Effects of trapidil after crush injury in peripheral nerve.

In this study, we evaluated the effects of trapidil on crush injury by monitoring nitric oxide, malondialdehyde and transforming growth factor-Beta2 levels and by transmission electron microscopy in the rat sciatic nerve. The sciatic nerve was compressed for 20 sec by using a jewelers forceps. Trapidil treatment groups were administrated a single dose of trapidil (8 mg/kg) intraperitoneally just after the injury. The crush and crush + trapidil treatment groups were evaluated on the 2nd, 7th, 15th, 30th and 45th days of the post-crush period. On the 7th and 15th days, damage in thin and thick myelinated axons, endoneural edema and mitochondrial swelling were less severe in the trapidil group histopathologically. These findings supported the idea that trapidil prevented cell damage and edema at the injury site. Day/group interaction with regard to serum nitric oxide, malondialdehyde and transforming growth factor-Beta2 levels did not show significant changes.</p

Anatomy of master knot of henry: A morphometric study on cadavers

WOS: 000433350100010PubMed ID: 29366540Objective: The objective of this study was to evaluate the features of flexor hallucis longus (FHL), flexor digitorum longus (FDL) and flexor digitorum accessorius (FDA) muscles with relevance to the tendon grafts and to reveal the location of Master Knot of Henry (MKH). Methods: Twenty feet from ten formalin fixed cadavers were dissected, which were in the inventory of Anatomy Department of Medicine Faculty, Mersin University. The location of MKH was identified. Interconnections of FHL and FDL were categorized. According to incision techniques, lengths of FHL and FDL tendon grafts were measured. Attachment sites of FDA were assessed. Results: MKH was 12.61 +/- 1.11 cm proximal to first interphalangeal joint, 1.75 +/- 0.39 cm below to navicular tuberosity and 5.93 +/- 0.74cm distal to medial malleolus. The connections of FHL and FDL were classified in 7 types. Tendon graft lengths of FDL according to medial and plantar approaches were 6.14 +/- 0.60cm and 9.37 +/- 0.77cm, respectively. Tendon graft lengths of FHL according to single, double and minimal invasive incision techniques were 5.75 +/- 0.63cm, 7.03 +/- 0.86cm and 20.22 +/- 1.32 cm, respectively. FDA was found to be inserting to FHL slips in all cases and it inserted to various surfaces of FDL. Conclusion: The exact location of MKH and slips was determined. Two new connections not recorded in literature were found. It was observed that the main attachment site of FDA was the FHL slips. The surgical awareness of connections between the FHL, FDL and FDA, which participated in the formation of long flexor tendons of toes, could be important for reducing possible loss of function after tendon transfers postoperatively

Thoracodorsal and Lateral Thoracic Arteries in Coronary Bypass Surgery as an Alternative Arterial Graft: A Morphological Study

Amaç: A. thoracica interna ve v. saphena magna günümüzde en sık kullanılan koroner by-pass greftleridir. Arteryel greftler, venöz greftlere göre daha iyi açık kalma oranlarına sahiptir. A. thoracica interna ve v. saphena magna'nın kullanılamayacağı veya daha önceki operasyonda kullanıldığı, ayrıca birden fazla koroner artere aynı anda by-pass gerektiren veya birden fazla grefte ihtiyaç duyulan durumlarda halen alternatif arteryel greftlere ihtiyaç vardır. Gereç ve Yöntem: Bu çalısmada, yas ortalaması 56,676,38 olan 9 erkek kadavradan bilateral olarak elde edilen, a. thoracica lateralis ve a. thoracodorsalis'in koroner by-pass operasyonlarında greft olarak kullanıma uygun olup olmadıklarının ortaya konulması amaçlandı. Bu arterlerin bas, orta ve son kısımlarına ait morfolojik özellikler (boy, lümen çapı, tunica intima ve media kalınlıkları, lamina elastica interna ve externa'nın özellikleri, tunica media tabakasının elastik ve düz kas dokusu içeriği) a. thoracica interna, a. radialis ve koroner arterlerin (r. interventricularis anterior, r. circumflexus, a. coronaria dextra) morfolojik özellikleriyle karsılastırıldı. Bulgular: A. thoracica lateralis ve a. thoracodorsalis'in iyi gelismis lamina elastica interna'ya sahip oldukları saptandı. Ayrıca a. thoracica lateralis ve a. thoracodorsalis'nin tunica intima ve media kalınlıkları genellikle a. thoracica interna ve a. radialis'in tunica intima ve media kalınlıklarına benzer veya daha ince olduğu görüldü. Bu bulgular, her iki arterin koroner by-pass cerrahisinde greft olarak kullanılabilmesi açısından olumlu özellikler olarak değerlendirildi. Sonuç: A. thoracica lateralis'in boy ve lümen çapı, tek basına serbest greft olarak kullanım için yeterli bulunmazken, a. thoracodorsalis ise yeterli bulundu. Bununla birlikte her iki arterin, diğer greftlerle birlikte kompozit greft (Y greft gibi) uygulamalarında, boy ve lümen açısından yeterli olabileceği sonucuna varıldı.By-pass Cerrahisi. Objectives: Today, the internal thoracic artery and great saphenous vein are the most used coronary bypass grafts. Patency of the arterial grafts is better than vein grafts. Alternative arterial grafts are needed in the following cases: when the internal thoracic artery and great saphenous vein cannot be used or they were used in the previous operations, when more than one coronary artery is needed for grafting, or more than one graft is neded at the operation. Material and Methods: This study aims to reveal whether lateral thoracic and thoracodorsal arteries taken from 9 male cadavers at 56,67±6,38 years old, bilaterally are available to be used as a graft in coronary bypass surgery. The morphologic properties (length, lumen diamater, thickness of tunica intima and media, properties of internal and external elastic lamina, elastic and smooth muscle component of tunica media) of the proximal, middle and distal parts of these arteries are compared with internal thoracic, radial and coronary arteries's (anterior interventricular branch, circumflex branch, right coronary artery). Results: It is determined that the lateral thoracic and thoracodorsal arteries have well-developed internal elastic lamina. Furthermore thickness of tunica intima and externa of the lateral thoracic and thoracodorsal arteries are observed to be similar or thinner than of the internal thoracic and radial arteries. These data are evaluated as positive properties in terms of using both of these arteries as graft in coronary bypass surgery. Conclusions: Length and lumen diameter of thoracodorsal artery are found adequate while lateral thoracic artery is not found adequate for single free graft. Neverthless, both of these arteries are found suitable to be used as composite grafts (as Y graft) with other grafts in terms of lenght and lumen diameter

