Anatomy of rectus femoris muscle flap and anterolateral thigh muscle flap and their application in reconstruction of postoperative defects of oral malignant tumour / 中华显微外科杂志

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.

Feasibility analysis of inferior vena cava variability combined with rectus femoris atrophy fraction in predicting the outcome of weaning from invasive mechanical ventilation / 中华急诊医学杂志

Objective:To identify the feasibility of inferior vena cava variability (ΔDIVC) combined with rectus femoris atrophy fraction in predicting the outcome of weaning from invasive mechanical ventilation (IMV).Methods:From January to December 2021, the patients with the need for IMV admitted to the Affiliated Yixing Hospital of Jiangsu University were recruited into prospective case-control study. The patients who met the withdrawal criteria were treated with a 2-h spontaneous breathing trial (SBT) and then extubated immediately. Patients with stable spontaneous breathing after extubation for more than 48 h were classified as successful weaning group, and on the contrary, the other patients were classified as failed weaning group. The clinical data and withdrawal indexes of the two groups were evaluated. The correlation between ΔD IVC and rectus femoris atrophy fraction was assessed. The influencing factors of weaning outcome were observed. The diagnostic value of ΔD IVC, rectus femoris atrophy fraction and the combination of two indexes in predicting weaning success were calculated by a plotting receiver operating characteristic (ROC) curve. Results:Sixty IMV patients were included in this study, including 38 cases of successful weaning and 22 cases of failed weaning. The two groups were comparable with regard to clinical data (all P>0.05). The rectus femoris cross-sectional area in the two groups diminished gradually with the length of ICU stay ( F=3.266, 3.625, both P<0.05). The rectus femoris cross-sectional area at the first SBT was significantly lower than that on the first day of admission in both groups [the successful weaning group: (2.54±0.88) cm 2vs. (3.08±0.98) cm 2; the failed weaning group: (2.22±0.87) cm 2vs. (3.02±1.10) cm 2, both P<0.05], but there was no significant difference between the two groups (all P>0.05). Patients in the successful weaning group had higher ΔD IVC and higher rectus femoris atrophy fraction than those in the weaning failure group [ΔD IVC: (25.02±4.65)% vs. (20.30±3.16)%; rectus femoris atrophy fraction: (81.89±5.09)% vs. (72.68±8.98)%, both P<0.05]. There was a positive correlation between ΔD IVC and rectus femoris atrophy fraction ( r=0.346, P=0.007). Both ΔD IVC and rectus femoris atrophy fraction played an important role in affecting weaning success (all P<0.05). The area under the curve (AUC) of ΔD IVC combined with rectus femoris atrophy fraction for predicting the weaning success was 0.880, which was significantly higher than that of ΔD IVC (AUC=0.791) or rectus femoris atrophy fraction (AUC=0.826). Conclusions:The predictive value of ΔD IVC combined with rectus femoris atrophy fraction for successful weaning of patients undergoing IMV is relatively accurate, which can be used to guide weaning.

A study on the shape change of the rectus femoris muscle with knee flexion / 体力科学

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.

Effect of acupotomy intervention on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To observe the effect of acupotomy on the morphology and ultrastructure of rectus femoris muscle in rabbits with knee osteoarthritis and to reveal the possible therapeutic mechanism involved in the effect of acupotomology on the treatment of knee osteoarthritis(KOA).@*METHODS@#Twenty-four male New Zealand rabbits aged 6 months and weighed (2.0±0.5) kg were randomly divided into blank group, model group and acupotomy group, 8 rabbits in each group. KOA model was established by modified Videman method with left hind limb extended plaster immobility for 6 weeks. In acupotomy group, the transfascial focal points of quadriceps femoris muscle were released by acupotomy under the guidance of Jingjin theory for 4 times and once a week, and the treatment points include Hedingci, Binwaixia, Binneixia. Blank group and model group were fed normally without intervention. One week after the end of the intervention, the pennation angle(PA), muscle thickness(MT), cross-sectional area(CSA) and strain ratio(SR) of rectus femoris were measured by ultrasound. HE staining was used to observe the changes of the tissue morphology, the number of muscle fibers and the average area of muscle fibers. The myofibril of rectus femoris, sarcomere and myofilament were observed by transmission electron microscope.@*RESULTS@#The PA of rectus femoris muscle in the blank group was (9.05±0.21)°. The MT was(1.09±0.09) cm and the CSA was(1.30±0.01) cm2. The PA of rectus femoris muscle in the model group was (3.06±0.15)°. The MT was (0.71±0.02) cm and the CSA was(0.77±0.02) cm2. The PA of rectus femoris muscle in the acupotomy group was (6.94±0.28)°. The MT was (0.80±0.05) cm and the CSA was(0.94±0.03) cm2. The muscle PA, MT and CSA of rectus femoris in the model group were significantly smaller than those in the blank group (P<0.05). Those in acupotomy group were significantly increased compared with those in model group (P<0.05). The SR of rectus femoris muscle was 1.19±0.02 in the blank group, 3.50±0.05 in the model group and 1.99±0.07 in the acupotomy group. The elastic SR of the model group was significantly higher than that of the blank group (P<0.05). These in acupotomy group was significantly lower than that in model group(P<0.05). The results of HE staining showed:in blank group, the fascicles of rectus femoris were arranged neatly, the number of beam of muscle fibers within the fixed visual field was 94.38±3.50 and the average CSA was(0.75±0.22) mm2. In model group, the fascicles of rectus femoris with different sizes were disorganized with a small amount of inflammatory cell infiltration, the number of beam of muscle fibers within the fixed visual field was 196.63±2.62 and the average CSA was(0.26±0.03) mm2. Compared to the blank group, a significant increase in the number of muscle fibers in the fixed field in the model group (P<0.05) and the average CSA decreased significantly(P<0.05). In acupotomy group, the rectus femoris fascicles in the acupotomy group tended to be arranged in a more orderly manner, with the inflammatory cells decreased, the number of beam of muscle fibers within the fixed visual field was 132.88±4.61 and the average CSA was(0.70±0.07) mm2. Compared to the model group, a significant decrease in the number of muscle fibers in the fixed field in the model group(P<0.05) and the average CSA increased significantly(P<0.05). The results of transmission electron microscope showed:compared with the blank group, the overall arrangement of the myofibrils of the rectus femoris in the model group was less structured. There was fracture between the muscle fibers and the sarcomere, the myofilaments were disordered, and the fracture of the Z line was discontinuous. Compared with the model group, the myofibrillar texture of rectus femoris in acupotomy group was clearer, and the Z line was more continuous.@*CONCLUSION@#Based on the jingjin theory, the release of quadriceps femoris by acupotomy can effectively improve the morphology and structure of rectus femoris, and promote the repair and reconstruction of chronic skeletal muscle injury in rabbits with KOA, which may be one of the mechanisms of acupotomy in the treatment of KOA.

Heart rate and lower limb muscle activity on cycle ergometer / Frequência cardíaca e atividade muscular dos membros inferiores em cicloergômetro / Frecuencia cardíaca y actividad muscular de los miembros inferiores en cicloergómetro

ABSTRACT Introduction: Muscle activity in the pedal stroke movement on a cycle ergometer can be measured by surface electromyography, as an effective and improved method for studying muscle action and objectively determining the different action potentials of the muscles involved in specific movements. Heart rate behavior is an important factor during exercise with load. Objective: To identify heart rate behavior and pattern of muscle activity of the rectus femoris and vastus medialis in healthy subjects in the pedaling dynamic at different loads, submaximal test, on an instrumented cycle ergometer. Methods: 20 healthy adults were evaluated. Heart rate measurement was performed, together with electromyographic analysis, in the time domain, of the rectus femoris and vastus medialis muscles during incremental exercise of the lower limbs on the cycle ergometer. Results: Heart rate behavior presented significant difference for p≥0.05 in relation to increased loads. The EMG signal intensity from the vastus medialis muscle (normalized RMS value) in each quadrant of the pedaling cycle showed significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants III and IV. In the rectus femoris (RF) muscle, there was significant difference for p≥0.05 in relation to quadrants I, II and IV and significant difference for p≥0.05 in relation to quadrants I, II and III. Conclusion: An increase in heart rate proportional to the increase in load was observed, as well as an increase in the amplitude of the electromyographic signal proportional to the increase in load. It was possible to identify the pattern of muscle activation in the studied quadrants during pedal stroke movements, independent of load. Level of evidence III; Study of non-consecutive patients; without uniform application of the "gold" standard reference.

RESUMO Introdução: A atividade muscular no gesto motor da pedalada no cicloergômetro pode ser mensurada por meio da eletromiografia de superfície. A eletromiografia de superfície tem sido um método efetivo e aprimorado para estudar a ação muscular, determinando com objetividade os diferentes potenciais de ação dos músculos empenhados em movimentos específicos. O comportamento da frequência cardíaca tem relação importante durante o exercício com carga. Objetivo: Identificar o comportamento da frequência cardíaca e o padrão da atividade muscular do reto femoral e vasto medial em indivíduos saudáveis na dinâmica da pedalada em diferentes cargas, teste submáximo, no cicloergômetro instrumentado. Métodos: Foram avaliados 20 adultos saudáveis, realizando-se a mensuração da frequência cardíaca e a análise eletromiográfica no domínio do tempo dos músculos reto femoral e vasto medial durante o exercício incremental dos membros inferiores em cicloergômetro. Resultados: O comportamento da frequência cardíaca apresentou diferença significante para p ≥ 0,05 com relação ao incremento das cargas. A intensidade do sinal EMG do músculo vasto medial (valor RMS normalizado) em cada quadrante do ciclo da pedalada mostrou diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes III e IV. No músculo reto femoral (RF) verificou-se diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e IV e diferença significativa para p ≥ 0,05 com relação aos quadrantes I, II e III. Conclusão: Constatou-se aumento da frequência cardíaca proporcional ao incremento das diferentes cargas e também se evidenciou um aumento na amplitude do sinal eletromiográfico proporcional ao incremento da carga. Foi possível identificar o padrão da ativação dos músculos com relação ao ciclo da pedalada nos quadrantes estudados, independentemente do nível da carga. Nível de evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción: La actividad muscular en el gesto motor de la pedaleada en el cicloergómetro se puede medir por medio de la electromiografía de superficie. La electromiografía de superficie ha sido un método efectivo y mejorado para estudiar la acción muscular, determinando con objetividad los diferentes potenciales de acción de los músculos empeñados en movimientos específicos. El comportamiento de la frecuencia cardíaca tiene relación importante durante el ejercicio con carga. Objetivo: Identificar el comportamiento de la frecuencia cardíaca y el patrón de la actividad muscular del recto femoral y vasto medial en individuos en la dinámica de la pedaleada en el cicloergómetro instrumentado. Métodos: Se evaluaron 20 adultos saludables, realizándose la medición de la frecuencia cardíaca y el análisis electromiográfico en el dominio del tiempo de los músculos recto femoral y vasto medial durante el ejercicio incremental de los miembros inferiores en cicloergómetro. Resultados: El comportamiento de la frecuencia cardíaca presentó una diferencia significativa para p ≥ 0,05 con relación al incremento de las cargas. La intensidad de la señal EMG del músculo vasto medial (valor RMS normalizado) en cada cuadrante del ciclo de la pedaleada mostró diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes III y IV. En el músculo recto femoral (RF) se verificó diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y IV, y diferencia significativa para p ≥ 0,05 con relación a los cuadrantes I, II y III. Conclusión: Se constató aumento de la frecuencia cardíaca proporcional al incremento de las diferentes cargas y también se evidenció un aumento en la amplitud de la señal electromiográfica proporcional al incremento de la carga. Fue posible identificar el patrón de la activación de los músculos con relación al ciclo de la pedaleada en los cuadrantes estudiados, independientemente del nivel de la carga. Nivel de evidencia III; Estudio de pacientes no consecutivos; sin patrón de referencia "oro" aplicado uniformemente.

Free chimeric anterolateral thigh cutaneotendinous flap with rectus femoris muscular flap for repairing the complex tissue defect of dorsum wrist / 中华显微外科杂志

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.

Morphometric study of tensor of vastus intermedius in South Indian population / 대한해부학회지

Tensor of vastus intermedius is a newly discovered muscle located between vastus lateralis and vastus intermedius. The purpose of this study was to investigate the detailed morphology of tensor of vastus intermedius, specifically to provide data pertaining to the attachments, innervations, variation in the types and its morphometry in South Indian population. The tensor of vastus intermedius was studied in thirty six cadaveric lower limbs using macrodissection techniques. The origin of the muscle was from upper part of intertrochanteric line and anterior part of greater trochanter of femur inserted to medial aspect of upper border of patella. The muscle was classified into four types based on the origin and also the aponeurosis course with independent type (type 1) being common. The mean and standard deviation of the length of tensor of vastus intermedius and aponeurosis were 145.40±37.55 mm and 193.55±42.32 mm, respectively. The results of the study suggest that tensor of vastus intermedius is variable and the information provided regarding the attachments, types and quantitative data will contribute to the existing knowledge of the muscle.

The Correlation between Knee Flexion Lower Range of Motion and Osgood-Schlatter's Syndrome among Adolescent Soccer Players.

Aims: To evaluate the association between knee flexion range of motion (ROM) and Osgood-Schlatter syndrome among adolescent soccer players. Study Design: Observational case-control study. Methodology: A study group of 20 male soccer players, mean age 13.4 years (13.4±0.7) diagnosed with Osgood-Schlatter syndrome and a control group of 21 healthy soccer players, mean age 13.5 years (13.5±0.9) were enrolled. The knee flexion ROM was bilaterally measured in a prone position by the Ely's test and using a digital inclinometer for angle measurement. Results: No significant difference between groups was found as to age, height, weight and dominant leg. Body mass index (BMI) was significantly higher (t = 2.249; P = .03) in the study group (18.97±1.61 kg/m2) compared to the controls (17.79±1.71 kg/m2). A statistically significant (t = -2.701; P =.01) difference was found in knee flexion ROM between the symptomatic leg in the study group and the dominant leg in the controls, with a lower ROM in the study group (132.52±12.40) and (141.40±8.35) in the controls. In a logistic regression analysis, BMI and knee flexion ROM both showed a significant association with the presence of symptoms (BMI: P = .014; ROM: P = .013). Conclusions: Proper training including stretching regime to the quadriceps muscles, with focus on the rectus femoris muscle, during the growth phase of adolescent soccer players should be considered in order to reduce OSS symptoms or even trying to prevent them.

Desgarros del músculo recto femoral: Actualización en RM / Muscle injuries of the rectus femoris muscle. MR Update

El desgarro del músculo recto femoral (RF) es el más frecuente dentro del grupo muscular cuadricipital y representa una de las causas más habituales de lesiones musculares del miembro inferior (luego de la injuria del grupo isquiotibial). Dada la complejidad de su anatomía, la sintomatología puede ser poco clara, por lo que los métodos de diagnóstico por imagen y, en especial, la resonancia magnética (RM) aportan información precisa sobre el tipo de desgarro, topografía, extensión y severidad. En el presente artículo, se describe detalladamente la anatomía del RFy su estudio selectivo mediante RM, con aportes técnicos específicos para optimizar este método de estudio. Además, se desarrollan los conceptos actuales del desgarro tendinoso, miotendinoso y el infrecuente desgarro miofascial, aportando datos clave que deben estar contemplados en el informe de RM y que son de suma importancia para el médico traumatólogo.

The tear of the anterior rectus femoris is the most frequent injury of the quadriceps muscle group, and one of the most common causes of lower limb muscle lesions (after the injury of the hamstring muscle group). As its anatomy is complex, and symptoms may be unclear, imaging and in particular, Magnetic Resonance Imaging (MRI) provides precise information on the type of tear, topography, extent, and severity. This article presents a detailed description of the anatomy of the RF and a selective study by MRI, with specific technical inputs to optimise this study method. The current concepts of tendinous, myotendinous, and the infrequent myofascial muscle-tendon tears are also presented, with details of key information that must be contemplated in MRI reports of paramount importance to the traumatology doctor.

Modified free vascularized fibular grafting for the osteonecrosis of the femoral head / 中华显微外科杂志

Objective To evaluate the short term results of repairing osteonecrosis of the femoral head by modified free vascularized fibular grafting through Smith-Peterson approach without cutting the rectus femoris.Methods Between January,2009 and September,2012,14 osteonecrotic hips of 14 patients who underwent free vascularized fibular grafting were retrospectively studied including 10 male and 4 female.The follow up period was 24 months.The preoperative and postoperative symptoms relief,recovery of hip function (Harris score),radiographic assessment (X-ray).Results All patients got postoperative ipsilateral hip pain relief.Average Harris hip score improved significantly (68.47 ± 5.33,86.80 ± 4.72 points in preoperation and postoperation,respectively; paired t test,t =18.724,P ＜ 0.01).Postoperative X-ray results showed there were no progresses of osteonecrosis and no collapse in the operative side within 2 years follow-up.Conclusion The short term treatment results of femoral head avascular necrosis were satisfactory by using free vascularized fibular graft through Smith-Peterson approach without cutting off the rectus femoris and it may be a relatively practical option of surgical approach.

