Hypothenar Muscles and Guyon’s Canal

The increased number of articles in the last years about hypothenar variations and some misdescriptions and the role of the additional structures to ulnar nerve and artery compression, as well as my unostentatious contribution in the field, provoked me to write this chapter. The aim of it is to present in detail the usual hypothenar muscular anatomy, including the origins and insertions of the hypothenar muscles, their relations to each other, the vascular supply and innervation, the function of the muscles, the reported variations and their possible clinical implications. Herein, I also presented briefly the Guyon’s canal anatomy and some interesting comments about it. Presenting the compendium about hypothenar muscles and the canal to my opinion will help the anatomists and the clinicians to better understand the clinically oriented anatomy. They also will be more qualified in the anatomical dissection course as well as during the surgical interventions. The detailed knowledge of the anatomy in the region would be also useful to medical students in better understanding the hypothenar region

Please be very careful, when describing variant muscle

This is Letter accompanies a Case Report, see articl

Tarsal tunnel syndrome caused by anomalous muscle: case report

Accessory muscles within the tarsal tunnel have been reported as a rare cause of tarsal tunnel syndrome. The most common variation provoking this pathologic condition is the flexor digitorum accessorius longus muscle. Herein, we present a rare case of a patient with tarsal tunnel syndrome due to this muscular variation. The discussion of this case report can prompt foot and ankle surgeons to be more aware of this infrequent finding

The Deep Fascia of the Forearm and the Ulnar Nerve: An Anatomical Study.

Introduction A reoperation for a cubital tunnel syndrome is not uncommon. Patients often complain of sensorimotor symptoms in the ulnar nerve distribution after their primary surgery. The documented etiologies for such a phenomenon include a new kinking of the distal ulnar nerve and a new compression of the ulnar nerve by the fascial septum in between or tendinous bands over the muscles of the forearm. The deep fascial plane along which the ulnar nerve travels in the forearm has had scant attention. We present an anatomical study to provide a better understanding of such etiologies to aid physicians in performing successful primary ulnar nerve release that does not lead to risky reoperations and ultimately yields improved patient satisfaction. Materials and methods The forearms of 12 fresh frozen cadavers (24 arms) underwent dissection, during which the fascial relationships between the ulnar nerve and muscles of the anterior compartment were explored with a blunt technique. The relationship between the fascial planes and the ulnar nerve was quantitatively and qualitatively documented. The ranges of motion of the elbow were also observed for any potential compression points on the nerve during the movement. Results In all specimens (n = 24), the ulnar nerve entered the forearm between the humeral and ulnar heads of the flexor carpi ulnaris, after which it routed deep to a deep fascia between the anterior surface of the flexor carpi ulnaris and the posterior surface of the flexor digitorum superficialis. Ulnar nerve branches to the flexor carpi ulnaris pierced this fascial septum while en route to the posterior surface of the muscle. Medially, the branches to the flexor digitorum profundus also pierced this fascial plane. In most arms, the fascia became thinner near the junction between the proximal two-thirds and distal one-third of the forearm. On no side was the ulnar nerve found to be grossly compressed by this deep fascia. However, with the extension of the elbow, a degree of angulation of the proximal ulnar nerve was observed due to its compact connection with the deep fascia. Conclusion Our study revealed that there is an intimate relationship between the ulnar nerve and the deep fascia of the forearm. Since the ulnar branches to the overlying flexor carpi ulnaris pierce this deep structure, a care should be given to its anatomical course during surgery in this region to prevent denervation of the muscle

Comparative electron microscopic and immunohistochemical study of stromal cells in giant cell tumor of bone

