PURPOSE: The structure of the proximal margin of the superficial layer of the supinator muscle is of high interest to many researches. Its tendinous appearance, called the arcade of Frohse, may be clinically important because of its close relationship to the deep branch of the radial nerve passing beneath it and is considered to be the cause of several syndromes. Given the importance of this structure, we aimed to provide a comprehensive and evidence-based review with meta-analytic techniques. MATERIALS AND METHODS: The meta-analysis was performed in adherence to the PRISMA guidelines. Three medical databases were searched in order to identify all potentially eligible articles. Included studies were assessed for quality and the extracted morphological and morphometric data from the relevant articles was analyzed with the use of random effects meta-analysis. RESULTS: A total of 20 studies were included into this meta-analysis. The pooled prevalence of the arcade of Frohse was calculated to be 66% within the adult population and 0% in the fetuses. Other variations regarding the arcade of Frohse were identified as very rare. Analysis of the morphometric parameters revealed the average proportions to be 23.22 mm for the length, 11.05 mm for the width and the mean thickness is 0.67 mm. CONCLUSIONS: The arcade of Frohse is a commonly found structure in adults and thoughtful knowledge of its texture and morphology is especially useful in neurology, neurosurgery, orthopedics, trauma surgery and hand surgery, because it is considered to be the most common source of compression for the deep branch of the radial nerve.
- MeSH
- kosterní svaly anatomie a histologie chirurgie MeSH
- lidé MeSH
- nervus radialis zranění MeSH
- neuropatie nervus radialis etiologie MeSH
- ortopedické výkony metody MeSH
- předloktí anatomie a histologie chirurgie MeSH
- šlachy anatomie a histologie chirurgie MeSH
- úžinové syndromy etiologie chirurgie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- systematický přehled MeSH
- MeSH
- cévy anatomie a histologie MeSH
- kosti a kostní tkáň anatomie a histologie fyziologie krevní zásobení MeSH
- lidé MeSH
- muskuloskeletální systém * anatomie a histologie krevní zásobení MeSH
- šlachy anatomie a histologie krevní zásobení MeSH
- tkáně anatomie a histologie krevní zásobení MeSH
- Check Tag
- lidé MeSH
We have found an interesting coincidental variation of the superficial branch of the radial nerve and the brachioradialis muscle in a male cadaver. The superficial branch of the radial nerve was duplicated with one branch taking an aberrant course between two bellies of the brachioradialis muscle. The variant brachioradialis muscle featured two muscle bellies, a superficial one and a deep one, with one common origin and one common insertional tendon. The accessory nerve branch was impinged by two blood vessels and pierced through muscle bundles connecting two bellies of the brachioradialis muscle. The knowledge of this neuromuscular variant is of clinical relevance for the differential diagnosis of pain and paresthesia on the dorsoradial aspect of the hand and for the surgical management of the Wartenberg's syndrome.
- MeSH
- anatomická variace * MeSH
- diferenciální diagnóza MeSH
- kosterní svaly anatomie a histologie inervace MeSH
- lidé MeSH
- mrtvola MeSH
- nervus radialis abnormality krevní zásobení MeSH
- parestezie diagnóza MeSH
- ruka inervace MeSH
- senioři MeSH
- šlachy anatomie a histologie MeSH
- úžinové syndromy diagnóza chirurgie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- MeSH
- lidé MeSH
- pooperační péče MeSH
- poranění šlachy * diagnóza klasifikace terapie MeSH
- ruka anatomie a histologie patologie MeSH
- šlachy anatomie a histologie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- MeSH
- experimenty na zvířatech MeSH
- lidé MeSH
- odběr tkání a orgánů MeSH
- šlachy * anatomie a histologie imunologie transplantace MeSH
- uchovávání tkání MeSH
- vaskularizovaná kompozitní alotransplantace metody MeSH
- výsledek terapie MeSH
- zákroky plastické chirurgie metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- Achillova šlacha anatomie a histologie fyziologie patofyziologie MeSH
- deformity nohy (od hlezna dolů) patofyziologie patologie rehabilitace MeSH
- hlezenní kloub * anatomie a histologie fyziologie patofyziologie MeSH
- kosterní svaly fyziologie patofyziologie patologie MeSH
- kosti nohy (od hlezna dolů) anatomie a histologie fyziologie patofyziologie MeSH
- lidé MeSH
- ligamenta anatomie a histologie fyziologie patologie MeSH
- obnova funkce MeSH
- plochá noha komplikace patofyziologie patologie MeSH
- poranění nohy (od hlezna dolů) * komplikace rehabilitace terapie MeSH
- rehabilitace * metody trendy MeSH
- šlachy anatomie a histologie fyziologie patofyziologie MeSH
- terapie cvičením metody využití MeSH
- Check Tag
- lidé MeSH
A case of anomalous terminal branching of the axillary artery was encountered and described in a left upper limb of a male cadaver. A series of 214 upper limbs of Caucasian race was dissected. A variant artery, stemming from the very end of the axillary artery followed a superficial course distally. It passed the cubital fossa, ran on the lateral side of the forearm as usual radial artery, crossed ventrally to the palm and terminated in the deep palmar arch. This vessel is a case of the brachioradial artery (incorrectly termed as the "radial artery with high origin"). Moreover, it was associated with another variation, concerning the aberrant posterior humeral circumflex artery passing under the tendon of the latissimus dorsi muscle. The anatomical knowledge of the axillary region is essential for radiodiagnostic, surgical and traumatologic procedures. The superficially located artery brings an elevated danger of heavy bleeding in all unexpected situations, its variant branching can cause problems in radial catheterization procedures and the anomalously coursing other arterial variant poses an elevated danger in surgical procedures concerning the surgical neck of humerus.
