Ligament structures in the tarsal sinus and canal.

BACKGROUND: The concrete anatomy and functional characteristics of the subtalar ligaments have been a matter of debate that some believe has hampered the progress of clinical ligament reconstruction. METHODS: In 32 fresh-frozen cadaver feet, the course of the inferior extensor retinaculum (IER) and other subtalar ligaments was carefully measured and photographed both from the portal of the tarsal sinus and from a posterior view. RESULTS: The IER inserted inside the tarsal sinus and canal by means of 3 roots: a lateral, an intermediate, and a medial one. These roots, along with the tarsal canal, divided the subtalar space into 3 parts. In front of the IER and inside the tarsal sinus, the thick cervical ligament (CL) lay at a 45-degree angle to the calcaneus. Behind the IER and inside the posterior capsule, in most cases (25 of 32 specimens), the posterior capsular ligament (PCaL) lay directly in front of the posterior talocalcaneal facet. Inside the tarsal canal, the fan-shaped medial root of the IER spread from outside upper lateral to lower medial, and the interosseous talocalcaneal ligament (ITCL) ran from upper medial to lower lateral; fibers of these 2 ligaments blended tightly together to form a V-shaped ligament complex. Just anterior to this complex in some cases (20 of 32 specimens), a short narrow upright ligament, the tarsal canal ligament (TCL), was located behind the middle talocalcaneal joint. CONCLUSION: The results of this study show that the CL is the primary ligament in the tarsal sinus and that the ITCL is a thin single band rather than a strong bilaminar ligament located inside the tarsal canal. Instead, the medial root of the IER is the primary ligamentous structure in the tarsal canal. CLINICAL RELEVANCE: The anatomical description provided here may provide a more accurate theoretical foundation for clinical subtalar stability restoration.

An anatomical study on the characteristics of cutaneous branches-chain perforator flap with ulnar artery pedicle.

BACKGROUND: The objective of this study was to provide anatomical information for the repair of small tissue defects in the hands and forearms with ulnar artery pedicle cutaneous branches-chain perforator flaps. METHODS: Twelve ulnar artery pedicle cutaneous branches-chain perforator flaps taken from human cadavers were studied using three methods: latex perfusion for microanatomy analysis, denture material and vinyl chloride mixed packing for cast analysis, and polyvinyl alcohol and bismuth oxide perfusion for molybdenum target x-ray arteriography. Statistical analysis was performed on cutaneous perforators with a diameter of 0.2 mm or greater. Cluster analysis was conducted to determine the overall distribution of perforators. RESULTS: There are two main clusters of perforators at a relative distance of 22.34 percent and 58.73 percent along the pisiform bone to the medial epicondyle. Two thick cutaneous perforators extend through the flexor digitorum superficialis and the flexor carpi ulnaris muscle gap, which are located 4.57 ± 0.59 cm proximal to the pisiform bone and 7.73 ± 1.14 cm distal to the medial epicondyle, with diameters of 0.63 ± 0.09 and 0.75 ± 0.15 mm and pedicle lengths of 1.49 ± 0.34 and 1.46 ± 0.54 cm. At the two main clusters of perforator-intensive sites, vessel chains formed by adjacent perforators were parallel to the flexor digitorum superficialis and the flexor carpi ulnaris muscle gap. CONCLUSION: This study demonstrated that the ulnar artery has two main clusters of perforators in the proximal one-third and distal one-fourth of the forearm, which can be used for ulnar artery pedicle cutaneous branches-chain perforator flaps to repair hand and forearm parenchymal defects.

[Three-dimensional reconstruction and anatomic variation of the portal vein based on 64-slice spiral CT data].

OBJECTIVE: To investigate the three-dimensional reconstruction methods of the portal vein using 64-slice spiral CT data and the anatomical variation of the portal vein. METHODS: Three-dimensional reconstruction of the portal vein was performed using Mimics software based on the 64-slice spiral CT data of 64 cases. Each model of the portal vein and its branches was evaluated according to the presentation rate, depiction quality and anatomic variation. RESULTS: The reconstructed model showed a depiction rates of 100% for the 4-grade branches of the portal vein. The stem of the portal vein and the left and right branches of the level III or above were all displayed, but in 2 cases the superior mesenteric vein and in 1 case the spleen vein was displayed only to the level IV. Of the 64 cases, 50 (78.1%) had normal portal vein and 14 (21.9%) showed anatomical variations. CONCLUSION: The 3D model vividly mimics the anatomic variations of the portal vein to provide valuable information for surgical plans.

[Establishment of a whole-body visualization model of breast cancer with high hepatic metastatic potential in nude mice through serial passage in vivo].

OBJECTIVE: To establish a whole-body visualization model of breast cancer with high hepatic metastatic potential in nude mice and observe the development and metastasis of breast cancer by real-time imaging. METHODS: pEGFP-N1 plasmid was transfected into human breast cancer cell line MDA-MB-231 to obtain pEGFP-MDA-MB-231 cells that emitted fluorescence. pEGFP-MDA-MB-231 cells were inoculated orthotopically in BALB/C nude mice and cultured in vivo through serial passage, thereby establishing the mouse model bearing tumors with high hepatic metastasis potential. The fluorescence emitted from the tumors was quantitatively detected and imaged with a fluorescence stereo microscope for real-time visualization of the tumor growth and metastasis. RESULTS: The transfected breast cancer cells stably and efficiently expressed EGFP. After inoculation of the transfected cells in nude mice, 20% of the first-generation cells showed hepatic metastasis, and the rate increased to 80% among the second-generation and up to 100% among the third-generation cells. The reliability of this visualization model was validated with conventional pathological methods. CONCLUSION: The whole-body visualization model bearing breast cancer with high hepatic metastasis potential provides a reliable means for studying the mechanisms of hepatic tumor metastasis, and can be instrumental in the exploration of novel means for breast cancer treatment.