MARIA TERESA VAZQUEZ OSORIO - Academia.edu (original) (raw)
Papers by MARIA TERESA VAZQUEZ OSORIO
Journal of wrist surgery, Jan 15, 2016
Although the majority of arthroscopies can be performed adequately through dorsal portals, today ... more Although the majority of arthroscopies can be performed adequately through dorsal portals, today the wrist is not limited to a dorsal visualization; the joint can be thought of as a "box," which can be visualized from almost every perspective. 1 The two main volar portals currently used are the volar radial portal 2 and the volar ulnar portal. 3 They may be useful in some situations to visualize and treat the different structures of the radial and ulnar sides of the wrist, respectively.
Scientific Reports, 2021
The aim was to determine the variations in the level of origin of carotid bifurcation and diamete... more The aim was to determine the variations in the level of origin of carotid bifurcation and diameters of the common, internal, and external carotid arteries which is clinically important for several interventional procedures. Therefore, 165 human embalmed corpses were dissected. The data collected were analyzed using the Chi square-test and the Pearson correlation test. The results of previous studies have been reviewed. In relation to the level of the carotid bifurcation, taking as a reference point the hyoid bone, the values ranged from 4 cm below the hyoid body to 2.5 cm above the body of the hyoid, being the average height—0.33 cm, with a standard deviation of 1.19 cm. The right carotid bifurcation was established at a higher level (x = − 0.19 cm.) than the left one (x = − 0.48 cm.) (p = 0.046). On the contrary, no significant gender differences could be observed. The arterial calibres of the common and internal carotid arteries were higher in male than female. In the internal car...
European Spine Journal, 2021
Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebra... more Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43,...
European Journal of …, 2012
... Bilateral superfi-cial median arteries. J Anat, 194: 475-477. NUNOO-MENSAH J (1998). ... Anat... more ... Bilateral superfi-cial median arteries. J Anat, 194: 475-477. NUNOO-MENSAH J (1998). ... Anatomical description of the arteries of the human body. Thomas B. Wait & Co, Boston. ... Contrib Embryol, 70: 139-154. WOOD SJ, ABRAHAMS PH, SAÑUDO JR and FERREIRA BJ (1997). ...
Scientific Reports
Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can ... more Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can be attributed to structures called ossicles, nodules, or sesamoids. The aims of the present study were first to verify that ultrasonography (US) is a high-sensitivity tool for diagnosing an interphalangeal ossicle (IO), and second to prove that US-guided-shaving surgery (“milling”) is a safe and feasible technique for remodeling the IO. The study is divided into three parts. In the first part, the prevalence of IOs was estimated in 12 cadaver feet using US, anatomical dissection, and fluoroscopy. In the second, a detailed US and morphological description of the IO was obtained. In the third, six cadaver feet were subjected to surgical milling. IO prevalence was 41.6% in gross anatomy, 41.6% in US examination and just 16.6% in fluoroscopy. The ossicles had a mean length of 4 mm (± 2 mm) and a width of 7 mm (± 2 mm). The ossicles could be completely shaved in all specimens without injuring...
European Spine Journal, 2021
Unfortunately, the 9th author name was incorrectly published in the original publication. The com... more Unfortunately, the 9th author name was incorrectly published in the original publication. The complete correct name should read as follows. Jose Bouzada The original article has been corrected. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
European Journal of Anatomy, 2021
Anatomy is a fundamental subject for both medical and surgical training. Anatomy departments migh... more Anatomy is a fundamental subject for both medical and surgical training. Anatomy departments might collaborate with clinicians organizing continuing medical education (CME) and other professional development courses. The courses should have a large practical component (in content and organization) but also should provide the latest scientifically based theoretical knowledge, respecting the learning of anatomy as well as aiming at performing different techniques. Anatomy departments should support these courses by establishing hands-on practical training courses and components.
European journal of anatomy, 2016
We describe the supraescapular region’s anatomy providing distances between osseous landmarks (su... more We describe the supraescapular region’s anatomy providing distances between osseous landmarks (supraglenoid tubercle, suprascapular notch, glenoid rim, scapular spine) and measuring the total length of the suprascapular nerve (ssn), to determine ideal places or safe zones for shoulder surgery. Fifty shoulders from cadavers belonging to the Human Anatomy and Embryology donated under consent of the Spanish law were studied. The course of the nerve in each shoulder has been defined by measuring the distances from the supraglenoid tubercle to the suprascapular notch and to the scapular spine, the distance from the midpoint of the posterior glenoid rim to the base of the scapular spine, and finally the total length of the nerve. After leaving the suprascapular notch, the ssn courses posteriorly and laterally deep to the supraspinatus muscle to reach the base of the scapular spine. The distance from the supraglenoid tubercle to the notch averaged 3.54 cm (range 3 - 4.1 cm) and the distanc...