Giant cell tumor of bone is an osseous neoplasm that is histologically benign but clinically shows local aggression and high rate of recurrence. The histogenesis of this lesion remains unclear. The histological appearance does not predict the clinical outcome and there are still many unanswered questions with regard to both its treatment and prognosis. In order to further clarify this lesion, we examined ultrastructurally and immunohistochemically the tumor mononuclear cells in ten patients operated on in our hospital for matrix metalloproteinase-9. Positive reaction was detected in the spindle-like stromal cells of giant cell tumor of bone and these cells had the ultrastructural characteristics of fibroblastic cells. The other mononuclear cells did not express matrix metalloproteinase-9 and showed ultrastuctural characteristics of macrophage-like cells. The positive reaction for matrix metalloproteinase-9 in all patients clearly shows that this protease may play a key role in the pathophysiology of giant cell tumor of bone

A bicaudatus sartorius muscle: a rare variant with potential clinical implications

Background: Sartorius muscle (SM) belongs to the thigh anterior compartment musculature. It corresponds to the longest muscle of the human body, while its variations are described rarely. The current case reports aims to describe a distal bifurcation of the SM, forming the bicaudatus SM variant. Materials and methods: An 84-year-old male cadaver was dissected for educational and research purposes at the Department of Anatomy, National and Kapodistrian University of Athens. Results: On the left lower limb, the SM was typically originated from the anterior superior iliac spine. After 351.22 mm length, it was bifurcated into an anterior and posterior part. Both muscular parts were contributing to the pes anserinus morphology. Femoral nerve branches were providing innervation to the variant muscle, while the saphenous nerve and vein were coursed posteriorly to the variant muscle. Conclusions: SM morphological variability is described quite rarely. The current case report corresponds to the bicaudatus SM variant. Accessory parts of SM could lead to compression symptoms to the femoral nerve anterior branches, as well as to the saphenous nerve

Accessory part of the deltoid muscle

The shoulder and arm region has numerous morphological variations. The deltoid muscle usually consists of three parts: anterior, middle and posterior. This case report describes a very rare deltoid muscle variant, an addition to the spinal part that is attached proximally at the infraspinatus fascia and the spine of the scapula. The distal attachment transforms directly into the brachialis muscle. Additional parts can affect the biomechanics and function of the joints significantly

Histological and ultrastructural evaluation of the early healing of the lateral collateral ligament epiligament tissue in a rat knee model

<p>Abstract</p> <p>Background</p> <p>In this study, we evaluated the changes which occurred in the epiligament, an enveloping tissue of the ligament, during the ligament healing. We assessed the association of epiligament elements that could be involved in ligament healing.</p> <p>Methods</p> <p>Thirty-two 8-month old male Wistar rats were used in this study. In twenty-four of them the lateral collateral ligament of the knee joint was surgically transected and was allowed to heal spontaneously. The evaluation of the epiligament healing included light microscopy and transmission electron microscopy.</p> <p>Results</p> <p>At the eight, sixteenth and thirtieth day after injury, the animals were sacrificed and the ligaments were examined. Our results revealed that on the eight and sixteenth day post-injury the epiligament tissue is not completely regenerated. Till the thirtieth day after injury the epiligament is similar to normal, but not fully restored.</p> <p>Conclusion</p> <p>Our study offered a more complete description of the epiligament healing process and defined its important role in ligament healing. Thus, we provided a base for new strategies in ligament treatment.</p

First g(2+) measurement on neutron-rich 72 Zn, and the high-velocity transient field technique for radioactive heavy-ion beams

The high-velocity transient-field (HVTF) technique was used to measure the g factor of the 2+ state of 72Zn produced as a radioactive beam. The transient-field strength was probed at high velocity in ferromagnetic iron and gadolinium hosts using 76Ge beams. The potential of the HVTF method is demonstrated and the difficulties that need to be overcome for a reliable use of the TF technique with high-Z, high-velocity radioactive beams are revealed. The polarization of K-shell vacancies at high velocity, which shows more than an order of magnitude difference between Z = 20 and Z = 30 is discussed. The g-factor measurement hints at the theoretically predicted transition in the structure of the Zn isotopes near N = 40