Prevalence of the extensor digitorum, extensor digiti minimi and extensor indicis tendons and their variations.

We aimed to investigate tendon variations of the extensor digitorum (ED), extensor digiti minimi (EDM), and extensor indicis proprius (EIP) muscles. Our study was performed on 43 fetal cadavers (86 extremities), aged between 17 and 40 weeks of gestation. The number of ED tendons varied from three to six, proximal to the extensor retinaculum (ER), and from three to eight, distal to the ER. The ED most often had four tendons, both proximally and distally from the ER. The ED tendons of the fourth finger were observed to be most frequently duplicated. The most common juncturae tendinum (JT) was type 1 in the second intermetacarpal space (IMCS), type 2 in the third IMCS, and type 3r in the fourth IMCS according to von Schroeder classification. The number of EIP and EDM tendons varied from one to two and from one to five, respectively. The EIP double tendons inserted both into the ulnar and palmar sides of the extensor digitorum of the second finger, which had not been reported in the literature. In our study, 7% of hands had variant muscles. In 4.7% of hands, the extensor indicis et medii communis was observed, while the extensor medii proprius and the extensor digitorum brevis manus were observed in 1.2% and 1.2% of hands, respectively. Knowing the prevalence of the ED, EDM and EIP tendons and their variations in the fetal period should help to treat partial loss of hand function or injury after birth and to correct congenital hand deformities.

The effect of diclofenac sodium on neural tube development in the early stage of chick embryos.

BACKGROUND: Neural tube defects are congenital malformations of the central nervous system. Genetic predisposition and some environmental factors play an important role in the development of neural tube defects. This study aimed to investigate the effects of diclofenac sodium on the neural tube development in a chick embryo model that corresponds to the first month of vertebral deve- lopment in mammals. MATERIALS AND METHODS: Seventy-five fertile, specific pathogen-free eggs were incubated for 28 h and were divided into five groups of 15 eggs each. Diclofenac sodium was administered via the sub-blastodermic route at this stage. Incubation was continued till the end of the 48th h. All eggs were then opened and embryos were dissected from embryonic membranes and evaluated morphologically and histopathologically. RESULTS: It was determined that the use of increasing doses of diclofenac sodium led to defects of midline closure in early chicken embryos. There were statistically significant differences in neural tube positions (open or close) among the groups. In addition; crown-rump length, somite number were significantly decreased in high dose experimental groups compared with control group. CONCLUSIONS: This study showed that development of neurons is affected in chi- cken embryos after administration of diclofenac sodium. The exact teratogenic mechanism of diclofenac sodium is not clear; therefore it should be investigated.

Evaluation of normal tibial tubercle to trochlear groove distance in adult Turkish population.

PURPOSE: Many studies have confirmed the significance of tibial tuberosity-trochlear groove (TTTG) distance measurement for the preoperative assessment of tibial tubercle osteotomy and refixation of the patients that need surgery. TTTG distance is being used as threshold value for surgery decision. The purpose is to determine the TTTG values for the adult Turkish population and compare this with the values of other studies and establish a possible index. MATERIALS AND METHODS: This study was conducted on 200 patients (97 female, 103 male) aged between 18 and 65 years, retrospectively, who had magnetic resonance imaging at Istanbul Medipol Mega University Hospital Radiology Department. Individuals with no knee surgical history and deformation included to research group, any deformities related with knee were excluded. The scans were analyzed in Picture Archiving Communication System program and compared with other populations. Significance was evaluated with independent Student's t-test. RESULTS: The mean TTTG distance was found 10.07 ± 1.60 mm in males, 9.96 ± 1.41 mm in females, and 10.02 ± 1.51 mm for total cases. There was no statistically significant difference between sex (P > 0.05). However, overall TTTG distance of right and left knees found significantly different (P < 0.05). CONCLUSION: Obtained results are similar with the results of Caucasian population but different than Asian. It is believed that these results will be significant in evaluation of patellofemoral disorders and helpful in treatment.

Determination and classification of cutaneous innervation of the dorsum of the foot in foetal cadavers.

BACKGROUND: The aim of this study is to determine cutaneous innervation of the dorsum of the foot on foetal cadavers. MATERIALS AND METHODS: In this study. 200 limbs from 100 embalmed foetuses (54 males and 46 females) were studied in Anatomy Laboratory. Contributions of medial, lateral and intermediate dorsal cutaneous nerves (MDCN, LDCN and IDCN) of the foot were identified. RESULTS: Cutaneous innervation of the dorsum of the foot was classified into five types. Type I (75%) where MDCN innervated medial border of the foot and second interdigital cleft; IDCN innervated third, fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type II (21%) where MDCN innervated medial border of the foot, second and third interdigital clefts; IDCN innervated fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type III (1.5%) where saphenous nerve innervated medial border of the foot; MDCN innervated second and third interdigital clefts; IDCN innervated fourth and fifth interdigital clefts; and LDCN innervated the lateral border of the foot. Type IV (1.5%) was similar to type I, with an extra connection between the MDCN and IDCN on the dorsum of the foot. Type V (1%) where superficial fibular nerve innervated medial border of the foot, and second, third and fourth interdigital clefts; and sural nerve innervated fifth interdigital cleft and lateral border of the foot. CONCLUSIONS: The present study provides a new classification for the cutaneous innervation of the dorsum of the foot.

Anatomy and variations of palmaris longus in fetuses.

The aim of this study was to assess the absence of the palmaris longus, the proportion of the lengths of tendon and muscle belly, the development of the tendon and the belly during the fetal period, look for any difference between sides and gender. Fifty-eight spontaneously aborted human fetuses (26 female, 32 male, 116 upper extremities) were studied. The presence or absence of the palmaris longus was determined. The lengths of the belly and tendon were measured, and belly/tendon length ratio was calculated. Correlation with gestational age, body side and gender were studied. The muscle was absent in 44 forearms (37.93%; 20 right side, 34.48%; 24 left side, 41.38%); being bilateral in 19 of 58 fetuses (32.76%) and unilateral in six (10.34%). The unilateral absence rate was higher on the left side with a statistically significant difference. The absence of palmaris longus was more common in females, and the difference was statistically significant. The belly/tendon length ratio was 1.04 ± 0.35 on the right side and 1.09 ± 0.3 on the left. It did not show any difference according the fetal age. A sound knowledge on the anatomy and variations of palmaris longus is of great importance during surgical interventions; because it is the first choice for tendon grafts, by the virtue of its structure and function. Thus, this study is of academic interest for anatomists and hand surgeons alike.

Formation of the sural nerve in foetal cadavers.

The purpose of this study was to provide a morphologic description and assessment on the formation level of the sural nerve (SN) and its components. Also we aimed to reveal histological features of the SN components. An anatomical study of the formation of the SN was carried out on 100 limbs from 50 embalmed foetuses. The results showed that the SN was formed by the union of the medial sural cutaneous nerve (MSCN) and the peroneal communicating branch (PCB) in 71% of the cases (Type A); the MSCN and PCB are branches of the tibial and common peroneal nerve (CPN) or lateral sural cutaneous nerves (LSCN), respectively. Formation level of the SN was at the distal third of the leg in 43% of the cases, at the middle third of the leg in 46% of the cases, and at the upper third of the leg in 11% of the cases. The PCB originated in the CPN in 68% and the PCB originated in the LSCN in 3% of the cases. The SN was formed only by the MSCN in 20% of the cases (Type B). Type C was divided into four subgroups: in the first group the PCB and fibres of the posterior femoral cutaneous nerve joined the MSCN in 4% of cases; in the second group the MSCN, PCB, and sciatic nerve did not unite and coursed separately in 1% of cases; in the third group the SN arose directly from the sciatic nerve alone and the MSCN made a little contribution in 2% of cases; and in the fourth group the PCB, fibres of the sciatic nerve, and the MSCN formed the SN in 1% of the cases. The SN was formed only by the PCB in 1% of the cases (Type D). Distances of the formation level of the SN to the intercondylar line and the lateral malleolus were measured and also noted. A detailed knowledge of the anatomy of the SN and its contributing nerves are important in many interventional procedures.

A rare case of communicating branch between the posterior femoral cutaneous and the sciatic nerves.

During routine dissection of a 75-year-old male cadaver, we observed a communicating branch between the posterior femoral cutaneous nerve and the sciatic nerve. The connection was 11 cm below the infrapiriform foramen and was 3 cm long. Excluding this communicating branch, the origin, course and distribution of the posterior femoral cutaneous nerve showed no variation. The other branches of the sacral plexus were as usual.

Postpubertal testicular/epididymal epithelial thickness alterations in unilateral epididymal/vasal obstruction of prepubertal rats.

This study was conducted to evaluate postpubertal testicular and epididymal epithelial changes induced by unilateral epididymal and vasal obstruction in rats by measuring epithelium thickness of seminiferous tubuli (MSTet) and epithelium thickness of ductus epididymis (MDEet). Rats were randomly divided into 3 groups: group I underwent unilateral epididymal ligation; group II underwent unilateral vasal ligation and group III received sham operations. MDEet on the ipsilateral side of the epididymal ligation group significantly decreased compared to the contralateral side and sham group. For the contralateral side of the ligated vas, MDEet significantly decreased compared to the ipsilateral side and sham group. MSTet was less on the side of the operation than the contra lateral side and the sham group after both surgical procedures. The obstruction point of the male genital tract affect sperm parameters for clinical extraction or aspiration procedures.

Double superior vena cava.

Duplication of superior vena cava (SVC) is a rare anomaly. The incidence of double SVC in general population is 0.3% whereas in patients with congenital heart disease it varies between 10-11%. Double SVC cases have clinical importance if especially the one on the left side drains into the left atrium. Moreover, double SVC is surgically important in the presence of congenital heart disease. In this article, we presented adult patients who incidentally diagnosed with double SVC, one drained into the right atrium while the other into the left atrium and discussed the embryologic basis of these patent vessels.