Journal of Anatomy, 2001
A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brac... more A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brachioradialis and inserting into the radius, pronator teres or supinator muscle has been considered as a variation of the brachioradialis muscle (Dawson, 1822; Meckel, 1823; Lauth, 1830; Halbertsma, 1864; Gruber, 1868b; Testut, 1884; LeDouble, 1897; Spinner & Spinner, 1996). However, a similar description was used to report additional heads of the brachialis or biceps brachii muscles (Gruber, 1848; Wood, 1864, 1868; Macalister, 1864–66, 1966–69, 1875; Gruber, 1868a; Wolff‐Heidegger, 1937).
Journal of Anatomy, 2011
The larynx serves respiratory, protective, and phonatory functions. The motor and sensory innerva... more The larynx serves respiratory, protective, and phonatory functions. The motor and sensory innervation to the larynx controlling these functions is provided by the superior laryngeal nerve (SLN) and the recurrent laryngeal nerve (RLN). Classical studies state that the SLN innervates the cricothyroid muscle and provides sensory innervation to the supraglottic cavity, whereas the RLN supplies motor innervation to the remaining intrinsic laryngeal muscles and sensory innervation to the infraglottic cavity, but recent data suggest a more complex anatomical and functional organisation. The current neuroanatomical tracing study was undertaken to provide a comprehensive description of the central brainstem connections of the axons within the SLN and the RLN, including those neurons that innervate the larynx. The study has been carried out in 41 adult male Sprague-Dawley rats. The central projections of the laryngeal nerves were labelled following application of biotinylated dextran amines onto the SLN, the RLN or both. The most remarkable result of the study is that in the rat the RLN does not contain any afferent axons from the larynx, in contrast to the pattern observed in many other species including man. The RLN supplied only special visceromotor innervation to the intrinsic muscles of the larynx from motoneurons in the nucleus ambiguus (Amb). All the afferent axons innervating the larynx are contained within the SLN, and reach the nucleus of the solitary tract. The SLN also contained secretomotor efferents originating from motoneurons in the dorsal motor nucleus of the vagus, and special visceral efferent fibres from the Amb. In conclusion, the present study shows that in the rat the innervation of the larynx differs in significant ways from that described in other species.
Clinical Anatomy, 2002
The incidence and morphology of the intramuscular Martin-Gruber anastomosis are presented based o... more The incidence and morphology of the intramuscular Martin-Gruber anastomosis are presented based on the study of 118 human cadavers (55 male, 63 female). The Martin-Gruber anastomosis was found in 25 (21.2%) of the 118 cadavers. It occurred in 11 (20%) of the 55 male cadavers (4 bilateral, 7 unilateral; 5 left and 2 right) and in 14 (22.2%) of the 63 female cadavers (2 bilateral, 12 unilateral; 8 left and 4 right). Therefore, the Martin-Gruber anastomosis was found in 31 (13.1%) of the 236 upper limbs. According to a recent classification (Rodríguez-Niedenführ et al., 2000), pattern I was found in 29 cases (93.5%), corresponding to Type A in 13 (41.9%), Type B in 3 (9.7%) and Type C in 13 (41.9%), whereas pattern II was found in 2 cases (6.5%), both being a duplication of Type IC. Intramuscular Martin-Gruber anastomosis was a single anastomosis that originated in all cases from the anterior interosseous nerve (pattern IC) and then passed through a muscle bundle of the flexor digitorum profundus and behind the ulnar artery to join the ulnar nerve as a single connecting branch. It did not send branches to the flexor digitorum profundus. This intramuscular course was observed in 3 of the 13 cases of Type C anastomosis (23.1%) or 3 cases out of 31 Martin-Gruber anastomoses (10%).
