RESUMO

Dysfunction of the suprascapular nerve (SSN) is closely related to rotator cuff pathology; nerve dysfunction can lead to cuff disease and vice versa. Owing to repetitive microtrauma during overhead sports or massive cuff tears with significant tendon retraction, the SSN may suffer compression or traction neuropathy at the suprascapular notch. The SSN release technique has already been described. However, on the basis of the many hands-on cadaveric laboratories in which we have participated in the past 20 years, only a few instructors and almost none of the attendants have shown the experience and skill set needed to release the SSN at the suprascapular notch. Therefore, a review of the surgical technique following the anatomic descriptions of an expert anatomist (P.G.) of the shoulder girdle is quite valuable.

RESUMO

Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

RESUMO

Anatomical variations of the fingers extensor tendons are not uncommon and have been described by several authors. Participation of intertendinous band of fascia in this kind of variation can change muscle functionality. However, this element is scarcely described in the literature. In this case report, we describe the finding of an accessory tendon located between the extensor digitorum communis muscle tendon, destined for the index finger, and the extensor pollicis longus tendon. In an anatomical analysis, we observed a connection between the radial portion of the accessory tendon and the ulnar portion of the extensor pollicis longus tendon by intertendinous fascia. This finding corresponds anatomically to the supernumerary muscle denominated extensor indicis radialis, but due to the fascial connections observed with the extensor pollicis longus, this muscle would behave functionally as a supernumerary muscle denominated extensor pollicis et indicis communis. This report suggests that participation of fascia in muscular variation in this anatomical segment is essential to establish the correct morpho-functional denomination of muscular variants.

Assuntos

RESUMO

BACKGROUND: Recently, an interest has developed in understanding the anatomy of the posterior and posterolateral knee. The posterolateral compartment of the knee corresponds to a complex arrangement of ligaments and myotendinous structures. Undiagnosed lesions in this compartment are the main reason for failure of the anterior and posterior cruciate ligament reconstructions. Understanding the anatomy of these structures is essential to assist in the diagnosis and treatment of these lesions. The aim of this study was to better understand the relationship between these structures of the knee using three-dimensional technology. METHODS: Ten knees were included from cadaver lower limbs of adult patients. The skin and subcutaneous tissue were removed leaving only the muscle groups and ligaments. The neurovascular bundles and their ramifications were preserved. Images were acquired from the dissections using a Nikon D40 camera with AF-S Nikkor 18-55 mm (1:3.5 5.6 GII ED) and Micro Nikkor 105 mm (1:2.8) lenses. The pair of images were processed using Callipyan 3D and AnaBuilder software, which transforms the two images into one anaglyphic image. RESULTS: During the dissection of the knees, twelve pictures were acquired and transformed into anaglyphic images. CONCLUSION: The use of three-dimensional images in this study demonstrates that this technique is useful to improve the knowledge in anatomy of the knee as well as for knee reconstruction surgery.

RESUMO

O mecanismo extensor do joelho é uma estrutura complexa formada pelo músculo e tendão quadricipital, a patela, o tendão patelar e os ligamentos que os circundam e auxiliam na estabilização do joelho. Através do uso de técnica de visualização tridimensional de imagens do aparelho extensor do joelho pretendemos mostrar de forma didática as estruturas que compõem este complexo ósteo-músculo-ligamentar. Dissecção anatômica do joelho com ênfase nas estruturas do seu mecanismo extensor foi realizada seguida de fotografias com câmera e lentes adequadas para simulação da visão humana através de técnica de construção de imagem tridimensional. Em seguida, com a ajuda de software apropriado, as duas imagens da mesma estrutura de diferentes ângulos simulando a visão humana são sobrepostas com adição de camada polarizante, concluindo a construção da imagem anaglífica. As principais estruturas do mecanismo extensor do joelho podem ser observadas com efeito tridimensional. Dentre os principais benefícios relacionados a esta técnica, destacamos, além do ensino e estudo da anatomia musculoesquelética, o potencial uso em treinamento de procedimentos cirúrgicos e a realização de imagens em exames diagnósticos.

