BACKGROUND: Suprascapular nerve (SN) entrapment syndrome accounts for 1-2% of all shoulder pain. The SN travels within a space between the suprascapular notch (SSN) and the spinoglenoid notch (SGN). PURPOSE: To report a detailed topographical study of the suprascapular canal (SSC) and ultimately sort the different types of SN entrapment by its anatomical localization within the canal. BASIC PROCEDURES: Observational study on 30 free dissected limbs of formaldehyde-fixed cadavers. The SN and vessels were traced as they passed through the SSC and the boundaries of the SSC were observed and documented. The SSC was then exposed by reflecting away the bordering muscles. Dimensions of the SSC as well as parameters of the SSN and SGN were measured using a digital caliper. Finally, a thorough literature review was made to survey the SN entrapment occurrence by site. MAIN FINDINGS: The SSC is situated in the spinoglenoid fossa, has an average width of 13 mm, and runs underneath the supraspinatus muscle with an average distance of 25 mm between the SSN and SGN sloping in an infero-postero-lateral direction. The first segment represents the SSC entrance site and is composed of two spaces: osteofibrous and musculofibrous. The second segment is bordered by the supraspinatus muscle fascia, lateral margin of the supraspinous fossa, glenohumeral joint capsule, and the bony surface of the scapula (spinoglenoid fossa). This represents the SSC passage site. The third segment represents the SSC exit site around the spinoacromial arch at the SGN. PRINCIPAL CONCLUSIONS: The SSC is defined as an osteofibrous canal running between the SSN and SGN enclosed by the supraspinatus fascia. It is anatomically composed of three segments: an entrance, a passage, and an exit. The distal SN passes through the SSC via five intervals that correspond to five potential sites of anatomical nerve entrapment: at the pre-entrance site, entrance site, passage site, exit site, and post-exit site. Each of those sites was found to be associated with specific causes and forms of entrapment.

• Klíčová slova
• Canal, Entrapment, Spinoglenoid notch, Suprascapular, Suprascapular nerve, Suprascapular notch, Tunnel,
• MeSH
• lidé MeSH
• lopatka MeSH
• mrtvola MeSH
• ramenní kloub * MeSH
• rotátorová manžeta MeSH
• úžinové syndromy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH

Popliteal artery entrapment syndrome is a rare cause of lower limb ischaemia. It is caused by an abnormal relationship between popliteal artery and its surrounding musculotendineous structures (anatomic entrapment). Functional popliteal entrapment is characterized by normal anatomic relationships within popliteal fossa. The true incidence is unknown, it usually affects young patients, typically men, and is clinically presented with symptoms of calf claudication, calf cramping, coldness and paresthesia. CT angiography and MR angiography have become an imaging technique of choice. The mainstay surgical procedure is popliteal artery release. In cases of popliteal artery damage autologous saphenous vein bypass grafting offers the best long-term results. Authors on the basis of two case reports describe the clinical course, diagnosis and surgical technique used in the treatment of patients with advanced popliteal artery entrapmentsyndrome.

• MeSH
• arteria poplitea * MeSH
• arteriální okluzní nemoci diagnóza   diagnostické zobrazování   etiologie   MeSH
• bérec krevní zásobení   MeSH
• lidé MeSH
• magnetická rezonanční angiografie MeSH
• mladý dospělý MeSH
• radiografie MeSH
• syndrom MeSH
• výkony cévní chirurgie metody   MeSH
• Check Tag
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The biceps brachii is one of three muscles of the anterior compartment of arm. Variations of the biceps brachii are not rare. The most frequent is the existence of a third head called the humeral head by Le Double (1897) (Rodríguez-Vázquez et al., 1999). Our article is based on the unexpected result of a routine dissection class held for medical students. Dissection was performed according to the guidelines accepted by the anatomy department (Seichert, 1999). We describe a third (accessory) head of the biceps brachii. In addition of two regular heads, the third head originated together with the short head from the coracoid process and had three insertions on the humerus after enfolding the median nerve and the brachial artery. This particular variation is important from a clinical perspective as the third head may cause entrapment syndrome of the median nerve and hypoperfusion of the upper limb due to compression of the brachial artery.

• MeSH
• disekce MeSH
• kosterní svaly abnormality   MeSH
• lidé MeSH
• mrtvola MeSH
• neuropatie nervus medianus etiologie   MeSH
• paže * MeSH
• senioři MeSH
• úžinové syndromy etiologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

The authors describe the case of a 32-year-old man with intermittent claudications. Large abnormal muscular structures were found in the popliteal regions, incl. a secondary pterygium on the right. On both limbs these muscles arrested by their pressure during contraction the blood flow in the popliteal artery and caused its temporary lateral deviation. The described sings (abnormally large muscles, pterygium, deviation to the their side) differentiate this entrapment syndrome from known patterns of the latter. The syndrome was diagnosed in time before the artery was morphologically altered. The surgical treatment involved an extensive resection of the abnormal muscles and revision of the artery.