Annals of Anatomy - Anatomischer Anzeiger, 2021
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Surgical and Radiologic Anatomy, 2020
Background The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is p... more Background The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is performed to treat multiple musculoskeletal, neurological and metabolical pathologies related to a gastro-soleus unit contracture such as plantar fasciitis, Achilles tendinopathy, metatarsalgia, cerebral palsy, or diabetic foot ulcerations. Therefore, the aim of our research was to prove the effectiveness and safety of a new ultrasound-guided surgery-technique for the lengthening of the anterior gastrocnemius muscle aponeurosis, the “GIAR”- technique: the gastrocnemius-intramuscular aponeurosis release. Methods and results An ultrasound-guided surgical GIAR on ten fresh-frozen specimens (10 donors, 8 male, 2 females, 5 left and 5 right) was performed. Exclusion criteria of the donated bodies to science were BMI above 35 (impaired ultrasound echogenicity), signs of traumas in the ankle and crural region, a history of ankle or foot ischemic vascular disorder, surgery or space-occupying mass...
Surgical and Radiologic Anatomy, 2019
Background The aim of this study was to provide a safe ultrasound-guided minimally invasive surgi... more Background The aim of this study was to provide a safe ultrasound-guided minimally invasive surgical approach for a distal tarsal tunnel release concerning nerve entrapments. Methods and results The study was carried out on ten fresh-frozen feet. All of them have been examined by high-resolution ultrasound at the distal tarsal tunnel. The surgical approach has been marked throughout the course of the medial intermuscular septum (MIS, the lateral fascia of the abductor hallucis muscle). After the previous steps, nerve decompression was carried out through a MIS release through a 2.5 mm (± 0.5 mm) surgical portal. As a result, an effective release of the MIS has been obtained in all fresh-frozen feet. Conclusion The results of our anatomic study indicate that this novel ultrasound-guided minimally invasive surgical approach for the release of the MIS might be an effective, safe and quick decompression technique treating selected patients with a distal tarsal tunnel syndrome.
Surgical and Radiologic Anatomy, 2018
Background The aim of this study is to provide a safe ultrasound-guided minimally invasive surgic... more Background The aim of this study is to provide a safe ultrasound-guided minimally invasive surgical approach for a proximal tarsal tunnel release concerning nerve entrapments. Methods and results The study was carried out on ten fresh-frozen feet. All of them were examined by high resolution ultrasound at the medial ankle region. The surgical approach was marked throughout the course of the flexor retinaculum (laciniate ligament). Once the previous steps were done, the flexor retinaculum release technique was carried out with a 2-mm entry only. As a result, an effective and safe release of the flexor retinaculum was obtained in all fresh-frozen feet. Conclusion The results of our anatomic study indicate that our novel ultrasound-guided minimally invasive surgical approach for the release of the flexor retinaculum might be an effective, safe and quick decompression technique treating selected patients with a proximal tarsal tunnel syndrome.
Journal of Anatomy, 2014
The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been ana... more The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out. The peroneus longus tendon was fully visible until its insertion in the 1st metatarsal bone already at embryonic stage 23 (56-57 days). The peroneocuboid joint cavity appeared at the transition of the embryonic to the fetal period (8-9th week of gestation) and was independent of the proximal synovial sheath. The joint cavity extended from the level of the calcaneocuboid joint all the way to the insertion of the peroneus longus tendon in the 1st metatarsal bone. The frenular ligaments, fixing the peroneus longus tendon to the 5th metatarsal bone or the long calcaneocuboid ligament, developed in the embryonic period. The peroneus longus tendon presented a thickening in the area surrounding the cuboid bone as early as the fetal period. This thickening may be considered the precursor of the os peroneum and was similar in shape and in size relation to the tendon, to the os peroneum observed in adults. To the best of our knowledge, this is the first study to show that the os peroneum, articular facets of the peroneus longus tendon and cuboid bone, the peroneocuboid joint and the frenular ligaments appear during the embryonic/fetal development period and therefore they can not be generated exclusively by orthostatic and mechanical forces or pathological processes.
