatomical Dissection and Donation, Medical University of Lodz. The left lower limb was dissected using standard techniques according to a strictly specified protocol. Each head of the muscle was photographed and subjected to further measurement. RESULTS: During dissection, an unusual type of TVI muscle was observed. It consisted of two surfaces, superficial and deep. In addition, sixth head of QF muscle grew out from the vastus medialis muscle. CONCLUSIONS: The knowledge of the existence and possible variations of additional heads of QF muscle is necessary during diagnostic process of muscle strains. Moreover, according to course of tendons that heads may take part in patella stabilisation.

The morphological variability of fibularis tertius origin in human foetuses.

BACKGROUND: The purpose of this study was to characterize the morphology of the fibularis tertius (FT) in human fetuses, and to provide a classification based on its modes of origin in human fetuses. METHODS: The material comprised 100extremities from 50 spontaneously aborted human fetuses (19 male, 31 female, 100 lowerlimbs in total), aged 18-38 weeks of gestation. These were dissected and the presence or absence of the FT muscle as well as the type of its proximal attachment were determined, and the FT was measured morphometrically. RESULTS: The FT was present in 50% of fetuses. Four types of FT muscle origin were identified. The most common was Type 2, characterized by an origin on the middle third of the fibula and the intermuscular septum. Three other types were observed: Type 1 with an origin located on proximal third of the fibula and to the intermuscular septum, Type 3 characterized by an absent muscle belly, and an independent tendon originating from the that of the extensor digitorum longus, and Type 4 with an origin located on the distal third of the fibula and the intermuscular septum. CONCLUSIONS: The fibularis tertius demonstrates high morphological variability, with the most common origin located on third of the fibula and to the intermuscular septum.

Anatomical variations of the abductor pollicis longus: a pilot study.

BACKGROUND: The abductor pollicis longus (APL) originates from the lateral part of the dorsal surface of the body of the ulna below the insertion of the anconeus muscle, from the interosseous membrane, and from the middle third of the dorsal surface of the body of the radius. However, the number of its accessory bands and their insertion vary considerably. MATERIALS AND METHODS: Fifty upper limbs (2 paired, 31 male, 19 female) were obtained from adult Caucasian cadavers, and fixed in 10% formalin solution before examination. RESULTS: The APL muscle was present in all specimens. The muscles were divided into three main categories, with type II and III being dived into subtypes. Type I was characterised by a single distal attachment, with the tendon inserting to the base of the I metacarpal bone. Type II was characterised by a bifurcated distal attachment, with the main tendon inserting to the base of the first metacarpal bone; this type was divided into three subtypes (a-c). Type III was characterised by the main tendons inserting to the base of the first metacarpal bone, while the accessory band was characterised by mergers (fusion) with other tendons. This type was divided into two subtypes (a, b). CONCLUSIONS: The abductor pollicis longus is characterised by high morphological variability.