Biomechanical and morphometric properties of the long flexor tendons of the toes: A cadaver study

BACKGROUND: We sought to show the biomechanical and morphometric properties of flexor hallucis longus (FHL) and flexor digitorum longus (FDL) tendon grafts harvested by specific surgical approaches and to assess the contribution of FHL slips to the long flexor tendons of the toes. METHODS: Thirteen fresh-frozen amputated feet (average age, 79 years) were dissected. The connections between the FHL and FDL tendons and the contribution of FHL slips to the long flexor tendons were classified. The biomechanical properties of the tendons and slips were measured using a tensile device. RESULTS: The connections between the FHL and FDL tendons were reviewed in two groups. Group 1 had FHL slips (11 cases) and group 2 had cross-slips (two cases). The FHL slips joined the second and third toe long flexor tendon structures. Tendon length decreased significantly from the second to the fifth toe (P < .001). Apart from the second toe tendon being thicker than that of the fourth toe (P = .02) and Young's modulus being relatively smaller in the third versus the fourth toe tendon (P = .01), biomechanical and morphometric properties of second to fourth tendons were similar. Mechanical properties of those tendons were significantly different from fifth toe tendons and FHL slips. Morphometric and biomechanical properties of FHL slips were similar to those of the fifth toe tendon. CONCLUSIONS: Herein, FHL slips were shown to have biomechanical properties that might contribute to flexor functions of the toes. During the harvesting of tendon grafts from the FHL by minimally invasive incision techniques from the distal plane of the master knot of Henry, cutting slips between FHL and FDL tendons could be considered a cause of postoperative function loss in toes

Anatomy of Master Knot of Henry: A morphometric study on cadavers

Objective: The objective of this study was to evaluate the features of flexor hallucis longus (FHL), flexor digitorum longus (FDL) and flexor digitorum accessorius (FDA) muscles with relevance to the tendon grafts and to reveal the location of Master Knot of Henry (MKH). Methods: Twenty feet from ten formalin fixed cadavers were dissected, which were in the inventory of Anatomy Department of Medicine Faculty, Mersin University. The location of MKH was identified. Interconnections of FHL and FDL were categorized. According to incision techniques, lengths of FHL and FDL tendon grafts were measured. Attachment sites of FDA were assessed. Results: MKH was 12.61 ± 1.11 cm proximal to first interphalangeal joint, 1.75 ± 0.39 cm below to navicular tuberosity and 5.93 ± 0.74 cm distal to medial malleolus. The connections of FHL and FDL were classified in 7 types. Tendon graft lengths of FDL according to medial and plantar approaches were 6.14 ± 0.60 cm and 9.37 ± 0.77 cm, respectively. Tendon graft lengths of FHL according to single, double and minimal invasive incision techniques were 5.75 ± 0.63 cm, 7.03 ± 0.86 cm and 20.22 ± 1.32 cm, respectively. FDA was found to be inserting to FHL slips in all cases and it inserted to various surfaces of FDL. Conclusion: The exact location of MKH and slips was determined. Two new connections not recorded in literature were found. It was observed that the main attachment site of FDA was the FHL slips. The surgical awareness of connections between the FHL, FDL and FDA, which participated in the formation of long flexor tendons of toes, could be important for reducing possible loss of function after tendon transfers postoperatively. Keywords: Flexor hallucis longus, Flexor digitorum longus, Flexor digitorum accessorius, Master knot of Henry, Slip, Tendon transfe