Anatomical Location of the Tendinous Intersections of the Rectus Abdominis Muscle in Korean Women

PURPOSE: The transverse rectus abdominis myocutaneous(TRAM) flap has become a reliable method for autogenous breast reconstruction. However, dissection of the tendinous intersections of rectus abdominis is technically difficult. The tendinous intersection has significant vascularity within its fascial layers raising in importance of technique in elevation. If tendinous intersections are damaged during the elevation of the rectus muscle, circulation to TRAM flap can be endangered. The purpose of this study is to evaluate the number of tendinous intersections and to predict anatomical position of the tendinous intersections. METHODS: We dissected 182 consecutive TRAM flaps and measured the distance between xiphoid process and each tendinous intersection and evaluated the statistic correlation among the distance, patient's height and position of umbilicus. RESULTS: In this study, in 30.7% of patients, two tendinous intersections were observed in one rectus abdominis muscle, in 67.7% three tendinous intersections, and in 1.6% four tendinous intersections, respectively. But there was no correlation between patient's height and the distance between xiphoid process and each tendinous intersection. CONCLUSION: It still remains difficult to predict the position of tendinous intersections just by topography before the dissection. Careful and meticulous dissection of the tendinous intersections is still required.

DYNAMIC BEHAVIOR OF SEMITENDINOSUS MUSCLE DURING ISOMETRIC KNEE FLEXIONS / 体力科学

The purpose of this study was to investigate semitendinosus muscle (ST) behavior during isometric knee flexions. Healthy male subjects were directed to exert ramp isometric knee flexion up to a maximum of eight knee flexion angles (0, 15, 30, 45, 60, 75, 90, 105 degrees). Displacement of the tendinous intersection (TI) in ST was measured using ultrasonographic images. TI moved proximally 15.8±4.9mm by maximum isometric contraction at 0 degrees, and the displacement of TI was significant at over 30% ramp maximum. Maximum knee flexion torque significantly correlated to displacement of TI at every knee angle, and decreased as the flexion angle increased. These results suggested that TI moved proximally in accordance with flexion torque, and demonstrated the unique behavior of ST, that is, the proximal part concentrically contracted, whereas the distal part eccentrically contracted.