ABSTRACT
Background: The anterolateral ligament (ALL) originates from the lateral epicondyle of the femur and inserts onthe tibia in between Gerdy’s tubercle (GT) and fibula head (FH). The ALL exists as a ligamentous structure thatbecomes taut if tibia is rotated 30° medially. It has been suggested that the ALL of the knee has importance inlimiting rotational instability, and reconstruction of the same along with anterior cruciate ligament (ACL) mayprevent a continued pivot-shift following surgery. We describe our experience of cadaveric dissection withreference to other published.Materials and Methods: This study was conducted in Department of Anatomy, D.Y.Patil Medical College, Kolhapurfrom 2016 to 2018. The ALL was identified in 14 Females and 16 Males cadavers, total 60 knee joints. The ALLtissue was identified with internal rotation of the tibia. Measurements were made using a digital calliper anddetails of the origin and insertion were recorded.Results: The ALL was identified had mean dimensions were: length 38.06 ±3 mm on Right side and 37.94 ± 3 mmon Left side, width 4.38 ± 0.25 mm on Right side and 4.37 ± 0.25 mm on Left side, thickness 0.9 ± 0.02 mm on Rightside and 0.9 ± 0.02 mm on Left side. The femoral origin Posterior and Proximal (PP) in 23, Anterior and Distal (AD)in 29 and Femoral Lateral Epicondyle in 8 knee joint. The tibial insertion was a mean 1.79 ± 0.3 mm on Right sideand 1.82 ± 0.3 mm on Left side from Gerdy’s tubercle (GT) and 1.28 ± 0.03mm on Right side and 1.25 ± 0.03 mm onLeft side from the fibula head (FH).Conclusions: Our results go along the studies describing that the ALL is a capsular thickening and has meniscalattachment. The findings will help surgeon to perform reconstructive surgery and also help them to select theappropriate graft. Further, we feel this ligament should be added in all gross anatomy book so that medicalundergraduates are also aware of ALL.
ABSTRACT
Axillary arch muscle or the Langer’s muscle is one of the rare muscular variation in the axillary region. It is the additional muscle slip extending from latissimus dorsi in the posterior fold of axilla to the pectoralis major or other neighbouring muscles and bones. In the present article a case of 68 yrs old female cadaver with axillary arch in the left axillary region is reported. It originated from the anterior border of lattissimus dorsi and merged with the short head of biceps and pectoralis major muscles. The arch was compressing the axillary vein as well as the branches of the cords of brachial plexus. The presence of the muscle has important clinical implications, as the position, unilateral presence, axillary vein entrapment, multiple insertions makes the case most complicated. Recognising the presence of axillary arch muscle in such complex form is important in clinical practice as the arch causes the difficulties in staging lymph nodes, axillary surgery, thoracic outlet syndrome, shoulder instability or cosmetic problems. The anatomy, embryological and clinical importance of this muscular variation is discussed in this paper.