An unusual insertion of an accessory band of the semitendinosus tendon: case report and review of the literature

The Pes Anserinus is characterised by high morphological variability. It consists of three tendons: the sartorius, gracilis and semitendinosus. The semitendinosus and gracilis tendons are routinely harvested for reconstruction anterior cruciate ligament, and the presence of accessory bands within them can handicap the harvesting process. This report presents a case of a rare insertion of accessory band of the semitendinosus tendon (to the fascia of the soleus muscle and tibia). The current classification should be extended to accommodate such “rare cases” to facilitate more successful hamstring grafts

The plantaris muscle — rare relations to the neurovascular bundle in the popliteal fossa

The plantaris muscle is characterised by morphological variability, both for origin and insertion, and may sometimes be absent. Its strength allows the ligament to be used for reconstruction of other tendons and ligaments. This report presents the rare placements and course of the plantaris muscle in relation to the neurovascular bundle. In this case, the hypertrophy of this muscle might cause pressure on the tibial nerve and produce symptoms similar to sciatica

Correlation between morphometry of the suprascapular notch and anthropometric measurements of the scapula

The concept of the study was to find the correlation between the morphometry of the suprascapular notch and basic anthropometric measurements of the human scapula. The measurements of the human scapulae included: morphological length and width, maximal width and length projection of scapular spine, length of acromion, and maximal length of the coracoid process. The glenoid cavity was measured in two perpendicular directions to evaluate its width and length. The width-length scapular and glenoid cavity indexes were calculated for every bone. In addition to standard anthropometric measurements two other measurements were defined and evaluated for every suprascapular notch: maximal depth (MD) and superior transverse diameter (STD). The superior transverse suprascapular ligament was completely ossified in 7% of cases. Ten (11.6%) scapulae had a discrete notch. In the studied material, in 21 (24.4%) scapulae the MD was longer than the STD. Two (2.3%) scapulae had equal maximal depth and superior transverse diameter. In 47 (57.7%) scapulae the superior transverse diameter was longer than the maximal depth. There was no statistically significant difference between anthropometric measurements in the group with higher MD and the group with higher STD. The maximal depth of the suprascapular notch negatively correlated with the scapular width-length index. The maximal depth of the scapular notch correlated with the morphological length of the scapulae. (Folia Morphol 2011; 70, 2: 109–115

A symptomatic pelvic rib

Pelvic rib is a rare anomaly where ectopic rib is found in a pelvic region. It is usually found occasionally in asymptomatic patients. We report a case of 15-year-old male, diagnosed with a symptomatic pelvic rib. It had an unusual presentation creating a pseudotumour associated with pain and reduced range of motion in the hip joint. Patient was operated on with good result and final diagnosis was confirmed in pathological examination. (Folia Morphol 2018; 77, 2: 406–408

A quantitative study of the arrangement of the suprascapular nerve and vessels in the suprascapular notch region: new findings based on parametric analysis

Background: When closed by the superior transverse scapular ligament (STSL), the suprascapular notch (SSN) creates an osseo-fibrous tunnel which acts as a pathway for the suprascapular nerve (SN). Anatomical variations are common in this region, and these can increase the risk of neuropathy by restricting the space for nerve passage. The aim of this study is to identify any correlation between the area reduction coefficient parameters and the SN and vessel arrangements in the SSN region. Material and methods: The SSN region was dissected in 88 formalin-fixed cadaveric shoulders (40 left and 48 right). During dissection, the topography of the SN, artery and vein was evaluated. Quantitative visual data analysis software was used to measure the areas of the STSL and the anterior coracoscapular ligament (ACSL), as well as the diameters of the SN and associated vessels, and to assign those structures to existing classifications. The area reduction coefficient (ARC) was calculated for each shoulder. Results: The area of the STSL (aSTSL) and ACSL (aACSL) were significantly larger in Type IV than Type I of the triad. Similarly, the aSTSL and area of the SSN (aSSN) were found to be significantly larger in Type IV than Type III. However, no significant differences were found in the ARC of the STSL (ARCSTSL), the ARC of the ACSL (ARCACSL) or the total ARC (ARCtotal). Conclusions: Although the aSTSL, aACSL and aSSN varied according to the type of SN and vessel arrangement, coefficient analysis (ARCSTSL, ARCACSL and ARCtotal) indicated that combined effect of these variations did not significantly affect SSN morphology.