- MeSH
- arteria axillaris abnormality embryologie MeSH
- arteria brachialis abnormality embryologie MeSH
- arteria radialis abnormality embryologie MeSH
- lidé MeSH
- mrtvola MeSH
- povrchové zádové svaly anatomie a histologie krevní zásobení MeSH
- senioři MeSH
- šlachy anatomie a histologie krevní zásobení MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Onemocnění šlach a onemocnění šlachových a svalových úponů z pracovních vlivů. Onemocnění šlach a šlachových úponů, na jejichž vznik, zhoršení nebo recidivu mají vliv podmínky vykonávaných činností. U nemocí z povolání musí být pracovní podmínky uznanou příčinou vzniku onemocnění. U nemocí z povolání se jedná vždy o následky jednostranného dlouhodobého mechanického zatížení. Onemocnění úponů šlach vzniká podle autorů u všech druhů pracovních činností, a to i u běžných činností při chybějící nebo narušené adaptaci tkání na tahový stres. V převážné většině se jedná o postižení tkání předloktí horních končetin a rukou. Radiální epikondylitida je nejčastější onemocnění uvedené skupiny nemocí z pracovních vlivů.
It has been proved occupational activities have to result in pathological conditions which are classified as occupational disease. Long- -lasting repeated movement often causes excessive loading of connective tissue, tendons and joints. It is known that adaptive disorder is important impulse participating in loading of affected components. Majority of occupational diseases are concentrated to regions of hands and forearms. Radial epicondilitis is the most frequent and typical example of occupational disease.
- Klíčová slova
- epikondylitida,
- MeSH
- chronická nemoc MeSH
- lidé MeSH
- mechanický stres MeSH
- nemoci z povolání * MeSH
- poranění z opakovaného přetěžování MeSH
- posuzování pracovní neschopnosti MeSH
- šlachy anatomie a histologie fyziologie patofyziologie MeSH
- tenisový loket * diagnóza patofyziologie terapie MeSH
- Check Tag
- lidé MeSH
PURPOSE OF THE STUDY The flexor hallucis brevis (FHB) is one of the short muscles of the foot. It divides in front into two portions, which are inserted into the medial and lateral sides of the base of the first phalanx of the great toe. The detailed knowledge of its insertion into the proximal phalangeal base is decisive in any surgery involving the first metatarsophalangeal (MTP) joint, such as implant arthroplasty, resection arthroplasty or amputation. Complications resulting from injury to this insertion are commonly known. The aim of this study was to describe in detail the morphology of FHB insertion sites and to determine a safe extent of resection to be done at the base of the proximal phalanx. MATERIAL AND METHODS In 36 cadaver specimens we measured FHB insertion length from the plantar side of the proximal phalangeal base and from the plane perpendicular to the long axis of the phalanx and passing through the base of the concave articular surfa- ce of the phalanx. RESULTS Measured from the plantar base of the proximal phalanx, the mean length of the medial insertion site was 11.5 ± 0.9 mm (range, 9.5 to 13.0 mm) and that of the lateral insertion site was 9.5 ± 1.1 mm (range, 8.0 to 11.5 mm). After resection, the mean values for medial and lateral FBH insertion sites were 8.5 ± 1.7 mm (range, 6.5 to 11.0 mm) and 7.1 ± 1.4 mm (ran- ge, 5.5 to 9.5 mm), respectively. The mean total proximal phalangeal length was 33.1 ± 2.2 mm (range, 28.5 to 37.0 mm), reduced after resection to 30.5 ± 2.1 mm (range, 26.0 to 34.5 mm). DISCUSSION Our results show that the medial insertion site, where the medial FHB tendon and distal part of the abductor hallucis muscle are joining, is longer than the lateral site. Therefore the length of the lateral site is decisive for preserving FHB func- tion. Since the plane perpendicular to the long axis of the phalanx and passing through the base of the concave articular surface of the phalanx is almost identical with the beginnings of FHB insertions, it seems optimal for clinical practice to perform the initial resection along this plane. CONCLUSIONS To preserve at least one third of the FHB insertion, the final resection should not exceed 4 mm or 13 % of the proximal phalangeal length, as measured from the reference plane defined above. Key words: flexor hallucis brevis, metatarsophalangeal joint, proximal phalanx, hallux rigidus, hallux valgus.
