Fibrous metaphyseal defect.

The tendon and ligaments inserted into the perichondrium of the epiphyseal plate were examined in 152 autopsy specimens of tubular long bones. In the region of two areas where tendons were inserted (Ranvier's nodes), the normal medullary tissue is replaced by fibroblastic tissue. A retrospective radiological examination of 155 fibrous metaphyseal defects shows that they are situated at characteristic sites on the circumference of the metaphysis of long tubular bones. This can be related to the insertion of a tendon or ligament near the epiphyseal growth plate which corresponds to areas found in the morphological study and is the site of origin of fibrous metaphyseal defects.

[Anatomy of the atrophic mandible. 1. The location of the mandibular canal in the atrophic mandible]. / Anatomische Untersuchungen an der atrophen Mandibula. Teil 1. Die Lage des Canalis mandibulae im atrophen Unterkiefer.

43 atrophic left hemimandibles were divided by 6 saw cuts made between the mental foramen and the third molar to analyze the location of the mandibular canal. Mandibles were classified by the severity of alveolar absorption using Atwood's classification and changes in the distances of the mandibular canal from the superior and inferior borders of the mandibular body were correlated wit the degree of atrophy. Measurements were obtained with a digitizer and a computer and results were analyzed statistically. The following statistically significant observations were made: The distance of the mandibular canal to the external lingua and buccal cortical layers did not change with increasing atrophy, but remained remarkably constant. By contrast, highly significant changes in the distance of the mandibular body were found to be present. These were more pronounced at the superior than at the inferior border. The changes seen were consistently most severe at the level of the first molar. Prior to surgical interventions involving an atrophic mandible the location of the mandibular canal should invariably be identified by imaging techniques such as orthopantomography, telemetric X-rays, tomographies, CT and MRI, if indicated, in order to avoid injuries of the inferior alveloar nerve and preclude forensic consequences.

Comparative histochemistry of human and sheep laryngeal muscles.

Four laryngeal muscles of human male, human female and sheep female cadavers were evaluated by histological, histochemical and quantitative techniques. The muscle fibre sizes showed significant differences between human male, female and sheep. Fibre diameters of male human laryngeal muscles were 2 to 4 microns larger than in female human and 11 to 13 microns larger than in sheep muscles. In the group of human laryngeal muscles, the posterior cricoarytenoid muscle contained the highest percentage (65%) of type I fibres. In sheep, the homologous muscle consists only of 45% type I fibres. On the other hand, in sheep the cricothyroid muscle showed significantly more type I fibres (58%) than the human counterpart (43%). In both species the vocal muscles had a rather low content of type I fibres (26 to 37%).

Refixation of muscular insertions after endoprosthetic replacement of the proximal humerus.

We describe the refixation of muscle insertions after resection of the proximal humerus in tumor patients. The prosthesis specially designed for this purpose carries large drill holes in the places corresponding to the anatomical sites of the muscle insertions. The muscles are attached to the prosthesis by means of tendon strips from the fascia lata. This can be expected to produce better functional results and to prevent subluxation.

Fibrous metaphyseal defects. Magnetic resonance imaging appearances.

Sixteen patients with fibrous metaphyseal defects were examined with both plain radiography and magnetic resonance (MR) imaging. Depending on the age of the fibrous metaphyseal defects, characteristic radiomorphologic changes were found which correlated well with MR images. Following intravenous Gadolinium-DTPA injection, fibrous metaphyseal defects invariably exhibited a hyperintense border and signal enhancement. Healed lesions exhibited a transition to normal bone marrow. A line through the maximum longitudinal diameter of a fibrous metaphyseal defect invariably led to a point of tendinous or ligamentous insertion. Coronal MR images demonstrated the maximum longitudinal extension and the respective inserting tendon or ligamentous structure at the epiphyseal line.

Surgical anatomy of the mimic muscle system and the facial nerve: importance for reconstructive and aesthetic surgery.

Mimic muscles are arranged in four layers regarding their origins, and these four layers should be considered when muscle tissue is added or lifted. All mimic muscles are built up by parallel fibers. Mean values of length, width, and thickness of the three lip elevators have been determined. These data might be of importance when dealing with this muscle system, which appears rather different from all other muscles in the human. The individual muscles receive their innervating facial nerve branches from their deeper surface when they belong to the superficial (first, second, or third) layer and from outside when they lie in the deepest (fourth) layer. Nerve branches communicate at least four times before innervating their respective muscles.