A morphological study of the medial and lateral femoral circumflex arteries: a proposed new classification

Background: Confirming the branching pattern of the deep femoral artery (DFA) is vital in planning radiological and surgical procedures involving the medial circumflex femoral artery (MFCA) and the lateral circumflex artery (LFCA). The aim of this study was to characterise the course and morphology of branches of the DFA. Materials and methods: The anatomical dissection included 80 lower limbs which were fixed in 10% formalin solution. A dissection of the femoral region was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were obtained twice by two researchers. Results: Six types of medial and lateral femoral circumflex artery variations were distinguished. In type I, the DFA divides into the MFCA and the LFCA (observed in 45% of cases). In type II, the MFCA is absent and the LFCA origin normally from the DFA (18.75%). In type III, the MFCA arises from the femoral artery above the origin of the DFA, while the LFCA starts from the DFA (15%). Finally, in type IV, the LFCA arises from the femoral artery above the origin of the DFA, while the MFCA starts from the DFA (10%). In type V, the LFCA origin alone from the femoral artery below the origin of the DFA, while the MFCA origin from the DFA (7.5%), while in type VI (3.75%), both the MFCA and the LFCA origin from the femoral artery. The mean diameter of the femoral artery at the level of the DFA origin was greatest in type 2 (10.62 ± 2.07 mm) and the least in type 6 (7.90 ± 1.72 mm; p = 0.0317). The distance from inguinal ligament to where the DFA arose was the greatest in type 6 (78.24 ± 29.74 mm) and least in type 5 (28.85 ± 11.72 mm; p = 0.0529). Conclusions: The medial and lateral femoral circumflex arteries were characterised by high morphological variations. The diameter of the femoral artery at the level of inguinal ligament correlated with the diameter of the DFA and distance to where the DFA arises from femoral artery

Comparison of the Linke turbidity factor in Warsaw and in Belsk

The article describes the relationship between direct solar radiation in a city (Warsaw) and in its broadly-defined suburban area (Belsk). The analysis covers the days of 1969-2003 when observations were carried out at both sites. The degree of extinction of solar radiation was expressed by means of Linke’s turbidity factor. Its mean annual value on the selected days of the period under consideration was 3.00± 0.10 at Warsaw and 3.00±0.11 at Belsk. Any differences in the atmospheric turbidity between the Warsaw site and Belsk in individual seasons of the year were marginal and within the error margin of Linke’s factor. The period considered was also divided into two sub-periods (1969-1993 and 1994-2003), in which atmospheric turbidity in Warsaw and in Belsk was compared by individual seasons and whole years. At both analysed sites Linke’s atmospheric turbidity factor decreased in 1994-2003, compared to the values for the earlier sub-period (1969-1993). The differences in atmospheric turbidity between the Warsaw site and Belsk are small and often statistically insignificant. The reason for this is, perhaps, the location of the urban measurement site far from the city centre, even though the site was still situated in a typically urban environment

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

A computed tomography study on the correlation between the morphometry of the suprascapular notch and anthropometric measurements of the scapula

Background: The suprascapular notch is a clinically important site because it is the main site of injury and compression of the suprascapular nerve. Its shape and size are the most important factors in the aetiopathology of suprascapular nerve neuropathy. This article reports the first computed topography (CT) study on the correlation between the diameters of the suprascapular notch and anthropometric measurements of the human scapula. Materials and methods: A total of 130 scans of shoulders by a helical 32-row multidetector CT scanner were retrospectively analysed. The following scapular measurements were performed: morphological length, morphological width, projection length of the scapular spine, maximal width of the scapular spine, length of the acromion, maximal length of the coracoid process, length of the superior border of the scapula, morphological height of the supraspinous fossa, length of the lateral border of the scapula, and morphological height of infraspinous fossa. The following suprascapular notch dimensions were measured: maximal depth, superior transverse diameter, middle transverse diameter. Results: The maximum depth of the suprascapular notch correlates with the morphological length of the scapula, the length of the lateral border of the scapula and the morphological width of the scapula. The superior transverse diameter of the suprascapular notch correlates with the length of the superior border of the scapula and negatively with the length of the lateral border of the scapula. In addition it has been shown that the length of the superior border of the scapula correlates more closely with the superior transverse diameter of the suprascapular notch than the middle transverse diameter of the suprascapular notch. Conclusions: It could be supposed that humans with longer scapulae have deeper notches. It may be also concluded that scapulae with a wider superior border have a shallower suprascapular notch.

The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications

Background: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localisation of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. Materials and methods: In total, 628 patients (408 females and 220 males; aged 21–91 years), who underwent endoscopic retrograde cholangiopancreatography were included in this study. The patients were divided into two groups: a study group comprising 66 (10.5%) patients with periampullary position of diverticula (group A), and a control group comprising 562 (89.5%) patients without diverticula (group B). Results: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52–91 years) and 25 men (aged 54–83 years). Conclusions: Three types of localisation were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis