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Achilles tendinopathy is the most frequent foot overuse injury in ballet dancers and knowledge of clinically modifiable factors related to tendon structure in a population at risk, such as ballet dancers, would be important for the development of preventive programs. Therefore, the present study aimed to assess relationships of gastrocnemius muscle architecture and ankle plantar flexors function with Achilles tendon morphology in ballet dancers. Fifty-four measures from 27 ballet dancers were collected. Tendon morphology (thickness, echogenicity, hypoechoic areas and neovascularisation) and muscle architecture (thickness, pennation angle and fascicle length) were evaluated using ultrasonography; ankle plantar flexors torque was evaluated using hand-held dynamometry, flexibility was evaluated in maximal weight-bearing ankle dorsiflexion position using inclinometer, and endurance was evaluated using the heel rise test. Ankle plantar flexors torque and medial gastrocnemius muscle architecture (thickness, pennation angle and fascicle length) are associated with Achilles tendon thickness in ballet dancers (r2 = 0.24, p = 0.008). Ankle plantar flexors torque and medial gastrocnemius muscle fascicle length are also associated with the echogenicity of the Achilles tendon (r2 = 0.13, p = 0.03). These findings call attention to the potential importance of ankle plantar flexors muscle force in healthy ballet dancers for the prevention of alterations in Achilles tendon structure.

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Background: The prevalence of Achilles tendon (AT) pathology is common and can result in disability. Understanding normal AT properties can improve our ability to prevent AT injuries. We examined the cross-sectional area of the AT at multiple levels in an asymptomatic population of Army Rangers. Methods: This is a prospective cohort study composed of 41 voluntarily recruited United States Army Rangers deployed in a combat theater. All subjects were members of the Ranger Regiment participating in more than 20 h of intense bipedal non-sport weekly training with no history of AT pathology. While standing, each subject had bilateral AT calcaneal tuberosity insertions (0 cm) marked, along with skin markings made at 2 cm, 4 cm, and 6 cm superior to the AT insertion. AT diameter was measured at each level in the coronal and sagittal planes using ultrasound. Results: Mean sagittal diameter of the AT was 4.4 mm, 4.3 mm, 4.2 mm, and 3.9 mm at 0 cm, 2 cm, 4 cm, and 6 cm, respectively. Mean coronal diameter of the AT was 19.3 mm, 14.7 mm, 13.8 mm, and 14.5 mm at 0 cm, 2 cm, 4 cm, and 6 cm, respectively. The cross-sectional area was calculated as 0.66 cm2, 0.5 cm2, 0.46 cm2, and 0.44 cm2 at 0 cm, 2 cm, 4 cm, and 6 cm, respectively. Conclusion: Our data suggest that increased non-sport activity may not increase the cross-sectional area of the AT. Identifying the normal diameter at multiple levels throughout the most commonly injured area may improve the provider's ability to identify early disease processes and apply targeted interventions to help slow or prevent progression and possible rupture. Level of Evidence: Level III-V.

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It was aimed that the morphometric development of calcaneal tendon and the structures building it up in human fetuses during the fetal period be anatomically studied and that its clinical importance be evaluated. The study comprised a total of 102 fetus legs (51 human fetuses: 26 male and 25 female) whose ages varied between 15-40 gestational week, without external pathology or anomaly. The fetuses were divided in groups according to gestational weeks, trimesters and months. In the wake of the general external measurements of fetuses, leg dissection was performed. Afterwards, the morphometric parameters of gastrocnemius muscle, soleus muscle and calcaneal tendon were measured. The averages and the standard deviations of the measured parameters were determined according to gestational weeks, trimesters and months. There was a significant correlation between the measured parameters and the gestational age (p<0.001). There was no difference between sexes in terms of parameters (p>0.005). All the obtained results were discussed by making a comparison between them and the previous studies made. We are of the opinion that the data obtained in our study will be of use to the involved clinicians in the evaluation of the development of calcaneal tendon and the structures constituting it during the fetal period and in clinical studies and applications as well.

El objetivo de esta investigación consiste en el estudio del desarrollo morfométrico del tendón calcáneo y las estructuras que se desarrollan con él durante el período fetal humano y evaluar su importancia clínica. El estudio comprendió un total de 102 piernas de fetos (51 fetos humanos: 26 masculinos y 25 femeninos) cuyas edades variaron entre 15 a 40 semanas de edad gestacional, sin presencia de patología externa o anomalía. Los fetos fueron divididos en grupos de acuerdo con las semanas de gestación, trimestres y meses. Luego de realizar mediciones generales externas en los fetos, se procedió a la disección de las piernas. Se midieron parámetros morfométricos correspondientes a los músculos gastrocnemio, sóleo y tendón calcáneo. Los promedios y las desviaciones estándar de los parámetros medidos se determinaron de acuerdo a la edad gestacional de los fetos, en semanas trimestres y meses. Hubo una correlación significativa entre los parámetros medidos y la edad gestacional (p<0,001). No hubo diferencias entre los sexos en términos de parámetros (p>0,005). Todos los resultados obtenidos se discutieron haciendo una comparación entre ellos y los estudios previos realizados. Los datos obtenidos en nuestro estudio serán de utilidad para los médicos en la evaluación del desarrollo del tendón calcáneo y las estructuras que lo constituyen, durante el período fetal, para la utilización de este conocimiento en estudios clínicos y diversas aplicaciones.

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Poucos relatos têm descrito avulsões das cabeças lateral ou medial e avulsão bilateral das origens do músculo gastrocnêmio em cães e gatos. Este trabalho descreveu o primeiro relato de avulsão das origens lateral e medial do músculo gastrocnêmio em gata, bem como a técnica de reinserção cirúrgica. Uma gata, sem raça definida, com 10 anos, apresentou claudicação do membro posterior direito com postura plantígrada. Avulsão bilateral das cabeças do músculo gastrocnêmio foi diagnosticada com base nos achados do exame clínico. A técnica de reinserção foi realizada com fio mononáilon, numa sutura de Kessler modificada, ancorada em um orifício criado na porção metafisária distal do fêmur. Após período de imobilização externa complementar seguida de fisioterapia, houve recuperação satisfatória.

Few reports have described avulsions of the medial or lateral heads, as well as bilateral avulsion of the origins of the gastrocnemius muscle in dogs and cats. The objective of this study was to describe the first report of avulsion of the origins of the lateral and medial gastrocnemius muscle in a cat (Felis catus), as well as the surgical reinsertion technique. A mixed breed queen at 10 years of age presented claudication of the right hind limb with plantigrade stance. Bilateral avulsion of the heads of the gastrocnemius muscle was diagnosed based on findings from clinical a examination. The reinsertion technique was performed with monofilament nylon thread in a modified Kessler suture anchored in a hole created in the distal metaphyseal portion of the femur, obtaining satisfactory recovery after a period of additional external immobilization followed by physical therapy.

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Poucos relatos têm descrito avulsões das cabeças lateral ou medial e avulsão bilateral das origens do músculo gastrocnêmio em cães e gatos. Este trabalho descreveu o primeiro relato de avulsão das origens lateral e medial do músculo gastrocnêmio em gata, bem como a técnica de reinserção cirúrgica. Uma gata, sem raça definida, com 10 anos, apresentou claudicação do membro posterior direito com postura plantígrada. Avulsão bilateral das cabeças do músculo gastrocnêmio foi diagnosticada com base nos achados do exame clínico. A técnica de reinserção foi realizada com fio mononáilon, numa sutura de Kessler modificada, ancorada em um orifício criado na porção metafisária distal do fêmur. Após período de imobilização externa complementar seguida de fisioterapia, houve recuperação satisfatória.(AU)

Few reports have described avulsions of the medial or lateral heads, as well as bilateral avulsion of the origins of the gastrocnemius muscle in dogs and cats. The objective of this study was to describe the first report of avulsion of the origins of the lateral and medial gastrocnemius muscle in a cat (Felis catus), as well as the surgical reinsertion technique. A mixed breed queen at 10 years of age presented claudication of the right hind limb with plantigrade stance. Bilateral avulsion of the heads of the gastrocnemius muscle was diagnosed based on findings from clinical a examination. The reinsertion technique was performed with monofilament nylon thread in a modified Kessler suture anchored in a hole created in the distal metaphyseal portion of the femur, obtaining satisfactory recovery after a period of additional external immobilization followed by physical therapy.(AU)

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PURPOSE: To assess the mechanical behavior and the histology of collagen fibers after prolotherapy with 12.5% dextrose into rat Achilles tendons and to compare with those of corticosteroid treatment. METHODS: Out of 60 adult female Wistar rats (70 tendons), 15 received 12.5% dextrose (group I); 15 were treated with corticosteroid injection (group II); and 15 were given 0.9% saline injection (group III), all into the right Achilles tendon, whereas 13 animals received no injections (group IV). Three doses of each substance (groups I, II, and III) were given at a 5-day interval. Collagen fiber color was quantitatively assessed in three samples from each group and in five samples from the control group using picrosirius red staining under polarized and nonpolarized light. Twelve tendons from each group treated with the test substance and 20 tendons from the control group were submitted to the tensile strength test. RESULTS: There was no statistical difference across the groups with respect to maximum load at failure (n.s.) and absorbed energy (n.s.). With respect to tendon rupture, there was no difference between the myotendinous and the tendinous regions (n.s.). However, hematoxylin-eosin staining revealed statistical significance in lymphocytic inflammatory infiltrate (P = 0.008) and in parallel fiber orientation (P = 0.003) when comparing groups to the control group, without significance for either neovascularization (n.s.) or the presence of fibroblasts (n.s.). Likewise, there was no significant difference between the percentage of mature (n.s.) and immature (n.s.) fibers. CONCLUSIONS: Dextrose was not deleterious to the tendinous tissue, as it did not change the mechanical and histological properties of Achilles tendons in rats. The data obtained in this study may help clinicians in their daily work as they suggest that injections of 12.5% dextrose caused no harm to the tendons, although the clinical importance in humans still needs to be defined.

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El tendón calcáneo (TC) en el hombre es el más voluminoso y resistente del cuerpo, constituyéndose por su inserción en un elemento vital en la mecánica articular del pie como también en las numerosas patologías que afectan las regiones talocrural y calcánea. Para el estudio se utilizaron 120 miembros inferiores (60 derechos y 60 izquierdos), de cadáveres formolizados de individuos adultos, de ambos sexos. Se disecó la cara posterior de la pierna desde la línea articular de la rodilla hasta la parte inferior del calcáneo, se retiró el tejido adiposo precalcáneo dejando libre el TC. Se observó que el TC estaba formado, exclusivamente, por la fusión de las aponeurosis de los músculos gastrocnemio y sóleo en 62 casos (51,67 por ciento). El tendón del músculo plantar contribuye a la formación parcial del TC en 38 casos (31,67 por ciento) e integralmente en 20 casos (16,66 por ciento). El ancho del TC a nivel de la terminación del vientre del músculo sóleo fue de 12,88 mm +/- 2,0 en el hombre y de 11,55 mm +/- 1,6 en la mujer y el grosor del TC al mismo nivel de 4,29 mm +/- 0,64 en el hombre y de 4,36 mm +/- 0,64 en la mujer. El ancho del TC a nivel del margen posterosuperior del calcáneo fue de 17,98 mm +/- 1,7 en el hombre y de 17,06 mm +/- 1,53 en la mujer. El grosor del TC al mismo nivel fue de 3,79 mm +/- 0,61 en el hombre y de 3,93 mm /- 0,67 en la mujer. La distancia entre el margen posterosuperior del calcáneo y el inicio de la parte insertada del TC fue de 10,99 mm +/- 2,11 en el hombre y 10,84 +/- 2,71 en la mujer. El largo de la parte insertada del TC fue de 17,78 mm +/- 2,4 en el hombre y de 17,66 mm +/- 4,75 en la mujer. El ancho del TC a nivel de su inserción en el hueso calcáneo fue de 28,77 mm +/- 2,53 en el hombre y de 27,21 mm +/- 2,93 en la mujer. La tendinopatía en la inserción del TC suele ser frecuente requiriendo en algunos casos debridamiento quirúrgico del tendón. Por lo anterior, conocer aspectos morfométricos del TC y de su inserción adq...

