The Experts below are selected from a list of 489 Experts worldwide ranked by ideXlab platform
Edie Benedito Caetano - One of the best experts on this subject based on the ideXlab platform.
-
INNERVATION OF THE MEDIAN NERVE MOTOR BRANCHES IN THE FOREARM AND ITS CLINICAL SIGNIFICANCE.
Acta Ortopédica Brasileira, 2020Co-Authors: Edie Benedito Caetano, Luiz Angelo Vieira, JoÃo Paulo Nunes Toledo, SÉrgio Aparecido Do Amaral, Beatriz D'andrea Pigossi, Renato Alves De AndradeAbstract:Objective To analyse the anatomical variations of the median nerve motor branches in the elbow region. Methods Twenty upper limbs of 10 adult male cadavers were prepared by intra-arterial injection of a solution of 10% glycerol and formaldehyde. All cadavers belonged to the institution anatomy laboratory. Results We found a great variability within the distribution of median nerve branches leading to forearm Muscles. Only three limbs (14%) presented the normal standard of innervation described in anatomy treatises. The Pronator Teres Muscle (PTM), flexor carpi radialis (FCR), palmaris longus (PL), and the flexor digitorum superficialis (FDS) received exclusive innervation from the median nerve in all forearms. The anterior interosseous nerve (AIN) also originated from the median nerve in all dissected limbs. Conclusion A thorough understanding of the anatomy of the median nerve branches is important for performing surgeries such as: approach to the proximal third of the forearm, alleviation of Pronator Teres and anterior interosseous nerve compression syndromes, and distal nerve transfers. It also enables a better understanding the recovery of Muscle function after a nerve injury. Level of Evidence IV, Case series.
-
anterior interosseous nerve anatomical study and clinical implications
Revista Brasileira De Ortopedia, 2018Co-Authors: Edie Benedito Caetano, Luiz Angelo Vieira, Mauricio Ferreira Caetano, João José Sabongi Neto, Rodrigo Guerra SabongiAbstract:Abstract Objective The goal of this study was to describe anatomical variations and clinical implications of anterior interosseous nerve. In complete anterior interosseous nerve palsy, the patient is unable to flex the distal phalanx of the thumb and index finger; in incomplete anterior interosseous nerve palsy, there is less axonal damage, and either the thumb or the index finger are affected. Methods This study was based on the dissection of 50 limbs of 25 cadavers, 22 were male and three, female. Age ranged from 28 to 77 years, 14 were white and 11 were non-white; 18 were prepared by intra-arterial injection of a solution of 10% glycerol and formaldehyde, and seven were freshly dissected cadavers. Results The anterior interosseous nerve arose from the median nerve, an average of 5.2 cm distal to the intercondylar line. In 29 limbs, it originated from the nerve fascicles of the posterior region of the median nerve and in 21 limbs, of the posterolateral fascicles. In 41 limbs, the anterior interosseous nerve positioned between the humeral and ulnar head of the Pronator Teres Muscle. In two limbs, anterior interosseous nerve duplication was observed. In all members, it was observed that the anterior interosseous nerve arose from the median nerve proximal to the arch of the flexor digitorum superficialis Muscle. In 24 limbs, the branches of the anterior interosseous nerve occurred proximal to the arch and in 26, distal to it. Conclusion The fibrous arches formed by the humeral and ulnar heads of the Pronator Teres Muscle, the fibrous arch of the flexor digitorum superficialis Muscle, and the Gantzer Muscle (when hypertrophied and positioned anterior to the anterior interosseous nerve), can compress the nerve against deep structures, altering its normal course, by narrowing its space, causing alterations longus and flexor digitorum profundus Muscles.
-
Accessory Muscle of the flexor digitorum superficialis and its clinical implications.
