Post-mortem interval estimation of human skeletal remains by micro-computed tomography, mid-infrared microscopic imaging and energy dispersive X-ray mapping.

In this study different state-of-the-art visualization methods such as micro-computed tomography (micro-CT), mid-infrared (MIR) microscopic imaging and energy dispersive X-ray (EDS) mapping were evaluated to study human skeletal remains for the determination of the post-mortem interval (PMI). PMI specific features were identified and visualized by overlaying molecular imaging data and morphological tissue structures generated by radiological techniques and microscopic images gained from confocal microscopy (Infinite Focus (IFM)). In this way, a more distinct picture concerning processes during the PMI as well as a more realistic approximation of the PMI were achieved. It could be demonstrated that the gained result in combination with multivariate data analysis can be used to predict the Ca/C ratio and bone volume (BV) over total volume (TV) for PMI estimation. Statistical limitation of this study is the small sample size, and future work will be based on more specimens to develop a screening tool for PMI based on the outcome of this multidimensional approach.

[Anatomical considerations on treatment strategies for compression syndromes of the fibular nerve in the proximal leg]. / Anatomische Grundlage zur Spaltung des Septum Intermusculare Anterius bei der Behandlung des N. peronaeus-Kompressionssyndroms.

BACKGROUND: Posttraumatic or iatrogen compression syndromes of the common fibular nerve (CFN) are frequent. Based on previous anatomical investigations the aim of this study was to analyse the course of the CFN along the proximal portion of the leg with respect to its relationship to the anterior intermuscular septum (AIS). Further sites of constriction or fibrous fixation should be defined. MATERIAL AND METHODS: Anatomical dissection of 111 cadaveric leg specimens was performed. Twenty additional legs were used for histological examination of the respective region within the AIS of the leg. By means of medical records of three patients our current treatment strategy is demonstrated. RESULTS: A tight fixation of the most proximal motor branch of the deep fibular nerve (DFN) within the AIS at its entering point to the anterior compartment could be demonstrated. CONCLUSION: We conclude, that selective decompression not only of the CFN, but of the DFN branches which are fixed in the AIS along their course through the proximal portion of the leg, is mandatory during compression syndromes of the CFN.

Anatomic survey of the common fibular nerve and its branching pattern with regard to the intermuscular septa of the leg.

Compression syndromes of the common fibular nerve and its branches frequently occur primarily as well as secondarily to trauma and surgery. A keen knowledge of the course and the relationship of the deep fibular nerve to adjacent anatomical structures in the proximal leg is mandatory. Previous literature often lacks detailed information on the course of the deep fibular nerve and is based on a limited number of observations. The aim of this study was to investigate the common fibular nerve and its branching pattern with special regard to the relationship between the deep fibular nerve and the anterior intermuscular septum of the leg. Variations in the course of the fibular nerve were demonstrated. The fibular compartments of the leg (n = 111) were dissected in 57 embalmed cadavers and included: 1) investigation of the number of muscular branches; 2) entering passages to the respective compartments of the leg; and 3) the relationship between the fibularis longus muscle and the deep fibular nerve. The most proximal muscular branch of the deep fibular nerve directly "pierced" the anterior intermuscular septum of the leg. Narrow passages within the fibular compartment and, in consequence, areas of possible higher incidence of nerve compression were suggested at the level of the intermuscular septa of the leg, between the two distinct portions of the fibularis longus muscle and the crossing of the supplying vessels. There were hardly ever statistically significant differences between the two sides or male and female gender. According to our results, the anterior intermuscular septum of the leg may be regarded as an important landmark for the surgeon when dissecting the muscular branches of the deep fibular nerve. The variable branching pattern of the deep fibular nerve within the fibular compartment of the leg should be taken into account.

Anatomical considerations regarding the "bare spot" of the glenoid cavity.

The "bare spot" of the glenoid cavity has recently been described as a constant reference point to quantify the amount of bone loss from the inferior portion of the glenoid cavity. In shoulder surgery this spot should help the surgeon to determine the width of the inferior portion of the glenoid cavity arthroscopically. The aim of this study was to determine the localization of the bare spot within the glenoid cavity and to prove its usefulness in shoulder surgery by means of a macroscopic study using embalmed glenohumeral joints ( n=20; 12 left, 8 right). Each glenoid cavity was photographed and transferred to a commercial AutoCAD software program. The bare spot was marked and the mean distances between the center of the bare spot and the inferior ( a), anterior ( b(1)) and posterior ( b(2)) inner margins of the glenoid labrum as well as its relationship ( c) to the mid-point of a virtual circle formed by the inferior portion of the glenoid cavity were measured (mean values : a=9.70, b(1)=10.88, b(2)=13.71, c=3.2 mm). In most cases, the bare spot showed a significantly excentric position within the inferior part of the glenoid cavity ( p<0.05). Due to the great variability in the shape of the glenoid cavity, an inferior circle according to previous descriptions could only be observed in half the specimens. From the results of our study the bare spot seems to be an unreliable landmark for the determination of the center of the inferior portion of the glenoid cavity, although it has a constant appearance and is probably expressed as the result of cartilaginous distribution due to dynamic shoulder activity.