In man the calaneous tendon (CT) is the most voluminous and resistent tendon in the body; its insertion is a vital element of the foot joint mechanism as well as in a number of disorders that affect talocrural and calcaneal regions. For the present study 120 lower members (60 right and 60 left) of formolized cadavers, adult subjects of both sexes were used. Posterior surface of the leg was disected from the joint line of the knee to the lower part of the calcaneal removing precalcaneus adipose tissue, exposing the CT. We observed that in 62 cases (51.67 percent) the CT was formed exclusively by fusion of aponeurosis of the gastrocnemius and soleus muscles. In 38 cases (31.67 percent) tendon of the plantar muscle contributes to the partial formation of the CT, and fully integrated in 20 cases (16.66 percent). Width of the CT at the soleus muscle belly end, was 12.88 mm +/- 2.0 in men and 11.55 mm +/- 1.6 women and density at the same level was 4.29 mm +/- 0.64 in men and 4.36 mm +/- 0.64 in women. Width of the CT at the posterosuperior border of the calcaneal was 17.98 mm +/- 17 in men, and 17.06 mm +/- 1.53 in women. CT density at the same level was 3.79 mm +/- 0.61 in men and 3.93 mm +/- 0.67 in women. Distance between posterosuperior border of the calcaneal and starting point of the inserted portion of the CT was 10.99 mm +/- 2.11 in men and 10.84 +/- 2.71 in women. Length of the inserted portion of the CT was 17.78 mm +/- 2.4 in men and 17.66 mm +/- 4.75 in women. Width of the CT at the insertion level in the calcaneus bone was 28.77 mm +/- 2.53 in men and 27.21 mm +/- 2.93 in women. Insertional CT tendinopathy is a chronic condition in some cases requiring surgical debridement of the tendon. Therefore, knowledge of morphological aspects of the CT and its insertion is important at the time of surgical procedures of the talocrural region.

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Las lesiones de los tendones plantean siempre grandes problemas clínicos y terapéuticos, por su importancia funcional y su peculiar cicatrización. El apoyo fisiátrico, específicamente el tratamiento con ultrasonido, ha demostrado ser eficiente en la regeneración del tendón calcáneo. Este trabajo tuvo como objetivo analizar morfológicamente los efectos del uso de ultrasonido continuo en la regeneración post quirúrgica del tendón calcáneo de rata. Se utilizaron 15 ratas albinas, Sprager Dawle. Luego de 48 horas post tenorrafia se comenzó con una sesión diaria de ultrasonido terapéutico con una intensidad de 1W/cm², frecuencia de 3 MHZ, cabezal de 0,5 cm de ERA, por 30 segundos durante 10 días. Las ratas fueron sacrificadas 48 horas después de terminar las aplicaciones de ultrasonido para la extracción y disección del tendón calcáneo del miembro posterior derecho, mientras que el tendón del miembro posterior izquierdo sirvió de control normal. Para fines de comparación morfológica se trabajó con un grupo de ratas control del tratamiento, en el que se provocó la lesión sin aplicar ultrasonido. Las muestras fueron fijadas en formalina tamponada y teñidas con H.E. Los tendones del grupo experimental se encontraron en un estado de regeneración avanzada, cuyos fibroblastos presentaron características morfológicas propias de una célula activa en la síntesis y secreción de matriz extracelular, con un promedio de fibroblastos similar al obtenido en el tendón normal. A su vez, el tendón del grupo sin tratamiento presentó un estado de regeneración tardío. Las fibras colágenas estaban invadidas por tejido conjuntivo y vasos sanguíneos, con un promedio de fibroblastos que triplica al promedio encontrado en el control normal, lo que determinó que el tendón sin aplicación de ultrasonido se encontrara aún en proceso inflamatorio. Este estudio confirma que el uso de ultrasonido continuo genera una rápida proliferación celular en el tendón lesionado de rata, y en consecuencia, a...

Tendon injuries always account for major clinical and therapeutic problems, due to their functional significance and unique healing. Physiatrics support, specifically ultrasound treatment, has been shown to be effective in the regeneration of the calcaneal tendon.The objective of this study was to morphologically analyze the effect of the use of continuous ultrasound in the post surgery regeneration of the calcaneal tendon of the rat. Ten albino, Sprager Dawley rats were used. Following 48 hours of post tenorrhaphy, a daily session of therapeutic ultrasound was initiated, with an intensity of 1W/cm², frequency of 3 MHZ, header at 0.5 cm ERA, per 30 seconds for 10 days. The rats were sacrificed 48 hours after completion of the ultrasound treatments, for the extraction and dissection of the calcaneal tendon of the right posterior member, while the left posterior member was used for normal control. For purposes of morphological comparison a group of control rats for the treatment was used, in which the injury was caused without applying the ultrasound. Samples were fixed in buffered formalin and stained with H.E. The tendons of the experimental group were found to be in an advanced stage of regeneration which fibroblasts presented morphological characteristics of an active cell in the synthesis and secretion of the extracellular matrix, with an average of fibroblasts similar to that obtained in the normal tendon. At the same time, the tendon of the control group in the treatment, presented a later regeneration stage. The collagen fibers were infiltrated by conjunctive tissue and blood vessels, with an average of fibroblasts that tripled the average found in the normal control, which determined that the tendon without the ultrasound treatment was still in an inflammatory process. This study confirms that the use of continuous ultrasound generated a rapid cellular proliferation in the injured tendon of the rat, and consequently accelerates its regeneration.

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OBJETIVO: Determinar as espessuras e larguras dos tendões do calcâneo (tendão de Aquiles) em crianças eutróficas de ambos os gêneros, aos 2, 6, 9 e 12 meses de idade. MATERIAIS E MÉTODOS: Fizeram parte deste estudo prospectivo e descritivo 38 meninos e 31 meninas. As medidas dos tendões foram obtidas por meio de ultrassonografia, utilizando transdutor linear de 14 MHz, na altura do maléolo medial. RESULTADOS: Verificou-se que as espessuras dos tendões nos meninos foram de 2,4 mm, 2,3 mm, 2,4 mm e 2,4 mm, aos 2, 6, 9 e 12 meses, respectivamente. As larguras do tendão do calcâneo foram de 6,0 mm, 6,4 mm, 6,7 mm e 7,1 mm, respectivamente. Nas meninas, as espessuras obtidas aos 2, 6 e 9 meses foram de 2,4 mm, e aos 12 meses encontrou-se o valor de 2,5 mm. As quatro medidas da largura foram de 5,7 mm, 6,2 mm, 6,5 mm e 6,5 mm, respectivamente. CONCLUSÃO: Não houve diferença na espessura do tendão do calcâneo ao longo do primeiro ano de vida para ambos os gêneros, entretanto, houve diferença nas medidas da largura.

OBJECTIVE: To determine the thickness and width of the calcaneal tendon (Achilles tendon) in both male and female, eutrophic children at 2, 6, 9 and 12 months of age. MATERIALS AND METHODS: The present prospective and descriptive study included 38 boys and 31 girls. Measurements of the tendons were performed by means of ultrasonography, with a linear, 14-MHz probe, at the level of the medial malleolus. RESULTS: Tendon thicknesses observed in the boys were 2.4 mm, 2.3 mm, 2.4 mm, and 2.4 mm, respectively at 2, 6, 9 and 12 months. Widths were, respectively, 6.0 mm, 6.4 mm, 6.7 mm and 7.1 mm. In the girls, the tendon thicknesses observed at 2, 6 and 9 months were 2.4 mm, and 2.5 mm at 12 months. Widths were, respectively, 5.7 mm, 6.2 mm, 6.5 mm and 6.5 mm. CONCLUSION: No difference was observed in the calcaneal tendon thickness between boys and girls along the first year of their lives; however, width measurements demonstrated differences.

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This paper provides data (text and illustrations) about the digital flexor muscles of the pelvic limb and the / metatarsophalangeal joint, evaluating the suspensory (support) apparatus and weight bearing structures. Similar to the above mentioned paper, a literature search provided incomplete information about these anatomical structures. As in the thoracic limb, unique anatomically variations exist in the pelvic limb of the llama. The caudal tibial muscle is fused with the lateral head of the deep digital flexor muscle (DDF), and the soleus muscle is missing. A symmetrical unexpected lumbricalis pedis muscle was found; the tendons are fusing with the axial branches of the lateral tendon of the long digital extensor muscle. A quadratus plantae muscle, also unexpected is present on the medial aspect of the tarsal region. The superficial digital flexor muscle (SDF) resembles that of the domestic ruminants. The metacarpo/ metatarsophalangeal joints, referred to as the fetlock joints (FJ) are very different from those of the domestic ruminants. Particular structures were found and they will be described and illustrated in the text. The anatomy of the suspensory (support) apparatus in the pelvic limb is evaluated in this paper.

El presente artículo ofrece datos (texto e ilustraciones) sobre el músculo flexor digital del miembro pélvico y la articulación metatarsofalángica, evaluando el aparato suspensorio (de apoyo) y el peso que soportan estas estructuras. La literatura proporciona información incompleta acerca de estas estructuras anatómicas. Al igual que en el miembro torácico, existen variaciones anatómicamente únicas en el miembro pélvico de la llama. El músculo tibial caudal se fusiona con la cabeza lateral del músculo flexor digital profundo (FDP), y el músculo soleo no existía. Fue encontrada una simetría inesperada del músculo lumbrical del pie; los tendones se encontraban fusionados con las ramas axiales del tendón lateral del músculo extensor digital largo. Un músculo cuadrado plantar, se encontraba presente en la cara medial de la región tarsal. El músculo flexor digital superficial (FDS) se asemeja al de rumiantes domésticos. Las articulaciones metacarpo/metatarsofalángicas, denominadas articulaciones del nudillo (AN) son muy diferentes de las de rumiantes domésticos. Fueron encontradas estructuras particulares que se describen e ilustran en el texto. Se evalúa la anatomía del aparato suspensorio (de apoyo) en el miembro pélvico.

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Métodos de armazenamento de aloenxertos podem alterar certas características mecânicas dos tecidos. Com o objetivo de analisar a influência do fenômeno de congelamento e do tempo de armazenamento sobre as propriedades biomecânicas de tendões, os autores estudaram 40 tendões calcâneos obtidos de 20 cadáveres humanos com idade média de 41,95 anos, variando de 31 a 54 anos, sendo 17 do sexo masculino e três do sexo feminino. De cada cadáver foram retirados dois tendões, sendo que um foi testado a fresco e o contralateral congelado a - 85° C em freezer elétrico, durante um período de seis ou 12 semanas. Os corpos de prova foram submetidos a ensaios de tração em uma máquina de ensaios mecânicos Kratos K5002, fornecendo gráficos força-deformação. Foram analisados os parâmetros de força no limite de resistência máxima, rigidez, tensão no limite de resistência máxima, deformação relativa e módulo de elasticidade. Os resultados foram comparados e a analisados estatisticamente pelo método de "t-student", com índice de significância de 0,05, sendo que não houve diferença significativa nos valores obtidos entre os grupos. Concluímos que o congelamento a - 85° C não altera as propriedades biomecânicas de tendões, a despeito do tempo de armazenamento.

Allograft storage methods can change some mechanical characteristics of tissues. With the objective of analyzing the influence of freezing phenomenon and storage time on tendonsÆ biomechanical properties, the authors studied 40 calcaneus tendons obtained from 20 human cadavers, with an average age of 41.95 years, ranging from 31 to 54 years old, being 17 males and three females. From each cadaver, two tendons were removed, one tested in its fresh state and the contralateral one frozen at -85° C in an electric freezer, during a period of six or 12 weeks. The bodies of evidence were submitted to traction assays in a Kratos K5002 mechanical assay machine, delivering strength-deformation graphics. Strength at maximum resistance limit, stiffness, tension at maximum resistance limit, relative deformation, and elasticity module parameters were assessed. The results were compared and statistically analyzed by "StudentÆs t- method", with a significance level of 0.05, with no significant difference on values achieved between groups. We concluded that freezing at -85° C does not cause changes to tendonsÆ biomechanical properties, despite of storage time.

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Los músculos gastronecmio, plantar y sóleo pertenecen al grupo de músculos flexores del compartimiento posterior de la pierna. El músculo plantar es reponsable de la flexión plantar del pie. El músculo es un vestigio en el humano y tiene gran importancia clínica. Se sabe que el músculo plantar tiene muchas variaciones, pero hay pocos repórters sobre la existencia de músculos plantares dobles. El presente trabajo describe un músculo plantar doble en ambos lados, presente en un cadáver, encontrado durante una disección de rutina. El conocimiento del músculo plantar, ya sea normal como de sus variaciones anatómicas, son importantes para el cirujano cuando éste transfiere tendones y para el clínico en el diagnóstico de ruptura muscular.

The gastrocnemius, plantaris and the soleus muscles, comprise the posterior (flexor) compartment muscles of the leg. The plantaris muscle is responsible for causing plantar flexion of the foot. The muscle is vestigial in human beings and has much clinical importance. The muscle is known to exhibit variations but there are few reports on the existence of double plantaris muscle. The present case report describes double plantaris on both sides of a cadaver, which was detected during routine dissection. Knowledge of both normal and abnormal anatomy of the plantaris muscle is important for surgeons performing tendon transfer operations and clinicians diagnosing muscle tears.

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OBJETIVO: Determinar os valores normais dos diâmetros ântero-posterior e transversal do tendão de Aquiles na nossa população e correlacioná-los com sexo, faixa etária, cor da pele, grupo sanguíneo ABO e índice de massa corporal. MATERIAIS E MÉTODOS: Foi feita análise ultra-sonográfica de 100 tendões de Aquiles de 50 voluntários sadios, visando à mensuração dos diâmetros ântero-posterior e transversal desses tendões. Todos os exames foram realizados pelo mesmo examinador, em aparelho de ultra-sonografia com transdutor linear com freqüência de 10 MHz. RESULTADOS: Dos 50 voluntários estudados, 25 eram do sexo masculino e 25, do sexo feminino, com a faixa etária variando de 20 a 52 anos (média de 33,9 anos). O valor médio do diâmetro transversal do tendão de Aquiles foi de 13,3 ± 1,0 mm para o sexo feminino e 14,4 ± 1,4 mm para o sexo masculino; em relação ao diâmetro ântero-posterior, foi de 5,4 ± 0,5 mm para o sexo feminino e 5,6 ± 0,6 mm para o sexo masculino. Os diâmetros do tendão de Aquiles foram significativamente menores no sexo feminino (p < 0,05). Não houve diferença estatisticamente significativa entre os diâmetros ântero-posterior e transversal em relação a faixa etária, grupo sanguíneo e cor da pele. O grupo com índice de massa corporal de sobrepeso apresentou diâmetro transversal do tendão de Aquiles significativamente maior que do grupo com índice de massa corporal normal. CONCLUSÃO: Os valores médios encontrados na nossa casuística foram discordantes em relação à maioria dos estudos da literatura, demonstrando ser de grande importância a padronização e o emprego de tabelas próprias da nossa população na prática clínica diária.