Successful Treatment of Rectus Femoris Calcification with Ultrasound-guided Injection: A Case Report

Painful periarticular calcification most commonly occurs within the rotator cuff of the shoulder and rarely around the elbow, hip, foot, and neck. As acute inflammatory reaction develops, severe pain, exquisite tenderness, local swelling, and limitation of motion with pain occur. In case of calcific tendinitis of the shoulder, it can be easily diagnosed according to the symptoms and with x-ray. However, in lesions of the hip, as it is a rare location and usually involves pain in the posterolateral aspect of the thigh, which can simulate radicular pain from a lumbar intervertebral disc, it could be difficult to diagnose. Hence, physicians usually focus on lumbar lesions; therefore, misdiagnosis is common and leads to a delayed management. Here, we report the case of a 30-year-old female patient with calcific tendinitis of the rectus femoris that was successfully managed with ultrasound-guided steroid injection. This study offers knowledge about the rectus femoris calcification.

Anatomical Review of Anterolateral Thigh Flap for the Oral and Maxillofacial Reconstruction

Exploratory survey at the mexican marketplace on pork muscles characteristics from USA and Mexico

Trends in variation of physical, chemical and sensory traits due to country of origin (COO) were evaluated for samples from United States of America (U.S.A.) and Mexico of three pork muscles, Rectus femoris (RF, n = 20 from each COO), Vastus medialis (VM, n = 20 from each COO), and Longissimus dorsi (LD, n = 10 from each COO) in two separate, small-scale, exploratory surveys conducted at Mexico City. Compositional, physical and chemical properties and consumer acceptability traits of these Mexican and U.S.A. pork samples were quite similar, though Mexican pork samples generally were more variable. LD samples from U.S.A. had greater (P<0.05) water-holding and emulsifying capacities whereas both RF and LD from U.S.A. required lower shear force (P<0.05) compared to Mexican counterparts. Ratings from consumers did not indicate preference for pork from any of the countries. Because of the limited number of observations for the samples surveyed these results are preliminary and may not adequately characterize the populations of each country, but they did reveal important trends for selected traits of Mexican and U.S.A. pork currently available at the local market.

Se evaluaron tendencias en la variación de características físico-químicas y sensoriales debidas al país de origen (PDO), de muestras mexicanas y estadounidenses (EUA) de tres músculos del cerdo: Rectus femoris (RF, n = 20 por PDO), Vastus medialis (VM, n = 20 por PDO), and Longissimus dorsi (LD, n = 10 por PDO) mediante dos encuestas exploratorias separadas, a baja escala, conducidas en la Ciudad de México. Los resultados mostraron que músculos porcinos de los dos orígenes tienen propiedades físicas, químicas y sensoriales muy similares, aunque las muestras mexicanas mostraron mayor variabilidad. Las muestras de LD de EUA tuvieron mayor (P<0,05) capacidad de retención de agua y emulsificación, y al igual que las de RF, requirieron menos fuerza de corte que las mexicanas (P<0,05). Los consumidores no pudieron detectar diferencias entre muestras de diferente origen. Debido al limitado número de observaciones en las muestras encuestadas, los resultados deben considerarse preliminares y si bien no permiten caracterizar adecuadamente las poblaciones de cada país, las mismas revelan tendencias importantes para los rasgos seleccionados de la carne de cerdo procedente de México y EUA disponibles actualmente en el mercado local.

Avaliação da fadiga muscular pela mecanomiografia durante a aplicação de um protocolo de EENM / Muscle fatigue assessment by mechanomyography during application of NMES protocol

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.