The knee extensor mechanism is a complex structure formed by the quadriceps muscle and tendon, the patella, the patellar tendon and the ligaments that surround and help stabilize the knee. Through using a three-dimensional viewing technique on images of the knee extensor apparatus, we aimed to didactically show the structures that compose this bone-muscle-ligament complex. Anatomical dissection of the knee with emphasis on the structures of its extensor mechanism was performed, followed by taking photographs using a camera and lenses suitable for simulating human vision, through a technique for constructing three-dimensional images. Then, with the aid of appropriate software, pairs of images of the same structure from different angles simulating human vision were overlain with the addition of polarizing layer, thereby completing the construction of an anaglyphic image. The main structures of the knee extensor mechanism could be observed with a three-dimensional effect. Among the main benefits relating to this technique, we can highlight that in addition to teaching and studying musculoskeletal anatomy, it has potential use in training for surgical procedures and production of images for diagnostic tests.

Assuntos

RESUMO

PURPOSE: For many years, the anatomy of the medial knee corner has been reported. However, it is not exactly clear how all these structures function together. The purpose of this study is to identify and try to understand the relationship between the posteromedial corners of the knee using three-dimensional visualization techniques. MATERIALS AND METHODS: This study comprises of 10 knees from adult corpses. Images were acquired from the dissection of different layers of the posteromedial compartment of the knee using a camera Nikon D40 and AF-S Nikkor 18-55 mm (Nikon Corp., Japan) placed on a slide bar. The pair of images was processed using Callipyan 3D or Anabuilder software (Ana builder, France) that transforms the two different images of the same structure with the intrapupillary distance proportion into one anaglyphic image. RESULTS: During knee dissection, pictures were taken and transformed into three-dimensional images that become more realistic with the use of special glasses. The images were made during the dissection of the three layers of the posteromedial compartment of the knees. CONCLUSIONS: Posteromedial corner ligament structures are quite complex and are not always clearly described in the literature. Three-dimensional images of these structures can help better understanding its anatomy.

Assuntos

RESUMO

The stereoscopic imaging technique is an option for a more realistic understanding of what we normally see in 2 dimensions on paper or on a screen. To produce a 3-dimensional image of an object, it is necessary to register 2 different images of the same object at the same distance and height with the use of cameras that focus on one particular point. A convergence between the left and right images is required for human vision. The distance between the camera and the images necessary to create the stereo pair should be proportional to the normal distance between the pupils. Stereoscopic or polarization techniques are used to create the images, and special glasses are required to view them. In medicine, 3-dimensional images are an extremely effective resource in the study and teaching of anatomy at both the macroscopic and microscopic levels. With advancements in technology and the emergence of new diagnostic imaging techniques and innovative therapeutic modalities, 3-dimensional images can be an excellent educational tool.

Assuntos

RESUMO

The knee extensor mechanism is a complex structure formed by the quadriceps muscle and tendon, the patella, the patellar tendon and the ligaments that surround and help stabilize the knee. Through using a three-dimensional viewing technique on images of the knee extensor apparatus, we aimed to didactically show the structures that compose this bone-muscle-ligament complex. Anatomical dissection of the knee with emphasis on the structures of its extensor mechanism was performed, followed by taking photographs using a camera and lenses suitable for simulating human vision, through a technique for constructing three-dimensional images. Then, with the aid of appropriate software, pairs of images of the same structure from different angles simulating human vision were overlain with the addition of polarizing layer, thereby completing the construction of an anaglyphic image. The main structures of the knee extensor mechanism could be observed with a three-dimensional effect. Among the main benefits relating to this technique, we can highlight that in addition to teaching and studying musculoskeletal anatomy, it has potential use in training for surgical procedures and production of images for diagnostic tests.

RESUMO

En la práctica artro-endoscópica del aparato locomotor, se desarrollan constantemente nuevas opciones terapéuticas, en ocasiones insospechadas. En general, estas nuevas técnicas requieren de una gran habilidad y de un nuevo conocimiento anatómico, la anatomía artro-endoscópica. El objetivo de esta publicación es proporcionar un recuerdo anatómico útil para la realización de la liberación endoscópiea del nervio supraescapular.

Assuntos

RESUMO

En la práctica artro-endoscópica del aparato locomotor, se desarrollan constantemente nuevas opciones terapéuticas, en ocasiones insospechadas. En general, estas nuevas técnicas requieren de una gran habilidad y de un nuevo conocimiento anatómico, la anatomía artro-endoscópica. El objetivo de esta publicación es proporcionar un recuerdo anatómico útil para la realización de la liberación endoscópiea del nervio supraescapular.(AU)

Assuntos