Journal of Anatomy, 1999
This study confirms that the median artery may persist in adult life in 2 different patterns, pal... more This study confirms that the median artery may persist in adult life in 2 different patterns, palmar and antebrachial, based on their vascular territory. The palmar type, which represents the embryonic pattern, is large, long and reaches the palm. The antebrachial type,which represents a partial regression of the embryonic artery is slender, short, and terminates before reaching the wrist. These 2 arterial patterns appear with a different incidence. The palmar pattern was studied in the whole sample (120 cadavers) and had an incidence of 20 %, being more frequent in females than in males (1.3 : 1), occurring unilaterally more often than bilaterally (4 : 1) and slightly more frequently on the right than on the left (1.1 : 1). The antebrachial pattern was studied in only 79 cadavers and had an incidence of 76 %, being more frequent in females than in males (1.6 : 1) ; it was commoner unilaterally than bilaterally (1.5 : 1) and was again slightly more prevalent on the right than on the left (1.2 : 1). The origin of the median artery was variable in both patterns. The palmar type most frequently arose from the caudal angle between the ulnar artery and its common interosseous trunk (59 %). The antebrachial pattern most frequently originated from the anterior interosseous artery (55 %). Other origins, for both patterns, were from the ulnar artery or from the common interosseous trunk. The median artery in the antebrachial pattern terminated in the upper third (74 %) or in the distal third of the forearm (26 %). However, the palmar pattern ended as the 1st, 2nd or 1st and 2nd common digital arteries (65 %) or joined the superficial palmar arch (35 %). The median artery passed either anterior (67 %) or posterior (25 %) to the anterior interosseous nerve. It pierced the median nerve in the upper third of the forearm in 41 % of cases with the palmar pattern and in none of the antebrachial cases. In 1 case the artery pierced both the anterior interosseous and median nerves.
Journal of Anatomy, 2001
A total of 192 embalmed cadavers were examined in order to present a detailed study of a... more A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm.
Journal of wrist surgery, Jan 15, 2016
Although the majority of arthroscopies can be performed adequately through dorsal portals, today ... more Although the majority of arthroscopies can be performed adequately through dorsal portals, today the wrist is not limited to a dorsal visualization; the joint can be thought of as a "box," which can be visualized from almost every perspective. 1 The two main volar portals currently used are the volar radial portal 2 and the volar ulnar portal. 3 They may be useful in some situations to visualize and treat the different structures of the radial and ulnar sides of the wrist, respectively.
Scientific Reports, 2021
The aim was to determine the variations in the level of origin of carotid bifurcation and diamete... more The aim was to determine the variations in the level of origin of carotid bifurcation and diameters of the common, internal, and external carotid arteries which is clinically important for several interventional procedures. Therefore, 165 human embalmed corpses were dissected. The data collected were analyzed using the Chi square-test and the Pearson correlation test. The results of previous studies have been reviewed. In relation to the level of the carotid bifurcation, taking as a reference point the hyoid bone, the values ranged from 4 cm below the hyoid body to 2.5 cm above the body of the hyoid, being the average height—0.33 cm, with a standard deviation of 1.19 cm. The right carotid bifurcation was established at a higher level (x = − 0.19 cm.) than the left one (x = − 0.48 cm.) (p = 0.046). On the contrary, no significant gender differences could be observed. The arterial calibres of the common and internal carotid arteries were higher in male than female. In the internal car...
European Spine Journal, 2021
Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebra... more Purpose Lumbar discogenic diffuse pain is still not understood. Authors describe the sinuvertebral nerve (SVN) as one possible cause. Body-donor studies are rare and controversial. Therefore, the aim was to revisit the origin, course and distribution in a body-donor study. Methods Six lumbar blocks (3 female, 3 male) aged between 59 and 94 years were dissected. After removal of the back muscles, lamina, dura mater and cauda equina, the anterior vertebral venous plexus, spinal artery and SVN were exposed and evaluated. Results 43 nerves out of 48 levels could be evaluated. The origin of the SVN was constituted by two roots: a somatic and a sympathetic branch arising from the rami communicantes. In 4/48 intervertebral canals studied (8.3%), we found two SVN at the same level. In 35/48 cases, one SVN was found. In 9/48 cases, no SVN was found. The SVN had a recurrent course below the inferior vertebral notch; in the vertebral canal it showed different patterns: ascending branch (31/43,...
European Journal of …, 2012
... Bilateral superfi-cial median arteries. J Anat, 194: 475-477. NUNOO-MENSAH J (1998). ... Anat... more ... Bilateral superfi-cial median arteries. J Anat, 194: 475-477. NUNOO-MENSAH J (1998). ... Anatomical description of the arteries of the human body. Thomas B. Wait & Co, Boston. ... Contrib Embryol, 70: 139-154. WOOD SJ, ABRAHAMS PH, SAÑUDO JR and FERREIRA BJ (1997). ...
Scientific Reports
Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can ... more Painful lesions on the plantar aspect of the first interphalangeal joint (IPJ) of the hallux can be attributed to structures called ossicles, nodules, or sesamoids. The aims of the present study were first to verify that ultrasonography (US) is a high-sensitivity tool for diagnosing an interphalangeal ossicle (IO), and second to prove that US-guided-shaving surgery (“milling”) is a safe and feasible technique for remodeling the IO. The study is divided into three parts. In the first part, the prevalence of IOs was estimated in 12 cadaver feet using US, anatomical dissection, and fluoroscopy. In the second, a detailed US and morphological description of the IO was obtained. In the third, six cadaver feet were subjected to surgical milling. IO prevalence was 41.6% in gross anatomy, 41.6% in US examination and just 16.6% in fluoroscopy. The ossicles had a mean length of 4 mm (± 2 mm) and a width of 7 mm (± 2 mm). The ossicles could be completely shaved in all specimens without injuring...
European Spine Journal, 2021
Unfortunately, the 9th author name was incorrectly published in the original publication. The com... more Unfortunately, the 9th author name was incorrectly published in the original publication. The complete correct name should read as follows. Jose Bouzada The original article has been corrected. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
European Journal of Anatomy, 2021
Anatomy is a fundamental subject for both medical and surgical training. Anatomy departments migh... more Anatomy is a fundamental subject for both medical and surgical training. Anatomy departments might collaborate with clinicians organizing continuing medical education (CME) and other professional development courses. The courses should have a large practical component (in content and organization) but also should provide the latest scientifically based theoretical knowledge, respecting the learning of anatomy as well as aiming at performing different techniques. Anatomy departments should support these courses by establishing hands-on practical training courses and components.
European journal of anatomy, 2016
We describe the supraescapular region’s anatomy providing distances between osseous landmarks (su... more We describe the supraescapular region’s anatomy providing distances between osseous landmarks (supraglenoid tubercle, suprascapular notch, glenoid rim, scapular spine) and measuring the total length of the suprascapular nerve (ssn), to determine ideal places or safe zones for shoulder surgery. Fifty shoulders from cadavers belonging to the Human Anatomy and Embryology donated under consent of the Spanish law were studied. The course of the nerve in each shoulder has been defined by measuring the distances from the supraglenoid tubercle to the suprascapular notch and to the scapular spine, the distance from the midpoint of the posterior glenoid rim to the base of the scapular spine, and finally the total length of the nerve. After leaving the suprascapular notch, the ssn courses posteriorly and laterally deep to the supraspinatus muscle to reach the base of the scapular spine. The distance from the supraglenoid tubercle to the notch averaged 3.54 cm (range 3 - 4.1 cm) and the distanc...
Journal of Anatomy, 2001
A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brac... more A separate supernumerary muscle in the lateral cubital fossa originating from the humerus or brachioradialis and inserting into the radius, pronator teres or supinator muscle has been considered as a variation of the brachioradialis muscle (Dawson, 1822; Meckel, 1823; Lauth, 1830; Halbertsma, 1864; Gruber, 1868b; Testut, 1884; LeDouble, 1897; Spinner & Spinner, 1996). However, a similar description was used to report additional heads of the brachialis or biceps brachii muscles (Gruber, 1848; Wood, 1864, 1868; Macalister, 1864–66, 1966–69, 1875; Gruber, 1868a; Wolff‐Heidegger, 1937).
Journal of Anatomy, 2011
The larynx serves respiratory, protective, and phonatory functions. The motor and sensory innerva... more The larynx serves respiratory, protective, and phonatory functions. The motor and sensory innervation to the larynx controlling these functions is provided by the superior laryngeal nerve (SLN) and the recurrent laryngeal nerve (RLN). Classical studies state that the SLN innervates the cricothyroid muscle and provides sensory innervation to the supraglottic cavity, whereas the RLN supplies motor innervation to the remaining intrinsic laryngeal muscles and sensory innervation to the infraglottic cavity, but recent data suggest a more complex anatomical and functional organisation. The current neuroanatomical tracing study was undertaken to provide a comprehensive description of the central brainstem connections of the axons within the SLN and the RLN, including those neurons that innervate the larynx. The study has been carried out in 41 adult male Sprague-Dawley rats. The central projections of the laryngeal nerves were labelled following application of biotinylated dextran amines onto the SLN, the RLN or both. The most remarkable result of the study is that in the rat the RLN does not contain any afferent axons from the larynx, in contrast to the pattern observed in many other species including man. The RLN supplied only special visceromotor innervation to the intrinsic muscles of the larynx from motoneurons in the nucleus ambiguus (Amb). All the afferent axons innervating the larynx are contained within the SLN, and reach the nucleus of the solitary tract. The SLN also contained secretomotor efferents originating from motoneurons in the dorsal motor nucleus of the vagus, and special visceral efferent fibres from the Amb. In conclusion, the present study shows that in the rat the innervation of the larynx differs in significant ways from that described in other species.
Clinical Anatomy, 2002
The incidence and morphology of the intramuscular Martin-Gruber anastomosis are presented based o... more The incidence and morphology of the intramuscular Martin-Gruber anastomosis are presented based on the study of 118 human cadavers (55 male, 63 female). The Martin-Gruber anastomosis was found in 25 (21.2%) of the 118 cadavers. It occurred in 11 (20%) of the 55 male cadavers (4 bilateral, 7 unilateral; 5 left and 2 right) and in 14 (22.2%) of the 63 female cadavers (2 bilateral, 12 unilateral; 8 left and 4 right). Therefore, the Martin-Gruber anastomosis was found in 31 (13.1%) of the 236 upper limbs. According to a recent classification (Rodríguez-Niedenführ et al., 2000), pattern I was found in 29 cases (93.5%), corresponding to Type A in 13 (41.9%), Type B in 3 (9.7%) and Type C in 13 (41.9%), whereas pattern II was found in 2 cases (6.5%), both being a duplication of Type IC. Intramuscular Martin-Gruber anastomosis was a single anastomosis that originated in all cases from the anterior interosseous nerve (pattern IC) and then passed through a muscle bundle of the flexor digitorum profundus and behind the ulnar artery to join the ulnar nerve as a single connecting branch. It did not send branches to the flexor digitorum profundus. This intramuscular course was observed in 3 of the 13 cases of Type C anastomosis (23.1%) or 3 cases out of 31 Martin-Gruber anastomoses (10%).
Annals of Anatomy - Anatomischer Anzeiger, 2021
This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
Surgical and Radiologic Anatomy, 2020
Background The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is p... more Background The surgical procedure itself of lengthening the gastrocnemius muscle aponeurosis is performed to treat multiple musculoskeletal, neurological and metabolical pathologies related to a gastro-soleus unit contracture such as plantar fasciitis, Achilles tendinopathy, metatarsalgia, cerebral palsy, or diabetic foot ulcerations. Therefore, the aim of our research was to prove the effectiveness and safety of a new ultrasound-guided surgery-technique for the lengthening of the anterior gastrocnemius muscle aponeurosis, the “GIAR”- technique: the gastrocnemius-intramuscular aponeurosis release. Methods and results An ultrasound-guided surgical GIAR on ten fresh-frozen specimens (10 donors, 8 male, 2 females, 5 left and 5 right) was performed. Exclusion criteria of the donated bodies to science were BMI above 35 (impaired ultrasound echogenicity), signs of traumas in the ankle and crural region, a history of ankle or foot ischemic vascular disorder, surgery or space-occupying mass...
Surgical and Radiologic Anatomy, 2019
Background The aim of this study was to provide a safe ultrasound-guided minimally invasive surgi... more Background The aim of this study was to provide a safe ultrasound-guided minimally invasive surgical approach for a distal tarsal tunnel release concerning nerve entrapments. Methods and results The study was carried out on ten fresh-frozen feet. All of them have been examined by high-resolution ultrasound at the distal tarsal tunnel. The surgical approach has been marked throughout the course of the medial intermuscular septum (MIS, the lateral fascia of the abductor hallucis muscle). After the previous steps, nerve decompression was carried out through a MIS release through a 2.5 mm (± 0.5 mm) surgical portal. As a result, an effective release of the MIS has been obtained in all fresh-frozen feet. Conclusion The results of our anatomic study indicate that this novel ultrasound-guided minimally invasive surgical approach for the release of the MIS might be an effective, safe and quick decompression technique treating selected patients with a distal tarsal tunnel syndrome.
Surgical and Radiologic Anatomy, 2018
Background The aim of this study is to provide a safe ultrasound-guided minimally invasive surgic... more Background The aim of this study is to provide a safe ultrasound-guided minimally invasive surgical approach for a proximal tarsal tunnel release concerning nerve entrapments. Methods and results The study was carried out on ten fresh-frozen feet. All of them were examined by high resolution ultrasound at the medial ankle region. The surgical approach was marked throughout the course of the flexor retinaculum (laciniate ligament). Once the previous steps were done, the flexor retinaculum release technique was carried out with a 2-mm entry only. As a result, an effective and safe release of the flexor retinaculum was obtained in all fresh-frozen feet. Conclusion The results of our anatomic study indicate that our novel ultrasound-guided minimally invasive surgical approach for the release of the flexor retinaculum might be an effective, safe and quick decompression technique treating selected patients with a proximal tarsal tunnel syndrome.
Journal of Anatomy, 2014
The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been ana... more The peroneocuboid joint, between the peroneus longus tendon and the cuboid bone, has not been anatomically well-defined and no embryological study has been published. Furthermore, the ossification of the os peroneum (a sesamoid inside the peroneus longus tendon) and its associated pathology has been considered to be generated by orthostatic and/or mechanical loads. A light microscopy analysis of serially sectioned human embryonic and fetal feet, the analysis of human adult feet by means of standard macroscopic dissection, X-ray and histological techniques have been carried out. The peroneus longus tendon was fully visible until its insertion in the 1st metatarsal bone already at embryonic stage 23 (56-57 days). The peroneocuboid joint cavity appeared at the transition of the embryonic to the fetal period (8-9th week of gestation) and was independent of the proximal synovial sheath. The joint cavity extended from the level of the calcaneocuboid joint all the way to the insertion of the peroneus longus tendon in the 1st metatarsal bone. The frenular ligaments, fixing the peroneus longus tendon to the 5th metatarsal bone or the long calcaneocuboid ligament, developed in the embryonic period. The peroneus longus tendon presented a thickening in the area surrounding the cuboid bone as early as the fetal period. This thickening may be considered the precursor of the os peroneum and was similar in shape and in size relation to the tendon, to the os peroneum observed in adults. To the best of our knowledge, this is the first study to show that the os peroneum, articular facets of the peroneus longus tendon and cuboid bone, the peroneocuboid joint and the frenular ligaments appear during the embryonic/fetal development period and therefore they can not be generated exclusively by orthostatic and mechanical forces or pathological processes.
Journal of Anatomy, 1999
This study confirms that the median artery may persist in adult life in 2 different patterns, pal... more This study confirms that the median artery may persist in adult life in 2 different patterns, palmar and antebrachial, based on their vascular territory. The palmar type, which represents the embryonic pattern, is large, long and reaches the palm. The antebrachial type,which represents a partial regression of the embryonic artery is slender, short, and terminates before reaching the wrist. These 2 arterial patterns appear with a different incidence. The palmar pattern was studied in the whole sample (120 cadavers) and had an incidence of 20 %, being more frequent in females than in males (1.3 : 1), occurring unilaterally more often than bilaterally (4 : 1) and slightly more frequently on the right than on the left (1.1 : 1). The antebrachial pattern was studied in only 79 cadavers and had an incidence of 76 %, being more frequent in females than in males (1.6 : 1) ; it was commoner unilaterally than bilaterally (1.5 : 1) and was again slightly more prevalent on the right than on the left (1.2 : 1). The origin of the median artery was variable in both patterns. The palmar type most frequently arose from the caudal angle between the ulnar artery and its common interosseous trunk (59 %). The antebrachial pattern most frequently originated from the anterior interosseous artery (55 %). Other origins, for both patterns, were from the ulnar artery or from the common interosseous trunk. The median artery in the antebrachial pattern terminated in the upper third (74 %) or in the distal third of the forearm (26 %). However, the palmar pattern ended as the 1st, 2nd or 1st and 2nd common digital arteries (65 %) or joined the superficial palmar arch (35 %). The median artery passed either anterior (67 %) or posterior (25 %) to the anterior interosseous nerve. It pierced the median nerve in the upper third of the forearm in 41 % of cases with the palmar pattern and in none of the antebrachial cases. In 1 case the artery pierced both the anterior interosseous and median nerves.
Journal of Anatomy, 2001
A total of 192 embalmed cadavers were examined in order to present a detailed study of a... more A total of 192 embalmed cadavers were examined in order to present a detailed study of arterial variations in the upper limb and a meta-analysis of them. The variable terminology previously used was unified into a homogenous and complete classification, with 12 categories covering all the previously reported variant patterns of the arm and forearm.