• MeSH
• arteria poplitea * MeSH
• arteriální okluzní nemoci komplikace   diagnóza   chirurgie   MeSH
• bérec MeSH
• dospělí MeSH
• intermitentní klaudikace etiologie   MeSH
• lidé MeSH
• stenóza MeSH
• svalová kontrakce MeSH
• svaly chirurgie   MeSH
• syndrom MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH

OBJECTIVE: In a retrospective study we analyze 5 patients with popliteal artery entrapment syndrome who were treated since 1999 to 2000 in our department. METHODS AND RESULTS: 5 patients were found to have popliteal vascular entrapment during a two-year period. From the total number of 5 patients, we performed surgery in 3 patients (5 operations). One patient rejected proposed surgical therapy, in another case the morphological lesion of the popliteal artery was not suitable for revascularisation. 3 patients underwent interposition of the diseased popliteal artery using a venous graft from a dorsal approach. Twice the decompression (myotomy) of the medial head of gastrocnemius muscle was sufficient. The study group is included in our follow up programme (median follow up 12.8 months, range from 3 to 24 months), primary and long term patency has been 100%. RESULTS: On the basis of our experience, we advice total replacement of the diseased popliteal artery. A dorsal approach (Hamming's "S" shaped incision) with interposition of the popliteal artery with autogenous venous graft, end to end anastomosis on both sides, seems to be the optimal solution. In case, the arterial wall is not irreversibly changed, surgical decompression (myotomy) is sufficient to prevent the development of symptomatic disease, also using the dorsal approach.

• MeSH
• arteria poplitea * chirurgie   MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• onemocnění periferních cév * diagnóza   chirurgie   MeSH
• retrospektivní studie MeSH
• stenóza MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

BACKGROUND: The author presents the results of surgery of entrapment syndromes of the peripheral nerves implemented at his department in the course of 10 years (1990-2000). MATERIAL AND METHODS: In 72 patients 90 operations were performed in the course of which 85 entrapment syndromes were treated. The carpal tunnel syndrome was recorded in 40 patients (55.6%), the cubital canal syndrome in 24 patients (33.3%). The other entrapment syndromes of the peripheral nerves of the upper extremities-8(11.1%) were classified as rare. In 13 patients the entrapment syndrome was bilateral, the carpal tunnel syndrome in 12 and the cubital canal syndrome in one patient. In 17 patients there were re-operations, incl. 12 re-operations after primary treatment in another department. The clinical picture of compressive syndrome was divided according to the intensity according to Dellon's classification into 3 grades. Grade I compression was found in 2 cases (2.8%) (2/2). Grade II compression was found in 8 patients (11.1%) (9/10). Grade III Patients with grade III compression-62 (86.1%) predominated (68/80). The values are expressed as the number of patients/number of entrapment syndromes. The effectiveness of the surgical operation was analyzed with regard to the degree of compression, length of compression and duration of symptoms. RESULTS: Excellent and satisfactory results were recorded in all cases with grade I and II compression and duration of symptoms up to 12 months. The position was worse in patients with grade III compression where excellent and satisfactory results were recorded in 62 cases (77.5%) and when the complaints persisted for more than 12 months, i.e. in 30 of 48 cases (62.5%). CONCLUSION: The decisive factor which influences the result of the operation is the grade of nerve compression and its duration. Decisive factors improving the results of surgery are age under 30 years and period of complaints shorter than one year, when the symptoms are not yet irreversible.

• MeSH
• dospělí MeSH
• lidé MeSH
• paže inervace   MeSH
• syndrom karpálního tunelu diagnóza   chirurgie   MeSH
• syndrom kubitálního tunelu diagnóza   chirurgie   MeSH
• úžinové syndromy diagnóza   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

• MeSH
• arteria poplitea chirurgie   MeSH
• dospělí MeSH
• intermitentní klaudikace chirurgie   MeSH
• lidé MeSH
• syndrom MeSH
• věkové faktory MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články 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.

• Klíčová slova
• Entrapment, Radial nerve, Two-bellied brachioradialis muscle, 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

In a series of 120 elbow regions (66 male, 54 female) from embalmed human cadavers, the authors observed the course of the deep radial nerve and then related it to structures such as a) the deep surface of the initial part of the extensor carpi radialis brevis, which was found to be tendinous in 90% of the cases, b) the superior hiatus of the supinator muscle, which formed a fibrous arcade of Frohse in 61% of the cases, and the distance of its peak from the lateral condyle, which ranged from 4 to 6 cm, and c) the angle between the superficial oblique muscle fibres of the supinator and the long axis of the radius, which varies from 18 degrees to 38 degrees and crossed the nerve almost transversely. The above anatomical factors--and particularly the thickened fibrous arcade of Frohse--are all important for the deep radial entrapment neuropathy in predisposed individuals.

• MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• nervus radialis anatomie a histologie   patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• úžinové syndromy patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• krční svaly diagnostické zobrazování   MeSH
• lidé MeSH
• rameno * inervace   MeSH
• ultrasonografie MeSH
• úžinové syndromy * diagnostické zobrazování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH