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Objective:To investigate the anatomy of rectus femoris muscle flap and the anterolateral thigh muscle flap and their clinical application in reconstruction of large soft tissue defects after the removal of oral malignant tumour.Methods:From December 2006 to June 2009, 8 specimens of Chinese adult cadavers fixed in 10% formaldehyde were dissected to perform anatomy of anterolateral thigh region at the School of Basic Medical Sciences, Kunming Medical University. Anatomical images were analysed using Image-Pro Plus 6.0. Then, a retrospective study was performed on 19 patients who had postoperative defects after oral malignant tumour surgery and the defects were reconstructed with the rectus femoris muscle flap and the anterolateral thigh muscle flap from March 2020 to July 2022 at the Department of Oral and Maxillofacial Surgery, Affiliated Stomatology Hospital, Kunming Medical University. The postoperative defects of the 19 patients ranged from 3.0 cm×6.0 cm to 5.0 cm×10.0 cm. Ten rectus femoris muscle flaps, 8 anterolateral thigh muscle flaps and 1 combined rectus femoris muscle flap and anterolateral thigh muscle flap were used. The muscular flaps sized from 4.0 cm × 8.0 cm to 6.0 cm × 11.0 cm. Regular postoperative outpatient follow-ups were conducted.Results:The lengths of vessels of the harvested rectus femoris muscle flap and anterolateral thigh muscle flap were 63.4 mm± 12.9 mm and 112.5 mm± 19.6 mm, respectively. The starting outer diameters of the lateral circumflex thigh artery, the oblique branch of the lateral circumflex thigh artery and the descending branch of the lateral circumflex thigh artery were 2.92 mm±0.72 mm, 1.88 mm±0.23 mm and 2.29 mm±0.43 mm, respectively. Postoperative follow-up lasted for 7 to 32 months, with 17.5 months in average. Seventeen flaps were completely survived and the rectus femoris muscle flap was completely mucosalised 5 weeks after surgery. However, 2 rectus femoris muscle flaps had necrosis of which one was changed to a tongue flap reconstruction and the other encountered flap necrosis during postoperative radiotherapy and healed after debridement and dressing changes. There was no postoperative complication in the donor sites. Other than the 2 patients, all other 17 patients had satisfactory clinical outcomes.Conclusion:Both of the starting outer diameters and length of vessels of the femoris muscle flap and the anterolateral thigh muscle flap meet the requirements for reconstruction of maxillofacial defects, and both muscular flaps are simple to prepare, in good reconstructive results with few complication, as well as an excellent outcome. They are feasible approaches for reconstruction of large soft tissue defects left after the removal of an oral malignant tumour.
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Since the rectus femoris muscle is associated with trauma and disorders such as muscle strain, it is often a target for evaluation and treatment. However, in many studies, measurement results were obtained from only a part of the rectus femoris muscle and used as a representative value without considering the differences across the muscle. The rectus femoris muscle may change shape with knee flexion because the structure is complicated; it has an intramuscular tendon. The purpose of this study was to assess the changes in shape of the rectus femoris muscle during flexion of the knee joint in different directions. Twelve lower limbs of 12 male university students were analyzed. The rectus femoris muscle was divided into eight parts, and short-axis images were taken with an ultrasonic diagnostic imaging device at the knee joint; in extension; flexion at 30 °, 60 °, 90 °, and 120 °; muscle thickness; muscle width; and cross-sectional area. It was suggested that the thickness of the rectus femoris muscle increased from “A” to “F” due to knee flexion, and that this increase occurred because of stretching at the same site. In “G,” there was no difference between the angle conditions; conversely, in “H,” the muscle thickness decreased due to knee flexion. It should also be noted that D and E have the greatest muscle thickness when measuring in the knee flexion position.
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Objective To explore the clinical outcome of free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap for repairing the complex tissue defect of dorsum wrist. Methods From June, 2005 to March, 2014, free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap was used for repairing the complex tissue defect of dorsum wrist in 15 cases, which were 12 males and 3 females, and aged from 18 to 52 years old. The skin and soft tissue defect ranged from 8.0 cm×5.5 cm to 22.0 cm×12.0 cm. All ac-companied with extensor digitorum tendon loss. The tendon defect ranged from 5.0 cm to 12.0 cm (7.6 cm on average). The flap size ranged from 9.0 cm×6.5 cm to 23.0 cm×13.0 cm. The pedicle length ranged from 4.0 cm to 7.0 cm (5.3 cm on average). Results All flaps survived, and no postoperative complications occurred. The followed-up time ranged from 12 months to 36 months, and the texture of flap was flexible. No bulky was noted, and skin color was similar to the hand skin. The flexor and extensor function of wrist recovered satisfying. The 2-point discrimination of flap ranged from 9 mm to 15 mm (12.5 mm on average). Conclusion Free chimeric anterolateral thigh cutaneo-tendinous flap with rectus femoris muscular flap is a good option for repairing the complex tissue defect of dorsum wrist.
