Morphometric properties of the tensor fascia lata muscle in human foetuses

Background: In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used. However, there are not enough data about structural properties of TFL in foetuses, which can be considered as the closest to neonates in terms of sampling. This study’s main objective is to gather data about morphological structures of TFL in human foetuses to be used in newborn surgery. Materials and methods: Fifty formalin-fixed foetuses (24 male, 26 female) with gestational age ranging from 18 to 30 weeks (mean 22.94 ± 3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital callipers were used for length and width measurements whereas surface area was calculated using digital image analysis software. Results: No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p > 0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = –225.652 + 14.417 × age (weeks), y = –5.571 + 0.595 × age (weeks), y = –4.276 + 0.909 × age (weeks), and y = –4.468 + 0.779 × age (weeks), respectively. Conclusions: Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions in autopsy studies

The effect of anatomic differences on the relationship between renal artery and diaphragmatic crus

Background: The aim of this study is to investigate the effect of anatomic differences on the relationship between renal artery and diaphragmatic crus via the touch of two structures. Materials and methods: The study included dynamic computed tomography (CT) scans of 308 patients performed mainly for characterisation of liver and renal masses. Anatomic differences including the thickness of the diaphragmatic crus, the localisation of renal artery ostium at the wall of aorta, the level of renal artery origin with respect to superior mesenteric artery were evaluated. Statistical relationships between renal artery-diaphragmatic crus contact and the anatomic differences were assessed. Results: Thickness of the diaphragmatic crus at the level of renal artery origin exhibited a statistically significant relationship to renal artery-diaphragmatic crus contact at the left (p < 0.001) and right side (p < 0.001). There was a statistically significant relationship between high renal artery origin and renal artery- -diaphragmatic crus contact at the left (p < 0.001) and right side (p = 0.01). The localisation of renal artery ostium at the wall of aorta (right side, p = 0.436, left side, p = 0.681) did not demonstrate a relationship to renal artery-diaphragmatic crus contact. Conclusions: Thickness of the diaphragmatic crus and high renal artery origin with respect to superior mesenteric artery are crucial anatomic differences determining the relationship of renal artery and diaphragmatic crus. (Folia Morphol 2018; 77, 1: 22–28)

Biomechanical and morphometric features of long flexor tendons of toes: a cadaveric study

Tendons of flexor hallucis longus (FHL) and flexor digitorum longus (FDL) can be used as grafts. Slips from FHL to FDL have been reported to contribute to flexion function of toes.Aim of the study was to determine the contribution of FHL slips to function of small toes by biomechanical aspects. It was also aimed to determine the lengths of FHL and FHL tendon grafts harvested by different surgical techniques.Thirteen fresh frozen amputee legs were dissected. Some classification regarding connection types between FDL and FHL tendons, and contribution of FHL slips to long flexor tendons of toes were classified. Lengths of FHL and FDL tendon grafts, harvested by different surgical procedures, were measured by digital caliper. Biomechanical features of tendons and slips were evaluated with the help of tensile test device. All measurements were statistically analyzed. Connections between FHL and FDL tendons were classified as two types. Type I: slips from FHL to FDL in 11 cases. Type II: cross connections in 2 cases. FHL slips contributed into the long flexor tendons of second and third toes. Biomechanical features of tendons of second to four toes were similar to each other regarding stiffness, tensile strength, Young modulus, maximum stress. The same properties of these toes were significantly different from fifth toe. No statistical difference was found between FHL and FDL tendons. Lengths of FDL grafts, harvested by medial and plantar approaches were 6:16 cm and 9:05 cm, respectively. Lengths of FHL grafts, harvested by single, double and minimal invasive techniques were 5:08 cm, 7.02 cm and 20:16 cm, respectively. By this study, biomechanical features of the slips between FHL and FDL tendons, and long flexor tendons of toes were revealed. In addition, functional effects of these structures on toes were evaluated