The morphometry of distal tibia and posterior malleolus and its clinical implications in total ankle prosthesis.

PURPOSE: The aim of this study is to reveal the morphometry of the distal tibia and posterior malleolus and to generate morphometric reference data for the tibial component of total ankle prosthesis. METHODS: This study was performed on 121 human dry tibiae (47 right, 74 left). The morphometric measurements of distal tibial structures, tibial length and the distance between the medial and posterior malleolus were measured in this study. Measurements on 44 tibiae were repeated three times and averaged for minimizing intra-observer error. RESULTS: The tibial length was found 34.19 ± 2.31 cm. Mean values of width of fibular notch at tibial plafond and 10 mm proximal to the tibial plafond were 25.71 ± 2.44 mm and 17.81 ± 2.46 mm, respectively. Mean depth of fibular notch at tibial plafond and 10 mm proximal to the tibial plafond were 3.60 ± 1.04 mm and 3.37 ± 1.24 mm, respectively. Mean height of fibular notch was found 48.21 ± 10.51 mm. Mean width and height of medial malleolus were 25.08 ± 2.13 mm and 14.73 ± 1.85 mm, respectively. Mean width and length of tibial plafond were 27.71 ± 2.74 mm and 26.96 ± 2.62 mm, respectively. Mean values of width and height of posterior malleolus were measured 21.41 ± 3.26 mm and 6.74 ± 1.56 mm, respectively. Mean distance between medial and posterior malleolus was found 37.17 ± 3.53 mm. Mean width and depth of malleolar groove were 10.26 ± 1.84 mm and 1.73 ± 0.75 mm, respectively. The mean intra-class correlation values were found between the 0.959 and 0.999. CONCLUSIONS: Knowing the distal tibial morphometry is crucial for designing convenient ankle replacement implants for Turkish population. To our knowledge, this study is the first in the literature that identifies posterior malleolar morphometry on dry tibiae. We believe that this study will make a significant contribution to the literature about distal tibial morphometry and especially the posterior malleolus and the data of our study can be used for designing total ankle prosthesis in Turkish population.

Reappraisal of the proximal tibia anatomy in Turkish population.

OBJECTIVE: Total knee arthroplasty has been popular in recent years. Morphometry of proximal tibia is important for surgeons to perform successful total knee arthroplasty. Aim of this study was to reappraise the proximal tibia morphometry. METHODS: In this study, 57 human dry tibia were evaluated. Anteroposterior and mediolateral dimensions of tibial condyles, maximum width of superior articular surface and length of tibia were measured. Furthermore, morphometric measurements of the intercondylar area and Gerdy's tubercle (infracondylar tibial tubercle) were done. All measurements were performed by two observers using a digital caliper. RESULTS: Mean anteroposterior and mediolateral dimensions of medial tibial condyle were found 39.76 and 23.27 mm, respectively. Mean anteroposterior and mediolateral dimensions of lateral tibial condyle were measured 34.72 and 21.83 mm, respectively. Mean anteroposterior dimension of intercondylar area was 41.62 mm. Shape of the Gerdy's tubercle was oval in 76.8%, irregular in 12.5%, and triangular in 10.7%. Texture of the tubercle was smooth in 85.7% and rough in 14.3%. Mean superoinferior and mediolateral dimensions of Gerdy's tubercle were 12.28 and 10.27 mm, respectively. Anteroposterior and mediolateral dimensions of tibial condyles were significantly higher (p < 0.05) for the medial condyle. Positive and statistically significant correlations were found between the tibial length and the other parameters (p < 0.05, r > 0.40). CONCLUSION: The morphometric data of tibial plateau are important for surgeons during total knee arthroplasty. The superoinferior and mediolateral dimensions of the Gerdy's tubercle, the distance between Gerdy's tubercle and tibial tuberosity, the distance between Gerdy's tubercle and lateral tibial plateau were measured for the first time in our study. The data obtained from this study can be used as a guideline in designing tibial component of the total knee prosthesis in Turkish population. In arthroplasty, patient-specific prosthetic implants may eradicate implant mismatch in the near future.

The illustrations and terminology of Hamse-i Sânizâde written by Sânizâde Ataullah Efendi: the stomach / Las ilustraciones y terminología de Hamse-i Sânizâde escrito por Sânizâde Ataullah Efendi: el estómago

SUMMARY: The book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" written by Sânîzâde Mehmet Ataullah Efendi was the first illustrated anatomy book published in the Ottoman Empire. The aim of this study was to determine the similarities and differences between the terms and definitions of stomach anatomy used by Sânîzâde at that time and those used today. The stomach section of the "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" was examined and related plates were translated into the Turkish language. Anatomical terms and definitions of stomach anatomy in this book were compared to the stomach terminology used in "Terminologia Anatomica" which is the reference book for terminology today. The stomach section was explained under the title "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Illustrated Stomach Anatomy) in this book. Parts, margins, arteries, veins, nerves and layers of the stomach were explained with the terms and definitions of that period. Terminologia Anatomica has 33 anatomical terms related to the stomach, while 15 terms were identified in the book "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Although more terms related to the stomach anatomy are used today, the fundamental information on stomach anatomy in Sânîzâde's book was compatible with much of the information used in modern anatomy books today.

El libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l- Insân" escrito por Sânîzâde Mehmet Ataullah Efendi fue el primer libro de anatomía ilustrado y publicado en el Imperio Otomano. El objetivo de este estudio fue determinar las similitudes y diferen- cias entre los términos y definiciones de la anatomía del estómago utilizados por Sânîzâde en ese momento y los que se utilizan en la actualidad. Se examinó la sección del estómago del "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân" y las placas relacionadas se tradujeron al idioma turco. Los términos anatómicos y las definiciones de la anatomía del estómago en este libro se compararon con la terminología del estómago utilizada en Terminologia Anatomica, el libro de referencia para la terminología utilizado actualmente. La sección del estómago se explicó bajo el título "El-Babu-Sâlis fi Tesrihi'l-Mi'de" (Anatomía del estómago ilustrada) en este libro. Fueron definidas las partes, márgenes, arterias, venas, nervios y capas del estómago con los términos y definiciones de esa época. Terminologia Anatomica tiene 33 términos anatómicos relacionados con el estómago, mientras que 15 términos fueron identificados en el libro "Mirâtü'l-Ebdân fi Tesrîh-i Âzâü'l-Insân". Aunque hoy en día se utilizan más términos relacionados con la anatomía del estómago, la información fundamental sobre la anatomía del estómago en el libro de Sânîzâde era compatible con gran parte de la información utilizada en los libros de anatomía modernos en la actualidad.

Investigation into the ophthalmic artery and its branches by superselective angiography.

BACKGROUND: The vascular anatomy of orbit is highly complex, and the main blood supply to the orbit is via the ophthalmic artery, which is a branch of the internal carotid artery. The purpose of this study was to determine the morphometry of the ophthalmic artery and its branches by superselective angiography in a large series of pediatric patients. METHODS: We evaluated 134 angiographies performed on children with intraocular retinoblastoma undergoing intra-arterial chemotherapy. The origin, diameter, and angiographic visibility percentages of the ophthalmic artery and its branches were examined according to age group and sex. RESULTS: The ophthalmic artery originated 97.8% from the internal carotid artery and 2.2% from the middle meningeal artery. The mean diameter of ophthalmic artery was measured 0.76 ± 0.14 mm in girls, 0.80 ± 0.15 mm in boys and 0.79 ± 0.15 mm in general. The posterior ciliary, lacrimal, inferior muscular, and anterior ethmoidal arteries had a higher angiographic visibility percentages (> 85%) than the other OA branches. Only the diameter of the dorsal nasal artery showed a significant correlation with age. The supratrochlear and posterior ciliary arteries showed statistically significant relationship with sex. CONCLUSIONS: Present study will make a substantial contribution to the pediatric literature about the ophthalmic artery and its branches. A better understanding of ophthalmic artery morphology can help surgeons and neurointerventional radiologists to avoid possible severe complications during embolization, intra-arterial chemotherapy, cosmetic procedures, endonasal and orbital surgeries.

Rare congenital anomalies of the internal carotid artery: anatomic and radiologic aspects of three cases and review of the literature.

PURPOSE: Congenital anomaly of the internal carotid artery (ICA) is a rare entity. It is usually discovered incidentally by color doppler carotid sonography, angiography, computerized tomography (CT), or magnetic resonance imaging of the head and neck region taken for some other reasons. The aim of this study was to detect congenital ICA anomalies, to delineate existing collateral vessels and to find out its incidence. METHODS: 1847 patients' CT angiography images of the head and neck region taken between May 2013 and February 2018 were retrospectively evaluated for ICA anomalies. RESULTS: We detected three cases (0.16%) with unilateral agenesis of ICA, bilateral agenesis of ICA and bilateral hypoplasia of ICA, respectively. Most patients are asymptomatic because of collateral cerebral circulation supplied by the communicating arteries of the circle of Willis, intercavernous anastomosis, communicating arteries from the external carotid artery, and by persistent embryologic arteries to the carotid artery territory. CONCLUSION: Recognition of ICA anomalies has important implications during planned carotid or transsphenoidal surgery, in thromboembolic disease, and in the follow-up and detection of associated cerebral aneurysms.

Evaluation of the anastomoses between the ophthalmic artery and the middle meningeal artery by superselective angiography.

PURPOSE: There are three anastomoses between the ophthalmic artery (OA) and the middle meningeal artery (MMA): the anastomotic branch with MMA, the recurrent meningeal branch and the anterior falx artery. We aimed to evaluate the anastomotic branches between the OA and the MMA on superselective angiograms of pediatric patients with retinoblastoma. MATERIALS AND METHODS: We evaluated 126 angiographies performed on children with retinoblastoma. The mean diameter and angiographic visibility percentage of the anastomotic branches between the OA and the MMA were examined according to age group and sex. RESULTS: The mean diameter of anastomotic branch with MMA was measured 0.58 ± 0.13 mm and we found this branch in 15 of 126 angiographic images (11.9%). We detected the recurrent meningeal branch in 47 of total images (37.3%). The recurrent meningeal branch arose 85.1% from the lacrimal artery, 8.5% from the anastomotic branch with MMA and 6.4% directly from the OA. The mean diameter of this artery was measured 0.21 ± 0.06 mm. Anterior falx artery was found in 86 of 126 angiographic peocedures (68.3%) and the mean diameter was measured 0.22 ± 0.06 mm. CONCLUSION: Knowledge of the anastomoses between the OA and the MMA system are all necessary to perform safe and successful endovascular and surgical procedures involving the orbital region.