Search Results (5)

Background: The quadriceps femoris (QF) muscle is traditionally described as a four-headed structure (QF4), yet recent anatomical studies have identified significant morphological variations, including accessory heads and complex quadriceps femoris tendon (QFT) layering. These anatomical differences are especially relevant when harvesting the QFT for anterior cruciate ligament (ACL) reconstruction, where graft quality and structure are critical to surgical success. This study aimed to systematically review and quantitatively synthesize available data on QF variants, with a focus on accessory heads and tendon architecture. Methods: This systematic review and meta-analysis followed PRISMA 2020 and Evidence-Based Anatomy Workgroup guidelines. Cadaveric studies reporting QF variants were identified through searches of multiple databases and anatomical journals. Pooled prevalence estimates and mean QFT lengths were calculated using random-effects models. Heterogeneity and publication bias were also assessed. Results: Eighteen studies encompassing 1066 lower limbs met inclusion criteria. The five-headed QF (QF5) was the most common variant (54.11%), followed by the classical four-headed form (QF4) (40.74%). Rare morphologies with six to eight heads (QF6–QF8) were also documented. Among accessory heads, the vastus lateralis (VL) type was most prevalent (21.35%), while an independent tensor vastus intermedius (TVI) occurred in 13.54% of limbs. The QFT most frequently displayed a trilaminar structure (47.73%), with quadrilaminar architecture observed in 42.49%. The mean QFT length was 78.63 mm. Conclusions: This meta-analysis confirms that the QF often deviates from classical anatomical descriptions, frequently exhibiting supernumerary heads and multilayered tendon architecture. These findings highlight the importance of detailed preoperative imaging and personalized surgical planning to minimize complications and optimize graft selection in ACL reconstruction. Full article

The accessory ligament of the deep digital flexor tendon (AL-DDFT) plays a crucial role in the stay apparatus of the horse. This study aimed to investigate the anatomical relationship between the AL-DDFT, the superficial digital flexor tendon (SDFT), and other structures in the metacarpal region. Sixteen distal forelimbs from eight horses, aged 1 to 6 years, were evaluated through macroscopic, microscopic, and morphometric analyses, utilizing detailed dissection, E12 plastinated sections, and histological analysis. During lateral dissection, a connection was observed between the AL-DDFT and the SDFT. Histological evaluation revealed that this connection was a fibrous band (FB), extending the common synovial sheath (CSS) to the SDFT, along with associated collagen fibrils of the epiligament and peritenon. Additionally, two distinct forms of the AL-DDFT were identified, Type I and Type II, with Type II showing a greater cross-sectional area (CSA) than Type I. While numerous morphological and morphometric studies have explored the AL-DDFT and related structures, research incorporating plastination-based morphological and histological evaluations remains scarce. The findings provide valuable insights for both the morphological and clinical assessment of structures within the metacarpal region. Full article

Introduction: Tibial spine avulsion injury, tibial eminence injury, tibial spine fracture, and anterior cruciate ligament (ACL) avulsion are multiple terms that express the same pathological condition. It can be encountered both in the pediatric and adult population. A wide array of surgical techniques have been proposed to manage displaced tibial spine avulsions. Anyway, insufficient evidence is currently available to prefer one fixation technique over another, and a gold-standard arthroscopy-based technique is still missing. In this article, we describe a mini-invasive, safe and user-friendly technique for arthroscopic reduction and internal fixation of displaced tibial eminence fractures. Materials and methods: Standard and patient-specific accessory arthroscopic portals allow for full access to knee visualization and management of concomitant intraarticular lesions. After performing the debridement of the inflammatory tissue and the release of eventual interposed tissues in the fracture site, the tibial eminence avulsion can be reduced by using a less-invasive bone impactor. With the knee flexed to 90°, the fracture fragments are then synthesized (under fluoroscopic control) with three thin Kirschner wires inserted in a proximal–distal direction in a cross-shaped geometry. Results: This technique allows a fast surgical and hospitalization time, a punctiform arthrotomy, proximal tibial physis preservation, and an early rehabilitation program. Conclusions: This novel technique seems attractive and very promising since it is respectful of the epiphyseal growth plates and is thus suitable for children and adolescents. Full article

The objective of this study was to evaluate and compare the sonographic characteristics of the digital flexor tendons and ligaments of the palmar/plantar of the metacarpal and metatarsal regions in gaited horses, as well as to establish normal reference ultrasound values for Mangalarga Marchador (MM) and Campeiro breeds. Transverse sonographic images were obtained of 50 adult and healthy horses from the MM (n = 25) and Campeiro (n = 25) breeds. The images were taken in six metacarpal/metatarsal zones, and the following measurements were taken: transverse area, circumference, dorsopalmar/plantar length, lateromedial length, and mean echogenicity. Differences were observed between breeds in the fore- and hindlimbs, and, even when not significant, the Campeiro breed tended to have higher values for most variables and structures. Variations between zones and between structures in the same zone followed a similar trend in both breeds for all variables. In addition, the dimensions and variations between zones and structures were different between the fore- and hindlimbs, highlighting the need for specific values for the digital flexor tendons and ligaments of the metatarsal plantar region. In conclusion, the digital flexor tendons, suspensory ligaments, and accessory ligaments of the digital deep flexor tendon are influenced by the breed factor in gaited horses, and they are different between the fore- and hindlimbs. Full article

Background and Objectives: The symptoms of Eagle’s syndrome are associated with the elongated styloid process of the temporal bone or calcification of the stylohyoid ligament. The first mention of pain syndrome associated with the elongated styloid process dates back to 1937, when it was described by Watt Weems Eagle. Over the last decade, experts in the field have shown a lively interest in the issue of the relationship between the elongated styloid process and various symptoms. This article presents the correlation between the clinical signs of Eagle’s syndrome and alterations in surrounding anatomical structures. It includes a brief review of the evolutionary, embryological and clinical anatomical background of the elongated styloid process. Materials and Methods: Between 2018 and 2019, five patients were admitted to our workplace with 1–3-year history of bilateral or unilateral throat pain, otalgia and pharyngeal foreign body sensation. As a therapeutic novelty in the surgical approach to this condition, we used individual 3D printed models to measure and identify the exact location of the resection of the styloid process without damaging the surrounding anatomical structures, such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Results: Compared to traditional surgical methods without 3D models, 3D models helped to better identify cutting edges and major landmarks used in surgical treatment of Eagle’s syndrome. Printed models provided assistance with the exact location of the styloid process resection position without damaging the surrounding anatomical structures such as the facial, accessory, hypoglossal, and vagal nerves; the internal jugular vein; and the internal carotid artery. Conclusion: In our clinical report, we used 3D printed models for navigation and planning during surgical procedures involving resections of the elongated styloid process. Additionally, we can formulate a new hypothesis: the elongated styloid process is a form of atavism of the bony hyoid apparatus in our evolutionary ancestors that is evolutionarily encoded or arises from disrupted degeneration of the middle portion of embryonal Reichert´s cartilage of the second pharyngeal arch. Under normal conditions, this portion does not ossify but degenerates and transforms into a connective tissue band, the future stylohyoid ligament. Full article