OBJECTIVE: The aim of this study was to determine the normal values of the Achilles tendon thickness in the anteroposterior dimension and width in the transverse dimension in our population, correlating them with gender, age ranges, race, ABO blood group and body mass index. MATERIALS AND METHODS: Ultrasonographic examination was employed to evaluate 100 Achilles tendons of 50 healthy volunteers in order to measure the tendons thickness in the anteroposterior dimension and width in the transverse dimension. All examinations were performed by the same sonographer, using an ultrasound equipment with a 10 MHz linear transducer. RESULTS: Among the 50 volunteers studied, 25 were men and 25 were women, ranging from 20 to 52 years (average 33.9 years). The tendons average width was 13.3 ± 1.0 mm in the female group and 14.4 ± 1.4 mm in the male group; the average thickness was 5.4 ± 0.5 mm in the female group and 5.6 ± 0.6 mm in the male group. These measurements were significantly lower in the female group (p < 0.05). There was no significant correlation between the tendon measurements and the age ranges, ABO blood groups and races. The tendon width was significantly higher in the overweight body mass index group than in the normal body mass index group. CONCLUSION: Mean values found in our study differ significantly from the majority of other studies in the literature, demonstrating the importance of creating our own standards employing tables based on our population in daily clinical practice.

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Com a finalidade de se comparar as propriedades mecânicas do ligamento da patela e do tendão calcâneo foram realizados ensaios de tração em material obtido de 25 cadáveres humanos. A idade dos doadores foi 58 ± 14 anos (33-85), sendo 19 (76 por cento) masculinos e 6 (24 por cento) femininos, 23 brancos (92 por cento) e dois negros (8 por cento). Os materiais foram testados em seus 10 mm centrais, com velocidade de aplicação de carga de 30 mm/min. Foi obtida a área de secção dos corpos de prova para que fossem estudadas as propriedades estruturais e materiais. Foram estudadas as seguintes variáveis: carga máxima (N), tensão(MPa), módulo de elasticidade (MPa), energia (Nm), alongamento absoluto (mm) e específico ( por cento), limite de proporcionalidade (N), além da tensão (MPa) e alongamentos neste ponto. A análise estatística revelou que ambos possuem carga máxima, limite de proporcionalidade e tensão semelhantes (p>0,05). Nas outras variáveis ocorreu diferença significativa (p<0,05) com o tendão calcâneo apresentando valores maiores para energia e alongamento. O módulo de elasticidade, significativamente maior no ligamento da patela (p<0,05), foi a variável que melhor caracterizou a diferença do comportamento mecânico dos dois materiais.

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Peritenonitis is the most common cause of achillodynia. When conservative treatment fails, surgical decompression of the Achilles tendon (AT) has achieved high rates of satisfactory results. The aim of this study was to evaluate an alternative endoscopic procedure in Achilles peritenon releasing. We performed endoscopy in nine cadaveric limbs. Three 1-cm portal approaches were performed on the skin overlying the AT area where a slotted cannula was placed subcutaneously. The crural fascia and the peritenon were cut longitudinally using a reverse knife while adhesions were freed. After endoscopy, open exposure failed to disclose any damage to the sural or calcaneal nerve. Endoscopically, the AT was seen throughout its course from the myotendinous junction excepting the distal 2 cm where the tendon is normally attached to the skin. Since the crural fascia and the Achilles peritenon are readily released by endoscopy in cadaveric specimens, findings support this procedure as a valid alternative to treat AT disorders such as peritenonitis.

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