Anatomic Analysis of Rectus Femoris Functional Flap in Korean

purpose of this article to evaluate the availability of the rectus femoris flap in Korean subjects. Material and Methods is that Cadaveric dissections were done on 51 femoral triangles of 26 cadevers. We measured the length of the direct head of rectus femoris from anterior superior iliac spine to patella upper pole, ASIS to lateral border of femoral nerve, and entry point of femoral nerve and vessel branches to rectus. Usually, there were three terminal branches to rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal 17.5~31.4% portion of the rectus femoris. The second and the third branch entered at the proximal 22.5~40.7% and 26.3~42.3%, respectively. The vessel entry was at 20.2~37.3%. The length from ASIS to femoral nerve was 3.5~8.5 cm. Among the 51 rectus femoris muscles, 44 had one nutrient artery, and 7 had 2 nutrient arteries. The nutrient artery originated from the descending branch of the lateral femoral circumflex artery in 18(40.9%) cases, directly from the lateral femoral circumflex artery in 8(18.0%) cases, and from proximal(6 cases, 13.6%) and distal(12 cases, 27.3%) portion of the deep femoral artery. The average length of the nutrient artery was 29.8 mm and the width was 2.14 mm. The point where it meets the main feeding artery of the rectus femoris was 9.0~15.0 cm from the ASIS. In all cases, the main artery's entrance was proximal to the first nerve branch. Conclusion is that rectus femoris has available data for functional flap

Effects of Repetitive Ischemic Preconditioning on the Expression of Cu,ZnSOD and MnSOD in Rectus Femoris Muscles of Rats / 체질인류학회지

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.

Calcific Tendinitis of the Rectus Femoris Around the Hip Joint

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.

Safe Triangle Within Dangerous Femoral Triangle For the Potential Space of True Anterior Hip Approach / 대한정형외과학회잡지

PURPOSE: To evaluate the safe triangle within the femoral triangle for the potential space of the true anterior hip approach. MATERIALS AND METHODS: Cadaveric dissections were carried out on 28 femoral triangles from 14 cadavers. This study measured the length of the direct head of the rectus femoris from the anterior inferior iliac spine (AIIS) to the patella upper pole, the AIIS to the lateral border of the femoral nerve, and the entry point of the femoral nerve and vessel branches to the rectus. The safe portion within the risky femoral triangle was analyzed and applied to two clinical situations, a femoral head fracture and septic hip arthritis. RESULTS: The examination showed that there were three terminal branches to the rectus femoris from the femoral nerve. The entry point of the first branch was at the proximal 20.0-28.9% portion of the rectus femoris. The second and the third branch entered at the proximal 22.5-37.5% and 24.9-41.0%, portion, respectively. The vessel entry was at 21.4-37.3%. The length from the AIIS to the femoral nerve was 3.5- 8.0 cm. Using this space, the procedure was easier to perform in the two situations mentioned above. CONCLUSION: The space within the femoral triangle between the proximal 20% of the rectus femoris and iliacus can be used as one of the potential spaces for femoral head fracture fixation and septic hip irrigation in children, and as an arthroscopy portal.

Calcific Tendinitis of the Rectus Femoris: A Case Report / 대한정형외과학회잡지

The most common anatomic location of calcific tendinitis is the suprasupinatus muscle of the shoulder joint. However, it is known to develop in any joint including the hip, knee, wrist, and elbow. Around the hip joint, it occurs usually in areas such as the gluteus maximus tendon, the gluteus medius tendon, and the bursa between the gluteus medius and the greater trochanter. The occurrence of calcific tendinitis in the rectus femoris is very rare. We hereby report three cases of calcific tendinitis, which developed in the rectus femoris.

The role of Intramuscular nerve microsurgical repair in the recovery of laclacerated musculus rectus femoris / 重庆医科大学学报

Objective:To explore the intramuscular nerve effect on the recovery of lacerated muscle. Methods:thirty (30) healthy New Zealand rabbits were involved in the study and randomly divided into groups A and B.The right musculus rectus femoris of the animal was chosen as the lacerated skeletal muscle model with the contralateral muscle as sham control. Group A underwent muscle laceration with the intramuscular nerve microsurgical repaired and muscle repaired;group B only with muscle repaired. After a postoperative period of 28weeks,measured the muscle wet weight and the muscle strength of musculus rectus femoris by electrical stimulation test and observed the change of morphology by Hematoxyline/eosin stain,Masson stain,NADH-TR stain and mATPase stain. Compared the difference of two groups through t-test and ANOVA to decide the effects of intramuscular nerve effect on muscle injury and repair. Results:At 28 weeks postoperative,Compared with the controls,wet weight and isometric contraction of musculus rectus femoris reduced in the intramuscular neurotmesis group (P