Anthropometric parameters, lower limb functionality and quality of life after high-intensity interval training in healthy young people versus older adults / Parámetros antropométricos, funcionalidad de miembros inferiores y calidad de vida posterior al entrenamiento interválico de alta intensidad en jóvenes versus personas mayores

SUMMARY: The aim of this study was to determine the effects of High-intensity interval training (HIIT) on the quality of life in healthy young people (YNG) and older adults (OLD)and its correlation with physical health status (anthropometric parameters and lower limb functionality) YNG (21 ? 2 years, BMI 26.37 ? 2.69 n = 12) and OLD (67 ? 5 years, BMI 27.16 ? 3.04 n = 12) groups underwent 12weeks of HIIT. Before and after the HIIT, anthropometric assessments, lower limb functionality tests, and SF-36 quality-of-life questionnaire were performed. There were no significant changes in the SF-36 dimensions (P>0.05). After HIIT, there were improvement percentage changes in Mental Component Summary (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) and in Physical Component Summary (PCS) (YNG, +2.66 ? 20.54 % vs. OLD, +4.34 ? 22.71 %). Negative correlations were observed between body mass index (BMI) with PCS (R=-0.570, P=0.009) and with MCS (R=-0.649, P=0.002) in OLD as well as between MCS and waist circumference (R=-0.557, P?0.001) in both groups. Also, correlations were observed between PCS and the sit-to-stand test (R=-0.424, P=0.006) in both groups and gait speed (R=0.458, P=0.042) only in YNG. HIIT promotes positive percentage changes in quality of life, with YNG showing better results in PCS and OLD in MCS. Quality of life and physical health status were correlated in both groups.

RESUMEN: Determinar los efectos del entrenamiento interválico de alta intensidad (HIIT) sobre la calidad de vida en jóvenes sanos (YNG) y personas mayores (OLD) y su correlación con el estado de salud física (parámetros antropométricos y funcionalidad de miembros inferiores). Ambos grupos, YNG (21 ? 2 años, IMC 26,37 ? 2,69 n = 12) y OLD (67 ? 5 años, IMC 27,16 ? 3,04 n = 12) realizaron 12 semanas de HIIT. Antes y después del HIIT, se realizaron evaluaciones antropométricas, pruebas de funcionalidad de miembros inferiores y cuestionario de calidad de vida SF-36. No hubo cambios significativos en las dimensiones del SF-36 (P >0,05). Después del HIIT, hubo cambios porcentuales de mejora en el componente sumario mental (MCS) (YNG, +8.51 ? 25.80 % vs. OLD, +2.30 ? 9.05 %) y el componente sumario física (PCS) (YNG, +2,66 ? 20,54 % vs. OLD, +2,30 ? 9,05 %), correspondientes a la calidad de vida. Se observaron correlaciones negativas entre el índice de masa corporal (IMC) con PCS (R=-0,570; P=0,009) y con MCS (R=0,649; P=0,002) en OLD, así como entre MCS y circunferencia de cintura (R = - 0,557, P?0,001) en ambos grupos. Además, se observaron correlaciones entre PCS y la prueba de sentarse y levantarse (R = -0,424; P = 0,006) en ambos grupos y la velocidad de la marcha (R = 0,458; P = 0,042) solo en YNG. HIIT promueve cambios porcentuales positivos en la calidad de vida, con YNG mostrando mejores resultados en PCS y OLD en MCS. La calidad de vida y el estado de salud física se correlacionaron en ambos grupos.

Incidencia de la masa muscular de miembros inferiores en la repetición máxima en sentadilla media / Incidence of lower limb muscle mass in maximum repetition in half squat

Introducción: Las investigaciones sobre la incidencia de la masa muscular apendicular en la fuerza muscular en poblaciones sanas y clínicas es escasa, lo cual dificulta la práctica clínica y prescripción del ejercicio a los profesionales de la salud. Objetivo: Determinar la relación entre la masa muscular de miembros inferiores y la repetición máxima en sentadilla media en sujetos capacitados en el entrenamiento de la fuerza con sobrecargas. Métodos: Estudio descriptivo-correlacional con una muestra a conveniencia conformada por diez hombres (edad 17,40 ± 2,32 años, talla 172,10 ± 5,76 cm y una masa corporal de 79,13 ± 19,54 kg), se evaluó la fuerza máxima a través de un test de repetición máxima en el ejercicio sentadilla media, y la masa muscular de miembros inferiores fue estimada a través de una ecuación predictiva. Se utilizó el paquete estadístico PSPP (nivel de confianza del 95 por ciento y un p-valor de 0,05) para el análisis estadístico se aplicó las pruebas de normalidad (Shapiro-Wilk) y el coeficiente correlacional de Pearson. Resultados: La masa muscular de miembros inferiores y la repetición máxima en sentadilla media presentaron una distribución normal (p > 0,05), mientras que la relación entre la masa muscular de miembros inferiores y la repetición máxima en la sentadilla media fue negativa y no significativa (r = -0,45; p > 0,05). Conclusión: La masa muscular de miembros inferiores se relaciona de forma negativa y no significativa con la repetición máxima en sentadilla media en sujetos capacitados en el entrenamiento de la fuerza con sobrecargas(AU)

Introduction: Research on the incidence of appendicular muscle mass in muscle strength in healthy and clinical populations is scarce, making it difficult to practice and prescribe exercise for health professionals. Objective: Determine the relationship between lower limb muscle mass and maximum repetition in half squat in subjects trained in strength training with overloads. Methods: Descriptive-correlational study with a sample of ten men's convenience (age 17,40 ± 2,32 years, a size of 172,10 ± 5,76 cm and a body mass of 79,13 ± 19,54 kg), the maximum strength was evaluated through a maximum repetition test in the half squat exercise, and the muscle mass of lower limbs was estimated through a predictive equation. The PSPP statistical package (95 percent confidence level and a p-value of 0,05) was used for statistical analysis using the normality tests (Shapiro-Wilk) and Pearson correlational coefficient. Results: The muscle mass of lower limbs and the maximum repetition in half squat was presented a normal distribution (p > 0,05), while the relationship between the muscle mass of lower limbs and the maximum repetition in the half squat was negative and not significant (r = -0,45; p > 0,05). Conclusion: The muscle mass of lower limbs is negatively and not significantly related to the maximum repetition in half squat in subjects trained in strength training with overloads(AU)

Validation of a novel equation to predict lower-limb muscle mass in young soccer players: a brief communication / Validación de una nueva ecuación para predecir la masa muscular de los miembros inferiores en jugadores jóvenes de fútbol: una comunicación breve

Lower-limbs appendicular muscle mass is a key body composition trait related to health and performance. Considering the relevance of lower-limbs appendicular muscle mass in soccer players, the assessment and monitoring of this variable with a low-cost tool would be of great value in order to improve performance through training and nutritional interventions. This study aimed to develop a multiple regression model in order to validate, through dual-energy X-ray absorptiometry, a novel equation to predict lower-limbs appendicular muscle mass in young soccer players using anthropometric variables. Forty-two soccer players of the Chilean National Team (age, 17.1±1.3 years; body mass, 70.0±6.8 kg; height, 175.0±6.6 cm) underwent anthropometrically and body composition assessments. Forward stepwise linear regression was used to develop the equation to estimate the lower-limb appendicular muscle mass. The estimated results were compared with measurements by dual-energy X-ray absorptiometry. The best predictor model to estimate lower-limbs appendicular muscle mass was (kg): (-21.268 + (0.087*height) - (0.853*middle thigh circumference) - (0.329*middle thigh skinfold) + (1.136*corrected middle thigh circumference) + (0.306*calf circumference)) (R2= 0.83). The lower-limbs appendicular muscle mass estimated by the equation and measured by DXA were similar (14.71±1.72 kg vs 14.76±1.89 kg, respectively), and have a good concordance according to Bland-Altman method (mean difference: 0.049 kg; 95 % IC: -1.481 to 1.578 kg) and Lin's concordance correlation coefficient (0.91; 95 % CI: 0.85 - 0.96) methods. In conclusion, the predictive equation is a valid, easy to calculate, and a low-cost tool to predict lower-limbs appendicular muscle mass in young soccer players.

La masa muscular de los miembros inferiores es un factor antropométrico clave relacionado a la salud y el rendimiento deportivo. Considerando la relevancia de este factor en jugadores de fútbol, la medición y monitoreo de esta variable a través de herramientas prácticas de bajo costo puede ser de gran utilidad para lograr objetivos relacionados a mejorar el rendimiento a través del entrenamiento e intervenciones nutricionales. El objetivo de este estudio fue desarrollar un modelo de regresión lineal con el objetivo de validar una nueva ecuación predictiva de la masa muscular de miembros inferiores en jugadores jóvenes de fútbol. Cuarenta y dos jugadores jóvenes de fútbol pertenecientes a la Selección Nacional Chilena (17,1±1,3 años; 70,0±6,8 kg; 175,0±6,6 cm) fueron sometidos a evaluaciones antropométricas y de composición corporal. La regresión lineal de pasos hacia adelante fue utilizada para desarrollar la ecuación para estimar la masa muscular de miembros inferiores. Los resultados estimados fueron comparados con medición de absorciometría de rayos X de doble energía (DEXA). El mejor modelo predictor de masa muscular de miembros inferiores (kg) fue: (-21,268 + (0,087*talla) - (0,853*circunferencia de muslo medio) - (0,329*pliegue de muslo medio) + (1,136*circunferencia de muslo medio corregida) + (0,306*circunferencia de pantorrilla)) (R2= 0,83). La masa muscular estimada por la ecuación y la medida por DEXA fue similar (14,71±1,72 kg vs 14,76±1,89 kg, respectivamente), y tuvo una buena concordancia acorde al método Bland-Altman (diferencia promedio: 0,049 kg; 95 % IC: -1,481 to 1,578 kg) y el coeficiente de correlación de concordancia de Lin (0,91; 95 % CI: 0,85 - 0,96). En conclusión, la ecuación predictiva desarrollada en este estudio es una herramienta válida, fácil de calcular y de bajo costo que permite estimar la masa muscular de miembros inferiores en futbolistas jóvenes.

Differences in body composition of upper and lower limbs in elite taekwondo athletes / Diferencias en la composición corporal de los miembros superiores e Inferiores en atletas de taekwondo de élite

In this study, we analyzed the differences in body composition among athletes during different stages of their career Forty taekwondo athletes and 10 non-athletes (20 males and 30 females) with a mean age of 18.2 years (range, 15-23 years), a mean height of 173.4 cm, and a mean body weight of 64.8 kg were studied using dual energy X-ray absorptiometry and Biodex balance system. The bone mineral density of upper and lower limbs was higher among university athletes of both sexes than in high school athletes. The lean body mass of male athletes in the university was higher than in high school male athletes. By contrast, in case of females, the opposite results were obtained for the upper and lower limbs. Elucidation of the body composition according to career and sex of taekwondo athlete is worthwhile.

En este estudio, analizamos las diferencias de la composición corporal entre los atletas durante las diferentes etapas de su carrera. Se estudiaron cuarenta atletas de taekwondo y 10 no atletas (20 hombres y 30 mujeres) edad media de 18,2 años (rango, 15-23 años), una altura media de 173,4 cm y un peso corporal medio de 64,8 kg. Se utilizaron la absorciometría de rayos X de energía dual y el sistema de equilibrio Biodex. La densidad mineral ósea de las miembros superiores e inferiores fue mayor entre los atletas universitarios de ambos sexos, que en los atletas de educación secundaria. La masa corporal magra de los atletas varones en la universidad fue mayor que en los varones de la educación secundaria. Por el contrario, en el caso de las mujeres, se obtuvieron los resultados opuestos para las miembros superiores e inferiores. En conclusión se debe considerar un análisis de la composición corporal según la carrera y el sexo del atleta de taekwondo.

Correlación de la masa muscular apendicular medida por absorciometría dual de rayos X y antropometría en población pediátrica y adolescente sana / Correlation of appendicular muscle mass measured with dual-energy X-ray absorptiometry and anthropometry in a healthy population of pediatric and adolescent subjects

Resumen Introducción: Durante el proceso de crecimiento y desarrollo, los niños y adolescentes presentan cambios en su composición corporal. La masa muscular apendicular está relacionada con la movilidad, deambulación y, consecuentemente, con las actividades de la vida diaria. El objetivo del estudio fue determinar la correlación de la masa magra apendicular (MMA) de los miembros superiores e inferiores mediante absorciometría dual de rayos X (DXA) como método de referencia, en comparación con el área muscular apendicular (AMA) obtenida mediante antropometría. Métodos: Estudio transversal en niños y adolescentes sanos de 5 a 20 años de edad, residentes de la Ciudad de México y Área Metropolitana. Se incluyeron y midieron 1,081 sujetos clínicamente sanos. Resultados: La MMA obtenida con DXA y el AMA obtenida por antropometría tienen un coeficiente de determinación (r2) de 0.90. Al categorizarlos por percentil de índice de masa corporal, este se mantiene, aunque es ligeramente menor en el grupo de sujetos con obesidad, donde el coeficiente fue de r2 = 0.84. Conclusiones: La determinación de la masa muscular apendicular en niños y adolescentes mexicanos mediante antropometría es válida y precisa, y presenta una alta correlación con métodos como la DXA. La antropometría podría implementarse como parte de la evaluación de la masa muscular apendicular en el primer nivel de atención.

Abstract Background: Children and adolescents present changes in their body composition during their growth and development process. The appendicular muscle mass (AMM) is related to mobility, ambulation and, consequently, with the activities of daily life. The objective of this study was to determine the correlation of the AMM of upper and lower limbs, obtained by dual X-ray absorptiometry (DXA), as a reference method compared to the appendicular muscular area (AMA) obtained by anthropometric measurements. Methods: Cross sectional study in healthy children and adolescents from 5 to 20 years of age, residents of Mexico City and the Metropolitan Area. A total sample of 1081 clinically healthy subjects were included. Results: The AMM obtained with DXA and the AMA obtained by anthropometry showed a coefficient of determination (r2) of 0.90. Categorizing by percentile of body mass index, the correlation is maintained, being slightly lower in the group of obese subjects, where the coefficient was r2 = 0.84. Conclusions: Measurement of AMM in Mexican children and adolescents with anthropometry is a valid and accurate technic with a high correlation with methods such as DXA. Anthropometry could be implemented as part of the assessment of AMM in the first level care.

Calf circumference: clinical validation for evaluation of muscle mass in the elderly / Circunferencia de la pantorrilla: validación clínica para evaluación de masa muscular en mayores / Circunferência da panturrilha: validação clínica para avaliação de massa muscular em idosos

ABSTRACT Objective: To validate calf circumference as a technology for assessing muscle mass in the elderly. Method: Cross-sectional study with 132 elderly people from Goiânia, Goiás, Brazil. Decreased muscle mass was determined by the skeletal muscle mass index (IME) using Dual Energy X-Ray Absortometry (DEXA). The cutoff circumferences (CC) cutoff points to indicate muscle mass decrease were estimated by ROC curve, sensitivity, specificity and accuracy. Results: The most accurate cut-off points for detecting decreased muscle mass in the elderly were 34 cm for men (sensitivity: 71.5%, specificity: 77.4%) and 33 cm for women (sensitivity: 80.0%; specificity: 84.6%). Conclusion: CC can be used as a measure for early identification of muscle mass decrease in routine evaluations of the elderly in primary care.

RESUMEN Objetivo: Validar la circunferencia de la pantorrilla como tecnología de evaluación de masa muscular en mayores. Método: Estudio transversal con 132 mayores de Goiânia, Goiás, Brasil. La disminución de masa muscular fue determinada por el índice de masa muscular esquelética (IME) por medio de la Absorciometría por Rayos-X de Dupla Energía (DEXA). Los puntos de corte de la medida de circunferencia de la pantorrilla (CP) para indicar disminución de masa muscular fueron estimados por medio de curva ROC, sensibilidad, especificidad y precisión. Resultados: Los puntos de corte con mejor precisión para detección de masa muscular disminuida en mayores fue 34 cm para hombres (sensibilidad: 71,5%; especificidad: 77,4%) y 33 cm en mujeres (sensibilidad: 80,0%; especificidad: 84,6%). Conclusión: La CP puede ser utilizada como medida para identificación precoz de disminución de masa muscular en evaluaciones de rutina de mayores en la atención primaria.

RESUMO Objetivo: Validar a circunferência da panturrilha como tecnologia de avaliação de massa muscular em idosos. Método: Estudo transversal com 132 idosos de Goiânia, Goiás, Brasil. A diminuição de massa muscular foi determinada pelo índice de massa muscular esquelética (IME) por meio da Absorciometria por Raios-X de Dupla Energia (DEXA). Os pontos de corte da medida de circunferência da panturrilha (CP) para indicar diminuição de massa muscular foram estimados por meio de curva ROC, sensibilidade, especificidade e acurácia. Resultados: Os pontos de corte com melhor acurácia para detecção de massa muscular diminuída em idosos foi 34 cm para homens (sensibilidade: 71,5%; especificidade: 77,4%) e 33 cm em mulheres (sensibilidade: 80,0%; especificidade: 84,6%). Conclusão: A CP pode ser utilizada como medida para identificação precoce de diminuição de massa muscular em avaliações de rotina de idosos na atenção primária.

Lateral asymmetry in upper and lower limb bioelectrical impedance analysis in youth tennis players / Análisis de asimetría lateral de impedancia bioeléctrica de miembros superiores e inferiores en jugadores jóvenes de tenis

Tennis is a sport that requires asymmetric movements of dominat limbs and may lead to an asymmetric distribution of muscle mass. The main aim of the presented study was to determine the volume and degree of lateral asymmetry of the upper and lower limbs in youth tennis players using a bioelectrical impedance analysis. T-test was applied to find differences between the dominant and non-dominant arm and the right and left leg and thigh in four age categories. There were no significant differences between the right and left leg lean mass in the 12 and under, 14 and under and 16 and under age groups, but there were significant differences between the dominant and non-dominant arm lean mass and arm circumferences in all four age groups. All young tennis players had greater lean mass and arm circumferences of the dominant limb. Tennis players in the 18 and under group had higher average values of right leg lean mass and the differences are statistically significant. There were significant differences between right and left thigh circumferences in all age groups. Findings show that it is possible with such a simple, non-invasive and quick procedure as bioelectrical impedance to determine asymmetry in tennis players.

El tenis es un deporte que requiere movimientos asimétricos de los miembros dominantes y puede conducir a una distribución asimétrica de la masa muscular. El objetivo fue determinar el volumen y grado de asimetría lateral de los miembros superiores e inferiores en tenistas juveniles utilizando un análisis de impedancia bioeléctrica. Se aplicó la prueba T para encontrar diferencias entre el brazo dominante y no dominante y las piernas y muslos derecho e izquierdo en cuatro categorías de edad. No hubo diferencias significativas en la masa magra de las piernas derecha e izquierda en los grupos de edad: 12 y menor, 14 y menor, y 16 y menor. Sin embargo, hubo diferencias significativas en la masa magra de las circunferencias de los brazos dominante y no dominante en los cuatro grupos de edad. Todos los jugadores jóvenes de tenis tenían mayor masa magra en las circunferencias de los brazos del miembro dominante. Los jugadores de tenis en el grupo de 18 años y menor, tenían valores medios más altos de masa magra de la pierna derecha, con diferencias estadísticamente significativas. No hubo diferencias significativas entre las circunferencias de los muslos derecho e izquierdo en todos los grupos de edad. Los resultados muestran que es posible determinar con un procedimiento simple no invasivo y rápido, como la impedancia bioeléctrica, la asimetría en jugadores de tenis.

MR Imaging Appearances of Soft Tissue Flaps Following Reconstructive Surgery of the Lower Extremity

MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.

Primary Lymphedema of the Lower Limb: The Clinical Utility of Single Photon Emission Computed Tomography/CT

OBJECTIVE: The aim of this prospective study was to determine whether the additional use of the single photon emission computed tomography/CT (SPECT/CT) technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with primary lymph edema of the lower limb. MATERIALS AND METHODS: For a defined period of three years (April 2011-April 2014) a total of 34 consecutive patients (28 females; age range, 27-83 years) presenting with swelling of the leg(s) suspicious of (uni- or bilateral, proximal or distal) primary lymphedema were prospectively examined by planar lymphoscintigraphy (lower limbs, n = 67) and the tomographic SPECT/CT technique (anatomical sides, n = 65). RESULTS: In comparison to pathological planar scintigraphic findings, the addition of SPECT/CT provided relevant additional information regarding the presence of dermal backflow (86%), the anatomical extent of lymphatic disorders (64%), the presence or absence of lymph nodes (46%), and the visualization of lymph vessels (4%). CONCLUSION: As an adjunct to planar lymphoscintigraphy, SPECT/CT specifies the anatomical correlation of lymphatic disorders and thus improves assessment of the extent of pathology due to the particular advantages of tomographic separation of overlapping sources. The interpretation of scintigraphic data benefits not only in baseline diagnosis, but also in physiotherapeutical and microsurgical treatments of primary lymphedema.

Músculo aductor mínimo en individuos brasileños / Adductor minimus muscle in Brazilian individuals

Entre el grupo muscular que realiza la aducción de la articulación del cuadril se destaca el músculo aductor magno, cuya porción superior de la parte aductora puede constituir el músculo aductor mínimo. En la literatura hay pocas citaciones sobre este músculo, más allá de la presencia de datos divergentes entre diversos autores. De este modo, el objetivo de este estudio ha sido el de analizar el músculo aductor mínimo con relación: a sus inserciones proximal y distal, a las disposiciones de las fibras musculares y establecer la incidencia del mismo. Cincuenta miembros inferiores aislados de cadáveres adultos de ambos sexos fueron disecados. Los resultados encontrados demuestran que el músculo fue observado en dieciséis casos (32%), presentando: inserción proximal predominante en el ramo isquiopubiano (37,5%), e inserción distal en la línea áspera del fémur (100%). Las fibras musculares estaban dispuestas de forma oblicua en catorce casos (87,5%) y con disposición transversal en apenas dos casos (12,5%). Por lo tanto, este estudio servirá como base para nuevos trabajos científicos sobre el músculo aductor mínimo, con el objeto de clasificarlo como un músculo aislado.

Among the muscle group that performs the adduction of the hip joint, there is the adductor magnus muscle which upper portion of the adductor part may constitute the adductor minimus muscle. In the literature there are few quotes on this muscle, besides the presence of conflicting data among several authors. Thus, the objective of this study was to analyze the adductor minimus muscle in respect to: its proximal and distal insertions, the provisions of its muscle fibers and establish the incidence of it. Fifty lower limbs isolated from adult cadavers of both sexes were dissected. The results showed that the muscle was visualized in sixteen cases (32%), with proximal insertion predominant in ischiopubic ramus (37.5%), and distal insertion in the linea aspera of the femur (100%). The muscle fibers were arranged obliquely in fourteen cases (87.5%) and in only 2 cases (12.5%) the fibers were arranged transversely. Therefore, this study will serve as a foundation for new scientific work on the adductor minimus muscle, in order to classify it as an isolated muscle.

Variações anatômicas dos vasos tibiais: diagnostico diferencial de trombose venosa profunda antiga pela ecografia vascular / Anatomical variations of tibial vessels: differential diagnosis of deep vein thrombosis by vascular ultrasound

CONTEXTO: Apesar de a ultrassonografia vascular com Doppler colorido (UVDC) ser confiável na avaliação de TVP em membros inferiores, situações como variações anatômicas das veias tibiais podem limitar o diagnóstico ou mesmo induzir a um resultado falso-positivo. OBJETIVO: Apresentar uma variação anatômica das veias tibiais posteriores potencialmente responsável por resultados falso-positivos no diagnóstico da TVP antiga pela UVDC. MÉTODOS: Foram revisados exames de UVDC em pacientes com suspeita de trombose venosa profunda de membros inferiores realizados no período de janeiro a dezembro de 2012. Nestes, foram observados a presença, o número e o trajeto das veias profundas, e suas respectivas artérias. Os casos suspeitos de variação anatômica nas veias tibiais posteriores foram revisados por outro ultrassonografista vascular, para confirmação dos achados. A variação anatômica com agenesia ou hipoplasia das veias tibiais posteriores foi considerada somente quando a artéria tibial posterior também não foi identificada em toda a extensão ou nos respectivos segmentos nos quais não foram visibilizadas as veias. RESULTADOS: Foram realizados 1458 estudos pela UVDC em pacientes com suspeita de TVP em membros inferiores. Em seis pacientes (0,41%), houve agenesia parcial ou completa das veias tibiais posteriores. Cinco pacientes tiveram avaliação unilateral e um bilateral, totalizando sete membros inferiores, três membros inferiores direitos e quatro esquerdos. CONCLUSÃO: Apesar de encontrada em apenas 0,41% dos casos, o conhecimento da agenesia das veias posteriores é útil, a fim de diminuir erros diagnósticos e resultados falso-positivos para TVP em pacientes com essas variações. .

BACKGROUND: Even though color Doppler ultrasound (CDUS) imaging is reliable in assessing deep vein thrombosis (DVT) in lower extremities, anatomical variations of tibial veins may limit the diagnosis and even lead to false positive results. OBJECTIVE: To describe anatomic variations of the posterior tibial vein that may lead to false positive results in the CDUS diagnosis of chronic DVT. METHODS: CDUS scans of patients with suspected deep vein thrombosis of the lower extremities obtained from January to December 2012 were reviewed to record the presence, number and course of deep veins and arteries. Suspected anatomic variations of the posterior tibial veins were reviewed by another vascular sonographer to confirm findings. Anatomic variations, such as absence or hypoplasia of the posterior tibial veins, were recorded when the posterior tibial artery was not detected in any segments, as well as when the artery was also not visualized in the same segments. RESULTS: A total of 1458 CDUS scans of patients with suspected DVT in the lower extremities were reviewed. In six patients (0.41%), the posterior tibial veins were absent or hypoplastic. Scans were unilateral for five patients and bilateral for one, at a total of 7 lower extremities (3 right and 4 left). CONCLUSION: Although a rare condition, found in only 0.41% of the cases, awareness of posterior vein absence may help to avoid misdiagnoses and false-positive results of DVT in patients with this variation. .

Relacao entre o nivel de atividade fisica estimado pelo Baltimore Activity Scale for Intermittent Claudication e a pedometria em pacientes com claudicacao intermitente / Correlation between physical activity levels of patients with intermittent claudication estimated using the Baltimore Activity Scale for Intermittent Claudication and a pedometer

CONTEXTO: Os pacientes com claudicação intermitente apresentam níveis reduzidos de atividade física. A Baltimore Activity Scale for Intermittent Claudication (BASIC) foi validada para quantificar o nível de atividade física destes pacientes. No entanto, esta validação se baseou em apenas dois dias de monitoramento com acelerômetros, de modo que ainda permanece incerto se a BASIC fornece informações sobre os níveis de atividade física semanal. OBJETIVO: Analisar a correlação entre o nível de atividade física estimada pela BASIC e o nível obtido pelo pedômetro em uma semana, em pacientes com claudicação intermitente. MÉTODOS: Foram estudados 150 pacientes com claudicação intermitente, com idade entre 30 e 80 anos. Foram obtidos os dados sociodemográficos e verificada a presença de comorbidades e de fatores de risco cardiovascular, e a BASIC. O pedômetro foi utilizado por sete dias consecutivos, sendo a análise feita em três diferentes períodos de monitorização (todos os dias, dias da semana e do fim de semana). RESULTADOS: Foi observada correlação entre a BASIC e a média de passos de todos os dias (rho=0,343; p<0,001), dos dias de semana (rho=0,336; p<0,001) e dos dias do final de semana (rho=0,317; p<0,001). CONCLUSÃO: Em pacientes com claudicação intermitente, o nível de atividade física estimado pela BASIC se correlaciona com o nível de atividade física semanal. .

BACKGROUND: The levels of physical activity of patients with intermittent claudication (IC) are usually reduced. The Baltimore Activity Scale for Intermittent Claudication (BASIC) was designed to measure physical activity levels of patients with IC, but its validation was conducted against only two days of monitoring with an accelerometer, and it remains unclear whether BASIC provides information about weekly physical activity levels. OBJECTIVE: To analyze the correlation between physical activity levels of patients with IC estimated using BASIC or a pedometer for one week. METHODS: This study included 150 patients with IC aged 30 to 80 years. Sociodemographic data, comorbidities, cardiovascular risk factors and BASIC scores were recorded. Pedometers were used for seven consecutive days, and data were analyzed for three different periods (all days, weekdays and weekends). RESULTS: BASIC scores and mean number of steps were correlated on all days (rho=0.343, p<0.001), weekdays (rho=0.336, p<0.001) and weekends (rho=0.317, p<0.001). CONCLUSION: In patients with IC, physical activity levels estimated using BASIC correlate with weekly physical activity levels. .

Epifisiolistesis capital femoral: consecuencias del diagnóstico tardío: reporte de un caso y revisión de la literatura / Slipped capital femoral epiphysis: consequences of late diagnosis: a case report and literature review

La epifisiolistesis capital femoral es la pérdida de la relación anatómica entre la epífisis y la metáfisis del extremo proximal del fémur, producida por un desplazamiento a través del cartílago de crecimiento. Es la patología de cadera más frecuente de la adolescencia y su origen es multifactorial. El diagnóstico es clínico y se confirma radiológicamente. Es una urgencia traumatológica y su tratamiento debe ser precoz y quirúrgico. Es una lesión que requiere un alto índice de sospecha por parte del médico examinador y no realizar su diagnóstico a tiempo puede tener consecuencias devastadoras. Presentamos el caso de un adolescente, femenino de 12 años, quien sufrió una epifisiolistesis capital femoral, con 6 meses de evolución, no diagnosticada en su fase aguda; mostramos su evolución desde el inicio y su resolución mediante osteotomía de Dunn. El diagnóstico oportuno es la primera y única forma de evitar complicaciones a mediano y largo plazo(AU)

The slipped capital femoral epiphysis syndrome is the loss of the anatomical relationship between the epiphysis and metaphysis of the proximal end of the femoral head caused by a movement across the growth cartilage. Hip is the most common pathology of adolescence and its origin is multifactorial. Diagnosis is clinical and confirmed radiologically. It's an emergency trauma and its treatment should be early and surgical. It is an injury that requires a high index of suspicion by the examining physician and diagnose it early can have devastating consequences. We report the case of a female teenager aged 12, who presented a capital femoral epiphyseal, 6 months of evolution, which was not diagnosed in its acute phase. Introducing its evolution from the beginning and its resolution by Dunn osteotomy. Early diagnosis is the first and only way to avoid complications in the medium and long term(AU)

Perfil clínico e sociodemográfico dos portadores de doença venosa crônica atendidos em centros de saúde de Maceió (AL) / Clinical and socio-demographic profile of patients with venous disease treated in health centers of Maceió (AL), Brazil

CONTEXTO: A doença venosa crônica (DVC) consiste em alteração do sistema venoso causando uma incompetência valvar associada à obstrução de fluxo ou não. Acomete 10 a 20% da população mundial, tendo maior prevalência no sexo feminino. Apresenta como sintomas mais comuns dor e edema e na forma avançada, a úlcera venosa. Traz limitações funcionais e isolamento social, afetando a qualidade de vida. OBJETIVO: Traçar o perfil dos portadores de DVC, pelo levantamento de dados clínicos e sociodemográficos que indiquem características que possam contribuir para possível mudança de hábito na vida de pacientes que, por motivos de trabalho, falta de conhecimento e/ou instruções, tiveram sua rotina afetada pela doença, com consequente diminuição da sua qualidade de vida. MÉTODOS: Estudo descritivo, observacional do tipo transversal, sendo avaliados portadores de DVC atendidos em centros de saúde de Maceió (AL), aplicando um formulário para coleta de dados, como classificação CEAP, Critério de Classificação Econômica Brasil e Questionário SF-36. RESULTADOS: A amostra foi composta por 66 pacientes com DVC; 83% eram do sexo feminino e 17%, do masculino, a faixa etária predominante foi entre 50 a 60 anos; eram sedentários, assumindo ortostatismo prolongado, baixo nível de escolaridade e classe econômica, doença clínica grave (C6 sintomático) e qualidade de vida variável. CONCLUSÃO: Os resultados demonstraram predomínio da doença no sexo feminino, entre 50 a 60 anos de idade, com fatores desencadeadores e/ou agravantes para desenvolvimento da DVC como falta de atividade física, baixo nível de escolaridade e baixa renda econômica, afetando a qualidade de vida.

BACKGROUND: Chronic venous disease (CVD) is to change the system causing a venous valvular incompetence associated with obstruction of flow or not. It affects 10 to 20% of world population, with higher prevalence in females. It presents as the most common symptoms and pain and swelling in advanced form, venous ulcer, and brings functional limitations, social isolation, affecting quality of life. OBJECTIVE: Profiling of patients with CVD, the survey data indicate that clinical and socio-demographic characteristics that may contribute to possible change of habit in the life, who for reasons of work, lack of knowledge and/or instructions had affected their routine by the disease, with consequent decline in their quality of life. METHODS: A descriptive, observational, cross-sectional study that evaluated patients with CVD treated at health centers in Maceió (AL) Brazil, applying a form for collecting data, such as CEAP, Brazil Criterion of Economic Classification Questionnaire and SF-36. RESULTS: The sample consisted of 66 patients with CVD, 83% were female and 17% male. The patients had predominantly aged between 50 and 60 years who were sedentary, assuming prolonged standing, low educational level and economic status, severe clinical disease (symptomatic C6), and quality of life variable. CONCLUSION: The results showed a predominance of females, 50 to 60 years old, with triggering factors and/or aggravating factors for development of CVD as lack of physical activity, low education and low economic income, affecting quality of life.

Origem e distribuição anatômica do nervo isquiático de mão-pelada (Procyon cancrivorus) / Origin and anatomical distribution of ischiatic nerve in the crab-eating raccoon (Procyon cancrivorus)

O nervo isquiático é considerado o maior nervo do corpo, pertence tanto ao plexo sacral quanto ao lombossacral em carnívoros, continuando até a extremidade distal do membro pélvico, recebe fiibras dos ramos ventrais do sexto e sétimo nervos lombares e do primeiro nervo sacral. O objetivo do presente estudo é descrever a distribuição do nervo isquiático em mão-pelada (Procyon cancrivorus) e comparar com dados literários de animais domésticos e silvestres. Os animais são procedentes de coleta em rodovias, entre as cidades de Goiânia e Jataí, principalmente na BR 364 ou BR 060. (mortos por acidente) e fiixados em solução aquosa, a 10 por cento de formaldeído. Doados ao Museu de Anatomia Humana e Comparada da UFG (Universidade Federal de Goiás, Campus de Jataí, Proc.CAJ-287/2008). As dissecações e documentação fotográfiica permitiram observar a distribuição do nervo isquiático. O nervo isquiático de mão-pelada inerva o membro pélvico passando entre os músculos glúteo médio e profundo, emitindo ramos para a musculatura da região glútea e da coxa, respectivamente, para os músculos glúteo médio, glúteo bíceps, semimembranáceo, semitendíneo, bíceps femoral, gêmeos, quadrado femoral e adutor magno, emitindo nervo cutâneo lateral e caudal da sura para suprir a pele na superfiície lateral e caudal da perna, respectivamente. Próximo ao meio da coxa bifurca-se em nervo tibial e nervo fiibular comum. O conhecimento anatômico da origem e distribuição do nervo is quiático em mão pelada quando comparado com animais domésticos, silvestres e de fazenda, mostram um padrão de inervação semelhante entre os espécimes.

The ischiatic nerve is the largest nerve in the body, belongs both to the sacral and lumbosacral plexus in carnivores, continuing until the distal hind limb, and receives fibers from the ventral branch of the sixth and seventh lumbar nerves and the first sacral nerve. We aim to describe the distribution of the sciatic nerve in raccoon (Procyon cancrivorus) and compare with data of literary domestic and wild animals. The animals are coming to collect on highways (killed by accident) and subjected to fixation in aqueous solution, 10 percent formaldehyde. The dissection and photographic documentation (Sony α200 camera, 10.2mpx) shows the distribution of the sciatic nerve. The ischiatic nerve of raccoon innervates the hind limb passing between the middle and deep gluteal muscles, giving off branches to the muscles of the buttock and thigh, respectively, for the gluteus medius, gluteus biceps, semimembranosus, semitendinosus, biceps femoris, twins, quadratus femoris and adductor magnus, sending the lateral cutaneous nerve of the thickness and flow to supply the skin on the lateral surface of the leg and tail, respectively. Near the middle of the thigh nerve bifurcates into the tibial and peroneal nerve. The anatomical knowledge of the pattern of nervous raccoon (Procyon cancrivorus) is of fundamental importance in research to refer to the distribution of the ischiatic nerve, and show no disagreement with the corresponding data in the literature of domestic carnivores.

Músculo Plantar en Individuos Brasileños / Plantaris Muscle in Brazilian Individuals

El objetivo del trabajo fue obtener información más detallada sobre el músculo plantar, que permita mayor comprensión sobre su presencia, morfología, inserción, trayecto de su tendón y la extensión del vientre muscular y del tendón, facilitando su retirada para utilizarlo en injertos. Fueron realizadas disecciones de 60 miembros inferiores de cadáveres adultos fijados en formaldehído al 10 por ciento. El músculo plantar estuvo presente en 57/60 casos (95 por ciento). La forma de huso del músculo fue encontrada en 100 por ciento de los casos. La longitud del vientre muscular varió entre 7,0 cm y 13,7 cm. La extensión del tendón varió entre 25,5 y 40,0 cm. El trayecto del tendón fue oblicuo en 82,46 por ciento, entre los músculos sóleo y gastrocnemio, ubicándose en el resto del trayecto medialmente al tendón calcáneo. En 17,54 por ciento de los casos el tendón del músculo plantar, tras cruzar entre los músculos gastrocnemio y sóleo, se separó de éstos para seguir anterior al tendón calcáneo. El tendón se insertó en el 79 por ciento en la cara medial del tendón calcáneo. En el 21 por ciento de los casos, la inserción se realizó en diversos sitios como: cara anterior del tendón calcáneo; retináculo de los extensores o de los músculos flexores; en el calcáneo; en el músculo sóleo y en la cápsula de la articulación talocrural.

The aim of this study was to obtain more detailed information on the plantar muscle, which may provide a greater understanding of their presence, their morphology, their distal insertion, the path of its tendon, and the extent of the muscle and tendon, facilitating its removal for use in grafts. We performed 60 dissections of the lower limbs of adult cadavers in formaldehyde 10 percent. The plantar muscle was present in 57/60 of the cases (95 percent). In the 100 percent of the cases the muscle has a fusiform shape. The length of the muscle ranged from 7.0 cm to 13.7 cm. The length of the tendon ranged between 25.5 cm to 40 cm. The trajectory of the tendon was oblique in 82.46 percent between the medial gastrocnemius and soleus muscles, located in the remainder of its trajectory, medially to the calcaneous tendon. In 17.54 percent of the remaining cases the plantar tendon, after passing between the gastrocnemius and soleus muscles, it separated to move in the direction of the anterior calcaneal tendon. The muscle had its distal insertion in 79 percent on the medial calcaneal tendon. In 21 percent remaining cases, the insertion was in various locations such as on the soleus muscle, the flexor retinaculum and joint capsule of ankle joint.

Comparative osteometric study of long bones in Yankasa sheep and red Sokoto goats / Estudio osteométrico comparativo de los huesos largos entre oveja Yankasa y las cabras rojas Sokoto

A morphometric study was undertaken on the long bones in the two predominant breeds of small ruminant in Northern Guinea Savanna zone of Nigeria, to determine their anatomical differences and thus, provide a means of differentiating the remains of these two species during zooarchaeological studies and gross anatomy practical session. The pelvic and pectoral limbs from thirty animals (15 Yankasa sheep and 15 Red Sokoto goats) of both sexes were used for this study. The long bones of the pectoral limbs considered were the humerus, radius, ulna and metacarpal III while those of the pelvic limbs were the femur, tibia and metatarsal III. The parameters considered were the mean weights, lengths and diameters of the proximal extremity, mid-shaft and distal extremities of these bones. The result of this study showed that there is a very high statistically significant difference (p < 0.001) in the length of long bones between the two species, with that of the Yankasa sheep being significantly longer than the Red Sokoto goat. Also, the differences in weights as well as diameters of the proximal, middle and distal shafts of the tibia between the two species are of a very high statistical importance (p < 0.001). Conversely, the differences in the proximal and distal diameters of the femur between the two species are not statistically significant (p > 0.05). Factors that may be responsible for these differences were discussed. It is concluded that the bones of the Yankasa sheep and Red Sokoto goat can be differentiated by the disparity in the length of these long bones or the disparity in the entire morphometry of the tibia bone.

Se realizó un estudio morfométrico en los huesos largos en las dos razas predominantes de pequeños rumiantes del norte de Guinea, zona de Sabana de Nigeria, para determinar sus diferencias anatómicas y proporcionar un medio de que permita diferenciar los restos, de estas dos especies, durante los estudios zooarqueológico y en además en práctica de anatómica. Se utilizaron los miembros pélvicos y pectorales de treinta animales (15 ovejas Yankasa y 15 cabras rojas de Sokoto) de ambos sexos. Los huesos largos de los miembros pectorales considerados fueron: húmero, radio, ulna y III metacarpiano, mientras que en los miembros pélvicos fueron: fémur, fíbula y el III metatarso. Los parámetros considerados fueron los pesos medios, longitudes y diámetros de la extremidad proximal y tercios medio y distal de estos huesos. Los resultados mostraron que existe una diferencia altamente significativa (p <0,001) en la longitud de los huesos largos entre las dos especies. Los huesos en las ovejas Yankasa son significativamente más largos que los de la cabra roja de Sokoto. Además, de las diferencias en el peso, así como los diámetros de los ejes proximal, media y distal de la fíbula entre las dos especies son estadísticamente significativos (p <0,001). Por el contrario, las diferencias en los diámetros proximal y distal del fémur entre las dos especies no son estadísticamente significativas (p> 0,05). Fueron discutidos los factores que pueden ser responsables de estas diferencias. Se concluye que los huesos de las ovejas y cabras Yankasa Red Sokoto, se pueden diferenciar por la disparidad en la longitud de los huesos largos o en la morfometría de la tibia.

Carbonated water and necro-apoptotic cell death in chicken embrio low limb / Agua carbonatada y la muerte celular por necro-apoptosis en miembro inferior de embrión de pollo

Carbonated water is a fundamental part of many drinks and its effects have been studied in many pathological situations. However, cells and tissue damage as a consequence of carbonated water has not been the subject of extensive research. We assessed the short-term effects of soda on in vitro Hanging-drop culture of myoblasts and ex vivo lower limb of 8-day-old chicken embryo skeletal muscle tissue. Several groups weren designed: a) Control (Con-tyr), b) Carbonated water (Car), c) Coffe (Caf), and d) Cola beverage (Glu). The samples were observed with light microscopy and digital imaging analysis was performed. The ultra-structure of control and treated tissue were observed with electron microscopy. Immunohistochemistry techniques, such as terminal deoxynucleotidyl transferase-mediated dUTP nick- end labeling (TUNEL), TACTS Blue Label (TdT Kits) of R&D Systems were used. The myoblasts monolayers treated with soda showed plenty of eosinophilics elements. The eosinophily corresponds to higher percentage of cell death. The muscular tissue of the low limb treated with carbonated water (Car) showed calcium phosphate and collagen decreases, 53,86% and 82,95% respectively and enlarged nuclei of a higher size, with an evident loss of the parallel arrangement and fragmented nuclei. Compared to control samples, the muscular disorganization was accompanied by a positive reaction of the apoptotic bodies on TACS, also a positive reaction to ApopTacg and another positive reaction for the metalloproteases in the inter fibrillar cartilage matrix. These changes were not significant in Tyrode's solution controls, Coffee and Cola beverage groups. The morphological outcome can be apoptosis, necrosis or a mixed phenotype, suggesting that the carbonated water toxic effect might be related to these cell death processes. Further research, exploring biochemical factors will be required to elucidate necro-apoptotic cell death induced by carbonated water.

El agua carbonatada constituye una parte fundamental en muchas bebidas y su efecto ha sido estudiado en muchas situaciones patológicas. Sin embargo, el daño celular y de tejido como consecuencia del agua carbonatada no ha sido claramente investigado. El presente trabajo evalúa el efecto agudo in vitro de la soda sobre mioblastos obtenidos por cultivos en gota pendiente y el efecto sobre tejido muscular esquelético in vivo del miembro inferior de pollo de 8 días de desarrollo. Cuatro grupos de embriones fueron seleccionados al azar: a) Control (Con-tyr), b) Agua Carbonatada o Soda Club (Car), c) Café (Caf) y d) Bebida de cola (Glu). Las muestras fueron observadas por microscopía de luz. El análisis de imágenes digitales fue realizado. La ultraestructura del tejido control y tratado fue observada con Microscopía Electrónica de Transmisión (MET). La determinación de apoptosis fue realizada a través de TUNEL y l TACS Blue Label. La actividad de metaloproteasa MMP-1 fue ensayada. La población de mioblastos tratados con Soda Club mostró un elevado número de elementos eosinofílicos interpretado como un elevado número de células muertas, a diferencia del control y el grupo tratado con cafeína y bebida de Cola. En el tejido muscular se determinó una reducción de fosfatos de calcio y fibras de colágeno en una proporción de 53,86% y 82,95% respectivamente, acompañada por un desarreglo de las fibras y núcleos fragmentados, con reacción positiva para cuerpos apoptóticos y metaloproteasas en la matriz interfibrilar. Los resultados sugieren que el efecto tóxico del agua carbonatada sobre células y tejido pudiera estar vinculado con procesos combinados de muerte celular como necro-apoptosis. Se sugiere una mayor exploración de los eventos moleculares para dilucidar la combinación de los procesos de muerte celular sugerida en el presente trabajo.

The suspensory apparatus and digital flexor muscles of the llama (Lama glama) 2: The pelvic limb / El aparato suspensorio y los músculos flexores digitales de la llama (Lama glama) 2: El miembro pélvico

This paper provides data (text and illustrations) about the digital flexor muscles of the pelvic limb and the / metatarsophalangeal joint, evaluating the suspensory (support) apparatus and weight bearing structures. Similar to the above mentioned paper, a literature search provided incomplete information about these anatomical structures. As in the thoracic limb, unique anatomically variations exist in the pelvic limb of the llama. The caudal tibial muscle is fused with the lateral head of the deep digital flexor muscle (DDF), and the soleus muscle is missing. A symmetrical unexpected lumbricalis pedis muscle was found; the tendons are fusing with the axial branches of the lateral tendon of the long digital extensor muscle. A quadratus plantae muscle, also unexpected is present on the medial aspect of the tarsal region. The superficial digital flexor muscle (SDF) resembles that of the domestic ruminants. The metacarpo/ metatarsophalangeal joints, referred to as the fetlock joints (FJ) are very different from those of the domestic ruminants. Particular structures were found and they will be described and illustrated in the text. The anatomy of the suspensory (support) apparatus in the pelvic limb is evaluated in this paper.

El presente artículo ofrece datos (texto e ilustraciones) sobre el músculo flexor digital del miembro pélvico y la articulación metatarsofalángica, evaluando el aparato suspensorio (de apoyo) y el peso que soportan estas estructuras. La literatura proporciona información incompleta acerca de estas estructuras anatómicas. Al igual que en el miembro torácico, existen variaciones anatómicamente únicas en el miembro pélvico de la llama. El músculo tibial caudal se fusiona con la cabeza lateral del músculo flexor digital profundo (FDP), y el músculo soleo no existía. Fue encontrada una simetría inesperada del músculo lumbrical del pie; los tendones se encontraban fusionados con las ramas axiales del tendón lateral del músculo extensor digital largo. Un músculo cuadrado plantar, se encontraba presente en la cara medial de la región tarsal. El músculo flexor digital superficial (FDS) se asemeja al de rumiantes domésticos. Las articulaciones metacarpo/metatarsofalángicas, denominadas articulaciones del nudillo (AN) son muy diferentes de las de rumiantes domésticos. Fueron encontradas estructuras particulares que se describen e ilustran en el texto. Se evalúa la anatomía del aparato suspensorio (de apoyo) en el miembro pélvico.

Hypoplastic posterior tibial artery and the enlarged peroneal artery supplying the posterior crural region: a rare variation / Artéria tibial posterior hipoplásica e a artéria peroneal aumentada suprindo a região crural posterior: uma variação rara

Arterial variations of distal parts of lower extremities are well-documented and can be demonstrated with the help of Doppler ultrasound or by arteriography. However, absence or variation of posterior tibial artery is considered a rare finding. We present a case of hypoplastic posterior tibial artery that terminated by supplying soleus muscle. The variant arterial supply to the sole was provided by the enlarged peroneal artery that continued as the lateral plantar artery. The awareness of these variations is important to vascular surgeons while performing arterial reconstructions in femorodistal bypass graft procedures, and also to orthopedists during surgical clubfoot release.

Variações arteriais de partes distais dos membros inferiores estão bem documentadas e podem ser demonstradas com o auxílio de ultra-sonografia Doppler ou por arteriografia. Entretanto, a ausência ou variação da artéria tibial posterior é um raro achado. Apresentamos um caso de artéria tibial posterior hipoplásica que terminava suprindo o músculo solear. Esse suprimento arterial variante foi fornecido pela artéria peroneal aumentada que continuava como artéria plantar lateral. Estar consciente dessas variações é importante para cirurgiões vasculares ao realizarem reconstruções arteriais em procedimentos de derivação femorodistal, bem como para ortopedistas durante correção cirúrgica do pé torto.