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Curriculum , Fascia , Femoral Artery , Islands , Mouth , Muscles , Quadriceps Muscle , Running , Skin , Surgery, Oral , ThighABSTRACT
Contextualização: A estimulação elétrica neuromuscular (EENM) é uma técnica bastante utilizada na área da reabilitação em fisioterapia, porém a instalação da fadiga ocorre de maneira mais rápida se comparada à contração voluntária. Na prática clínica, torna-se necessário monitorar a fadiga muscular em protocolos de EENM, visando adequar os parâmetros da corrente elétrica e prolongar o tempo de estimulação. OBJETIVOS: O objetivo deste estudo foi utilizar a mecanomiografia como meio de avaliação da fadiga muscular periférica durante a aplicação de um protocolo de EENM. MÉTODOS: Um sistema de aquisição de sinais mecanomiográficos (MMG) e um protocolo experimental foram desenvolvidos. Durante os ensaios in vivo com 10 voluntários, foram realizados testes de contração voluntária máxima (CVM) para extensão do joelho. Realizou-se uma fase de potencialização com contrações dinâmicas produzidas por EENM a 10 por cento da CVM (100 Hz, 400 µm) no músculo quadríceps femoral, e o protocolo de EENM propriamente dito ocorreu a 30 por cento da CVM (50 Hz, 400 µm). Simultaneamente, foram adquiridos os sinais de MMG RMS (amplitude) e MMG MPF (frequência) do músculo reto femoral e de torque (amplitude) para a extensão do joelho. RESULTADOS: A linha de tendência da MMG RMS foi descendente, indicando que a MMG RMS relaciona-se à amplitude do torque. Porém, a MMG MPF não teve uma boa correlação com o torque para este protocolo de EENM. CONCLUSÕES: A MMG pode ser aplicada simultaneamente à EENM, pois não ocorre interferência elétrica, e pode ser utilizada na realização de movimentos funcionais na contração muscular gerada por EENM. Artigo registrado no Australian New Zealand Clinical Trials Registry (ANZCTR) sob o número ACTRN12609000866202.
Background: Neuromuscular electrical stimulation (NMES) is a widely used technique for rehabilitation in physical therapy, however it causes muscle fatigue more rapidly than does voluntary contraction. In clinical practice, it becomes necessary to monitor muscle fatigue during NMES protocols to adjust the parameters of electrical current stimulation and, thus, increase stimulation time. OBJECTIVES: The aim of this study is to use mechanomyography (MMG) as a means of evaluating peripheral muscle fatigue during the execution of an NMES protocol. METHODS: An MMG signal acquisition system and an experimental protocol were developed. During in vivo tests, 10 participants performed maximal voluntary contractions (MVCs) for knee extension. A maximization phase was conducted with dynamic contractions generated by NMES at 10 percent of MVC (100 Hz, 400 µs) on the quadriceps muscle, and the main NMES protocol occurred at 30 percent of MVC (50 Hz, 400 µs). Simultaneously, MMG RMS (amplitude) and MMG MPF (frequency) signals of the rectus femoris and the knee extension torque were acquired. RESULTS: The tendency line of the MMG RMS was descendant, indicating that MMG RMS correlates with torque amplitude. However, MMG MPF did not show a significant correlation with torque for the present NMES protocol. CONCLUSIONS: MMG is a technique that can be simultaneously applied to NMES because there is no electrical interference and it can be used during functional movements in the NMES-generated muscle contraction. Article registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) under the number ACTRN12609000866202.
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The present study was performed to investigate the dynamics of Cu,ZnSOD and MnSOD expression following courses of reperfusion after repetitive ischemic preconditioning on the left rectus femoris muscle of Spraque-Dawley rats. Nine or thirty five weeks-old rats were subjected to three, six and ten cycles of ischemic preconditioning that was 5 min ischemia and 5 min reperfusion at the left common iliac artery. Left rectus femoris muscle was isolated 0, 3, 6, 24 and 72 hours of reperfusion after ischemic preconditioning and assayed by immunohistochemical staining with anti-Cu,ZnSOD and anti-MnSOD antibodies. The results were as follows; The immunoreactivities of Cu,ZnSOD and MnSOD were increased in the repectitive three and six cycles of ischemic preconditioning. However, after the repetitive ten cycles of ischemic preconditioning, the Cu,ZnSOD immunoreactivities were decreased in the nine weeks-old rats while MnSOD immunoreactivities were decreased in thirty five weeks-old rats. These findings suggest that severe damayes result from decrease of Cu,ZnSOD in nine weeks-old rats and decrease of MnSOD in thirty five weeks-old rats after ten cycles of ischemic preconditioning.
