Exploring the Morphology of Anterior Interosseous Nerve and Relating It to Its Clinical Conditions.

AIM: To study topography and variability in the origin of anterior interosseous nerve; to identify the branching pattern of the anterior interosseous nerve supplying the flexor digitorum profundus, flexor pollicis longus, and pronator quadratus muscles. MATERIAL AND METHODS: The present study included 70 formalin-fixed upper limbs of adult human cadavers. The origin of the anterior interosseous nerve was categorized into 3 types. The morphometric data obtained in this study were represented as mean± SD and the dimensions were given in millimeter. The measurements were compared statistically by using 'EZR software, version 1.38, 2019'. The 'paired t-test' was applied and the 'p' value less than 0.05 was considered as statistically significant. RESULTS: It was observed that the origin of the anterior interosseous nerve was extremely variable. It was ranging from the midepicondylar point of the elbow joint up to as below as 86mm from it. The distance of its origin from the midpoint of the pronator teres muscle ranged between 70 mm above the pronator teres muscle to 22 mm below it. In one of the forearms, the median nerve supplied the medial two tendons of the FDP, instead of the ulnar nerve. CONCLUSION: The present study provided additional information about the origin, topography, and distribution of the anterior interosseous nerve. The data will provide further insight into the causes of nerve compression syndromes. It will also help in planning the surgical approach into the distal humerus, elbow joint, and proximal ends of radius and ulna, without causing any nerve injury.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Dimensions of pes anserinus of the lower extremity, an anatomical study with its surgical implications / 대한해부학회지

The reconstructive surgeries utilize pes anserinus (PA) tendons, because of their lesser post-operative clinical deficits and donor site morbidity. These surgeries require anatomical knowledge about the extent of PA formation. The goal of this study was to determine the length and width of the PA formation. The objectives were to measure the distance of its upper limit, lower limit, and vertical distance from the tibial tuberosity (TT). The present descriptive cross sectional study included 53 embalmed cadaveric lower extremities. The upper and lower limits of PA were exposed with the careful dissection. Measurements of the dimensions were performed with the help of a digital vernier caliper (Mitutoyo Co., Kanagawa, Japan). The PA length, width, distance of its upper limit, lower limit, and vertical distance of it from the TT were 47.4±13.3 mm, 37.3±7.2 mm, 47.6±12.5 mm, 54.6±10.4 mm, and 39.1±14.2 mm, respectively over the right extremity. The same measurements were 46.3±14.7 mm, 39.1±9.4 mm, 39.1±5.9 mm, 49.5±8.2 mm, and 36.4±12.1 mm, respectively for the left extremity. The extent of PA was observed to be extremely variable. The preoperative knowledge about the dimensions of PA will help the plastic and orthopedic surgeon put the accurate skin incision, decreasing the donor site morbidity and biomechanical instability of the PA grafts. We suggest that, preoperative ultrasound measurement of the PA may help the operating surgeon to prevent the complications like injury to the infrapatellar branch of saphenous nerve.

Morphometric study of the semitendinosus muscle and its neurovascular pedicles in South Indian cadavers / 대한해부학회지

The purpose of this study was to determine the length of the semitendinosus muscle belly and its tendon in South Indian population and to study the topography and diameter of its neurovascular pedicles. The study included 46 formalin fixed human cadaveric lower limbs. The length of the semitendinosus muscle belly and its tendon were measured. The neurovascular pedicles of the semitendinosus muscle were identified and counted. The diameter of the neurovascular pedicle was measured just before its entrance into the semitendinosus muscle. The topographical distance of the neurovascular pedicles from the origin of the semitendinosus muscle were determined. The mean length of the semitendinosus muscle belly was 332.3±36.1 mm and its tendon measured 154.8±31.9 mm. The mean diameter of the vascular pedicle was measuring 11.4±9.1 mm, just before its entrance into the semitendinosus muscle. The neurovascular pedicles, of the semitendinosus muscle were ranging between 1 and 7. The distance of the entrance of neurovascular pedicle to the semitendinosus muscle from its origin was ranging between 46 and 272 mm. It was observed that the neurovascular pedicles were highest (31%) at the range of 151–200 mm away from the ischial tuberosity. The morphometric data obtained in the present study is enlightening to the orthopedic and plastic surgeons. The topographical knowledge of the neurovascular pedicles has its implications during the harvesting of the grafts and pedicle flaps. The diameter of vessels in the pedicles is enlightening because of new method of anterior cruciate ligament reconstruction.

Morphological study of styloid process of the temporal bone and its clinical implications / 대한해부학회지

The objective of this study was to study the morphometry of the styloid process of temporal bone and prevalence of elongated styloid process. The morphology of elongated styloid process along with its embryological and clinical importance are discussed. The present study included 110 human dry skulls which were procured from the bone collections of the department of anatomy. The styloid process was observed macroscopically on both sides of all the skulls, the elongations if any were noted. All the styloids were measured for their length, thickness at different levels and interstyloid distance at various levels. Out of 110 specimens, only 5 skulls (4.5%) exhibited the elongated styloid process. Among them, 3 skulls (2.7%) had unilateral elongation and 2 skulls (1.8%) had bilateral elongation of the styloid process. The mean length of the styloid process was 17.8+/-9.3 mm and 18.2+/-5.6 mm for the right and left sides, respectively. The prevalence of elongated styloid process in the present study was 4.5%. The clinical anatomy of this congenital variant is important to the neurosurgeon and radiologist, while interpreting the computed tomogram and magnetic resonance image scans. The morphological knowledge of elongated styloid process is clinically important since the course of the vertebral artery may be distorted in such situations.