Revista Brasileira De Ortopedia, 2017Co-Authors: Edie Benedito Caetano, João José Sabongi Neto, Lucas Augusto Ayres Ribas, Edson Vinicius MilanelloAbstract:Abstract Anatomical variations of the flexor digitorum superficialis (FDS) Muscle and tendon unit are frequently reported by anatomists and clinicians. Anatomical Muscle variations of the FDS and its tendons may include variations of Muscle belly, presence of accessory or duplicate tendons, abnormal tendon connections, and absence of Muscle or tendon components. Such variations may or may not have clinical implications. This report presents a case not described previously: a unilateral accessory Muscle of the flexor digitorum superficialis which was connected by a thick tendon to the flexor digitorum superficialis Muscle; it was directed proximally to the insertion of the medial epicondyle of the humerus, next to the superficialis head of the Pronator Teres Muscle. The belly of the accessory Muscle was positioned anterior to the median and anterior interosseous nerve. This anatomical variation is known as type V in the classification of Elliot et al. The knowledge of these anatomical variations helps hand surgeons interpret the clinical examination, particularly in the evaluation of patients who have suffered tendon injuries or show sign s of possible peripheral nerve entrapment.
-
anatomical variations of Pronator Teres Muscle predispositional role for nerve entrapment
Revista Brasileira De Ortopedia, 2017Co-Authors: Edie Benedito Caetano, Luiz Angelo Vieira, Fabio Antonio Anversa Sprovieri, Guilherme Camargo Petta, Mauricio Tadeu Nakasone, Barbara Livia Correa SerafimAbstract:Abstract Objective To assess the anatomical variations of the Pronator Teres Muscle (PTM) and its implication in the compression of the median nerve, which passes through the humeral and ulnar heads of the PTM. Methods For the present study, 100 upper limbs from human cadavers from the anatomy laboratory were dissected. Forty-six specimens were male and four, female, whose aged ranged from 28 to 77 years; 27 were white and 23, non-white. A pilot study consisting of six hands from three fresh cadaver dissections was conducted to familiarize the authors with the local anatomy; these were not included in the present study. Results The humeral and ulnar heads of PTM were present in 86 limbs. In 72 out of the 86 limbs, the median nerve was positioned between the two heads of the PTM; in 11, it passed through the Muscle belly of ulnar head of the PTM, and in three, posteriorly to both heads of the PTM. When both heads were present, the median nerve was not observed as passing through the Muscle belly of the humeral head of PTM. In 14 out of the 100 dissected limbs, the ulnar head of the PTM was not observed; in this situation, the median nerve was positioned posteriorly to the humeral head in 11 limbs, and passed through the humeral head in three. In 17 limbs, the ulnar head of PTM was little developed, with a fibrous band originating from the ulnar coronoid process, associated with a distal Muscle component near the union with the humeral head. In four limbs, the ulnar head of the MPR was represented by a fibrous band. In both limbs of one cadaver, a fibrous band was observed between the supinator Muscle and the humeral head of the PTM, passing over median nerve. Conclusion The results suggest that these anatomical variations in relationship median nerve and PTM are potential factors for median nerve compression, as they narrow the space through which the median nerve passes.
-
STRUTHERS' LIGAMENT AND SUPRACONDYLAR HUMERAL PROCESS: AN ANATOMICAL STUDY AND CLINICAL IMPLICATIONS.
Acta Ortopédica Brasileira, 2017Co-Authors: Edie Benedito Caetano, Luiz Angelo Vieira, Mauricio Ferreira Caetano, João José Sabongi Neto, José Eduardo De Bona, Thais Mayor SimonattoAbstract:OBJECTIVE The objective of this study was to determine the frequency and anatomical characteristics of Struthers' ligament and the supracondylar humeral process and evaluate the clinical implications in compressive neuropathy of the median nerve . METHOD We dissected 60 arms from 30 cadavers (26 males and 4 females): 15 were previously preserved in formalin and glycerin and 15 were dissected fresh in the Anatomy Laboratory for this paper. The relationships between Struthers' ligament and the median nerve and brachial artery and veins were documented with drawings and photos . RESULTS The supracondylar humeral process was not found in any of the 60 dissected arms. Struthers' ligament was identified in six arms (two bilateral); in all cases high insertion of the Pronator Teres Muscle was observed . CONCLUSION Struthers' ligament is an aponeurotic structure that may or may not be associated with the supracondylar humeral process, and is an important potential site of median nerve compression in the lower third of the arm. Level of Evidence IV, Case Series.
Robert Martin - One of the best experts on this subject based on the ideXlab platform.
-
struthers ligament and associated median nerve variations in a cadaveric specimen
Yale Journal of Biology and Medicine, 1993Co-Authors: S F Gunther, D Dipasquale, Robert MartinAbstract:Abstract A Ligament of Struthers has been identified and studied in a cadaveric arm. Its relationships to a rudimentary supracondylar process, the Pronator Teres Muscle, the median nerve, and the medial epicondyle of the humerus are described. Compared to an extensively studied series of normals, the ligament in this case was associated with abnormally proximal branching of the median nerve, a finding which is surgically significant and not addressed in the literature to date.
Kateřina Vymazalová - One of the best experts on this subject based on the ideXlab platform.
-
Variability of the Pronator Teres Muscle and its clinical significance.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2015Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:While investigating the cause of entrapment syndrome of the peripheral nerves in the elbow region, we observed variability of the Pronator Teres Muscle and the relationship of this Muscle to the median nerve and the surrounding vessels. Attention was also paid to the occurrence of the supracondylar process of the humerus and Struthers' ligament with regard to their ontogenetic and phylogenetic development. For this purpose, a classical anatomical dissection of the upper limbs of 68 adults, three fetuses and a phylogenetic assessment of five mammalian species was performed. In terms of variability in the anatomical structures of the elbow region, we found the most serious clinical condition to be where the median nerve ran through the Pronator canal together with the ulnar vessels (1.5%), or when it passed through the ulnar head of the Pronator Teres (5.9%). The Pronator Teres examined by us in fetuses showed the same arrangement as in adult individuals, including the created ulnar head. The occurrence of a supracondylar process and Struthers' ligament was not observed in our collection. The presence of these structures was not confirmed during the fetal period, either. The phylogenetic part of the study re-opened the question of the meaning and function of the entepicondylar foramen, because we noted differences in the occurrence of this structure in two related genera with a very similar way of life (Djungarian hamster and golden hamster).
-
Uncommon course of the ulnar artery through the Pronator Teres Muscle
Nepal Medical Association, 2014Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:In this paper, we describe a very rare variant in the course of the ulnar artery that we encountered in dissecting the right upper limb of a 74-year-old man. The ulnar artery arose standardly from the brachial artery in the cubital fossa. However, its ensuing course differed from the norm. The artery entered together with the ulnar vein and median nerve into the Pronator canal (between the humeral and ulnar heads of the Pronator Teres). Further, the ulnar artery descended classically to the ulnar side of the forearm between the flexor carpi ulnaris and flexor digitorum superficialis. Knowledge of this variation in the course of the ulnar artery may have significance in clinical practice because accumulation of anatomical structures in the Pronator canal could be a predisposing factor for the compression of nerve or blood vessels. Keywords: anatomical variation; median nerve; Pronator canal; Pronator Teres Muscle; ulnar artery.
-
Variability of Pronator Teres Muscle with Regard to PronatorSyndrome
2012Co-Authors: Kateřina Vymazalová, Lenka VargováAbstract:Pain in the cubital region and in the proximal part of the forearm may be caused by compression of the median nerve by passing between two heads of the Pronator Teres Muscle (Pronator syndrome). The most frequent cause is hypertrophy of the Muscle during its professional overloading. Factors which are predisposing the origin of the entrapment syndrome of the median nerve may be deviations of anatomical structures of this region. 68 anatomical preparations of upper limbs with focus on the variability of the Pronator Teres Muscle and with regards to the course of the median nerve were made and studied due to this. The occurrence of supracondylar process and Struther’s ligament were monitored at the same time, as these variable structures may also contribute to the entrapment of the median nerve.
Marek Joukal - One of the best experts on this subject based on the ideXlab platform.
-
Variability of the Pronator Teres Muscle and its clinical significance.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2015Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:While investigating the cause of entrapment syndrome of the peripheral nerves in the elbow region, we observed variability of the Pronator Teres Muscle and the relationship of this Muscle to the median nerve and the surrounding vessels. Attention was also paid to the occurrence of the supracondylar process of the humerus and Struthers' ligament with regard to their ontogenetic and phylogenetic development. For this purpose, a classical anatomical dissection of the upper limbs of 68 adults, three fetuses and a phylogenetic assessment of five mammalian species was performed. In terms of variability in the anatomical structures of the elbow region, we found the most serious clinical condition to be where the median nerve ran through the Pronator canal together with the ulnar vessels (1.5%), or when it passed through the ulnar head of the Pronator Teres (5.9%). The Pronator Teres examined by us in fetuses showed the same arrangement as in adult individuals, including the created ulnar head. The occurrence of a supracondylar process and Struthers' ligament was not observed in our collection. The presence of these structures was not confirmed during the fetal period, either. The phylogenetic part of the study re-opened the question of the meaning and function of the entepicondylar foramen, because we noted differences in the occurrence of this structure in two related genera with a very similar way of life (Djungarian hamster and golden hamster).
-
Uncommon course of the ulnar artery through the Pronator Teres Muscle
Nepal Medical Association, 2014Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:In this paper, we describe a very rare variant in the course of the ulnar artery that we encountered in dissecting the right upper limb of a 74-year-old man. The ulnar artery arose standardly from the brachial artery in the cubital fossa. However, its ensuing course differed from the norm. The artery entered together with the ulnar vein and median nerve into the Pronator canal (between the humeral and ulnar heads of the Pronator Teres). Further, the ulnar artery descended classically to the ulnar side of the forearm between the flexor carpi ulnaris and flexor digitorum superficialis. Knowledge of this variation in the course of the ulnar artery may have significance in clinical practice because accumulation of anatomical structures in the Pronator canal could be a predisposing factor for the compression of nerve or blood vessels. Keywords: anatomical variation; median nerve; Pronator canal; Pronator Teres Muscle; ulnar artery.
Lenka Vargová - One of the best experts on this subject based on the ideXlab platform.
-
Variability of the Pronator Teres Muscle and its clinical significance.
Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2015Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:While investigating the cause of entrapment syndrome of the peripheral nerves in the elbow region, we observed variability of the Pronator Teres Muscle and the relationship of this Muscle to the median nerve and the surrounding vessels. Attention was also paid to the occurrence of the supracondylar process of the humerus and Struthers' ligament with regard to their ontogenetic and phylogenetic development. For this purpose, a classical anatomical dissection of the upper limbs of 68 adults, three fetuses and a phylogenetic assessment of five mammalian species was performed. In terms of variability in the anatomical structures of the elbow region, we found the most serious clinical condition to be where the median nerve ran through the Pronator canal together with the ulnar vessels (1.5%), or when it passed through the ulnar head of the Pronator Teres (5.9%). The Pronator Teres examined by us in fetuses showed the same arrangement as in adult individuals, including the created ulnar head. The occurrence of a supracondylar process and Struthers' ligament was not observed in our collection. The presence of these structures was not confirmed during the fetal period, either. The phylogenetic part of the study re-opened the question of the meaning and function of the entepicondylar foramen, because we noted differences in the occurrence of this structure in two related genera with a very similar way of life (Djungarian hamster and golden hamster).
-
Uncommon course of the ulnar artery through the Pronator Teres Muscle
Nepal Medical Association, 2014Co-Authors: Kateřina Vymazalová, Lenka Vargová, Marek JoukalAbstract:In this paper, we describe a very rare variant in the course of the ulnar artery that we encountered in dissecting the right upper limb of a 74-year-old man. The ulnar artery arose standardly from the brachial artery in the cubital fossa. However, its ensuing course differed from the norm. The artery entered together with the ulnar vein and median nerve into the Pronator canal (between the humeral and ulnar heads of the Pronator Teres). Further, the ulnar artery descended classically to the ulnar side of the forearm between the flexor carpi ulnaris and flexor digitorum superficialis. Knowledge of this variation in the course of the ulnar artery may have significance in clinical practice because accumulation of anatomical structures in the Pronator canal could be a predisposing factor for the compression of nerve or blood vessels. Keywords: anatomical variation; median nerve; Pronator canal; Pronator Teres Muscle; ulnar artery.
-
Variability of Pronator Teres Muscle with Regard to PronatorSyndrome
2012Co-Authors: Kateřina Vymazalová, Lenka VargováAbstract:Pain in the cubital region and in the proximal part of the forearm may be caused by compression of the median nerve by passing between two heads of the Pronator Teres Muscle (Pronator syndrome). The most frequent cause is hypertrophy of the Muscle during its professional overloading. Factors which are predisposing the origin of the entrapment syndrome of the median nerve may be deviations of anatomical structures of this region. 68 anatomical preparations of upper limbs with focus on the variability of the Pronator Teres Muscle and with regards to the course of the median nerve were made and studied due to this. The occurrence of supracondylar process and Struther’s ligament were monitored at the same time, as these variable structures may also contribute to the entrapment of the median nerve.