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Animals , Rats , Antibodies , Iliac Artery , Ischemia , Ischemic Preconditioning , Muscles , Quadriceps Muscle , ReperfusionABSTRACT
Purpose: To evaluate and introduce the technique of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia for the treatment of calcific tendinitis of the rectus femoris around the hip joint. Materials and Methods: Between March 2003 and May 2005, C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia were performed on 5 patients and a local excision were performed in 1 patient for the treatment of calcific tendinitis of the rectus femoris. The minimum follow-up period was 6 months. The radiology evaluation revealed the presence and size of the calcification. The clinical evaluation involved checking the level of pain relief, range of motion, recurrence, complications. Results: The hip pain improved immediately after treatment. There were no recurrences or complications. Conclusion: The combined treatment of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia is an effective method for treating calcific tendinitis of the rectus femoris, which can induce rapid symptom relief without any surgical morbidity.
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Humans , Anesthesia, Local , Follow-Up Studies , Hip Joint , Hip , Quadriceps Muscle , Range of Motion, Articular , Recurrence , TendinopathyABSTRACT
Free -flap which is transferred to recipients is a thin flat tissue isolated from human body and nutrient vessel of free - flap is ligated with similarly sized vessel. Free -flap reconstruction is widely used, due to high rate of flap survival and functional refinements, although it gives disadvantage of long surgery time and inefficient adaptation. This study demonstrates the characteristics and arterial supply of rectus femoris muscle of thigh. Seventy thighs (35 right, 35 left) of the 35 cadavers (19 males/16 females) which were clinically normal and without deformity were dissected and measured, according to Martin measurements. 1. The average length and width of rectus femoris muscle were 396.7 +/-39.9 mm and 36.5 +/-7.9 mm, respectively. The length of female subjects was significantly different from that of male subjects (P 0.05). 2. In the origin and insertion of rectus femoris muscle, anterior tendon and posterior tendon were not different between female and male subjects. 3. Artery of the rectus femoris muscle arises from deep femoral artery. The length of pedicle from the entering point of the rectus femoris muscle was average 19.0 +/-11.9 mm. The length from the entering point of the rectus femoris muscle to spliting point was 13.7 +/-7.7 mm of P1, 12.6 +/-7.5 mm of P2, and 14.8 +/-11.63 mm of P3 pedicles. 4. The frequency of the blood vessels inserted into the rectus femoris muscle was the first highest at the portion of 32.5 ~35% and the second highest of 35 ~37.5% and 37.5 ~40% ranges, when anterior superior iliac spine from center of the patellar was considered as 100% of portion. 5. According to the method by Kimata et al. (1998) classifying perforators based on the anatomic variations, type 1 and VIII were 83.58% and 5.97% respectively. Type 5, 6 and 7 were not observed. 6. Femoral nerves inserted into the rectus femoris muscle were distributed within 7.5 ~45% portion when anterior superior iliac spine from center of the patella was converted into 100%. The portion of 17.5 ~20% had the highest frequency of nerves. In conclusion, length of the rectus femoris muscle in Korean were different depending on gender, whereas tendon lengths were not. These data demonstrate artery pattern in Korean and provide anatomical potential for rectus femoris muscle to be used as a free -flap muscle.
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Female , Humans , Male , Arteries , Blood Vessels , Cadaver , Congenital Abnormalities , Femoral Artery , Femoral Nerve , Human Body , Patella , Quadriceps Muscle , Spine , Tendons , ThighABSTRACT
The purpose of this study was to clarify the changes in oxygen kinetics in two different thigh muscles recruited for dynamic knee-extension exercise at varying intensities in seven female subjects. Pulmonary oxygen uptake (Vo<SUB>2</SUB>) was measured by the 10-s mixing chamber method. Changes in oxygenated hemoglobin (HbO<SUB>2</SUB>), deoxygenated hemoglobin (Hb), and total hemoglobin (HbT) contents were measured in the vastus lateralis (VL) and rectus lemons (RF) muscles using near-infrared spectroscopy, and the oxygen saturation (SO<SUB>2</SUB>) was calculated as the HbO<SUB>2</SUB> divided by HbT in percent. The surface electromyograms (EMG) of both muscles were also recorded. The integrated EMGs (iEMG) of the VL and RF increased linearly with increasing exercise intensity up to 100%VO<SUB>2peak</SUB>. However, the HbO<SUB>2</SUB> and Hb remained unchanged when exercise intensity was below 50%Vo<SUB>2peak</SUB>, above which the increase in Hb and decrease in HbO<SUB>2</SUB> were observed. Thus the decline in SO<SUB>2</SUB> occurred at 60%Vo<SUB>2peak</SUB> in the RF, and 70%Vo<SUB>2peak</SUB> in the VL. These results suggest that muscle deoxygenation is accelerated during exercise above a certain intensity, which is lower in the RF than in the VL, during dynamic knee-extension exercise.