We have tried to demonstrate the arterial blood supply of the anterior cruciate ligament and inve... more We have tried to demonstrate the arterial blood supply of the anterior cruciate ligament and investigated the surgical measures that can be taken in case of an impairment in this supply. We have demonstrated in 14 specimens of cadaver knees treated with formalin that the-peri-and endoligamentous circulation of the ACL is derived by the medial genus artery, after we have injected drawing ink and Technovit from the popliteal artery. We have found that the point of jnsertion of the medial genus artery into the ACL is Iocated at the upper 1/3 of the ACL in 64% of our specimens and at the upper 1/4 in 36%. We have also observed that this artery terminates in ACL in two different anatomical patterns. The Ievel of the Iigamental rupture in injuries of ACL is not very important in the healing process but the Iigament should definetely be surrounded by the synovial membrane during the repair procedure.
Objectives: Short leg casts are routine applications in orthopaedic practice. The aim of the stud... more Objectives: Short leg casts are routine applications in orthopaedic practice. The aim of the study was to investigate the course of the common fibular nerve and its branches (deep and superficial fibular nerves) around the fibular neck in order to describe a convenient method for applying the lower extremity casts with low risk of fibular nerve entrapment. Methods: Fifty lower extremities of 26 cadavers were examined. The point where common fibular nerve itself or its branches (deep and superficial fibular nerves) crossed over the fibular neck were dissected. The points where the nerve or its branches have risk of compression between the fibula and the cast were investigated in relation to fibular length. Results: The average fibular length was 356.9±26.4 mm. The common fibular nerve did not pass over the fibular neck in any specimen, instead, its branches crossed over it. The average distance from the tip of the fibular head to deep fibular nerve and superficial fibular nerve were ...
Introduction Classically, a single renal artery supplies each kidney. However, renal artery varia... more Introduction Classically, a single renal artery supplies each kidney. However, renal artery variations are very common. The most common one is the presence of an additional vessel. According to Satyapal et al., the frequency of the additional renal arteries displays a wide range ...
During routine dissections at the Anatomy Department of the Istanbul Faculty of Medicine, the aut... more During routine dissections at the Anatomy Department of the Istanbul Faculty of Medicine, the authors encountered a bony structure in the right soleus muscle of a 78 year old male cadaver. The bony structure was not associated with any bones or capsular or ligamentous structures. In order to prove that this structure was a real bone but not a bony segment that was broken from the bones of the leg, first we took a radiograph of this region. In the radiograph, there was no evidence for broken leg bones. Moreover the bony structure had plainly normal trabecular bony scene. Secondly we took out this structure, then a propriate section from it was made and it was examined microscopically. As mature bony lamellae were observed microscopically, at last we felt certain that this was a real bone. There were two possibilities for this unusual structure. It could be an accessory bone that was stated in the soleus muscle like the fabella that can be stated in the gastrocnemius muscle or this ca...
Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepat... more Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. Descriptive study. We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2009
The aim of this study was to assess the course of the superficial branch of the radial nerve (SBR... more The aim of this study was to assess the course of the superficial branch of the radial nerve (SBRN) at the level of the wrist and its branches in relation to wrist arthroscopy portals. Dissections were performed on 11 hands from 6 cadavers in the section starting from the point where the SBRN begins to emerge and ending at the terminal branches of the dorsal hand. The distribution of the SBRN, the distance from the superficial branch to the dorsal portals used in wrist arthroscopy, and the distance from the superficial branch to the anatomic determinants (styloid process of the radius, Lister tubercle) were studied. At the level of the wrist, the nerve bifurcated into 2 branches in 8 of 11 wrists (73%) and into 3 branches in 3 of 11 wrists (27%). The mean distance from the SBRN where it was first detected proximal to the Lister tubercle was 73 mm. The mean distance between the styloids was 52 mm; the distance between the Lister tubercle and styloid process of the radius was 23 mm. At the wrist level, the distance from the branch closest to the radial side to the Lister tubercle was 28 mm (L-D1), 21 mm (L-D2/3), and 7 mm (RS-D1). The distance of the closest nerve branch to the 3-4 portal was 9 mm. The distances of the other portals were 5 mm (1-2RMC-D1), 8 mm (1-2RMC-D2/3), 8 mm (1-2P-D1), and 9 mm (1-2P-D2/3). The limited size of the area where portals can be positioned and the anatomic variations between individuals are major obstacles in developing a guideline for reducing the risk of SBRN injury in wrist arthroscopy. Great care must be taken when using the 1-2 portal. We suggest making a skin-only incision for this portal and then using blunt dissection to help prevent injury to the SBRN.
To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) a... more To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) and classify its shape and structure macroscopically. Forty lower extremities were dissected to expose the AH. Its shape and structure were macroscopically noted, and the AH was classified into four types. For determining the localization, measurements were made with digital calipers. Twenty-four oval fibrous types, 12 oval muscular types, 2 bridging fibrous types and 2 bridging muscular types of AH were determined. For the horizontal localization of AH, the apex of the AH was determined to be located medial to the vertical line between the midpoint of the interepicondylar distance and the line which was drawn transversely from the apex of the AH, in all of the cadavers. For the vertical one, the apex of the AH was located in the middle third of the femur length in 14 thighs, and in the remaining 26 ones, the apex of the AH was located in the distal third of the femur length. Adductor hiatus was classified according to its shape and structure for the first time. Moreover, the localization of the AH was practically defined, in order not to harm the popliteal artery and vein.
We have tried to demonstrate the arterial blood supply of the anterior cruciate ligament and inve... more We have tried to demonstrate the arterial blood supply of the anterior cruciate ligament and investigated the surgical measures that can be taken in case of an impairment in this supply. We have demonstrated in 14 specimens of cadaver knees treated with formalin that the-peri-and endoligamentous circulation of the ACL is derived by the medial genus artery, after we have injected drawing ink and Technovit from the popliteal artery. We have found that the point of jnsertion of the medial genus artery into the ACL is Iocated at the upper 1/3 of the ACL in 64% of our specimens and at the upper 1/4 in 36%. We have also observed that this artery terminates in ACL in two different anatomical patterns. The Ievel of the Iigamental rupture in injuries of ACL is not very important in the healing process but the Iigament should definetely be surrounded by the synovial membrane during the repair procedure.
Objectives: Short leg casts are routine applications in orthopaedic practice. The aim of the stud... more Objectives: Short leg casts are routine applications in orthopaedic practice. The aim of the study was to investigate the course of the common fibular nerve and its branches (deep and superficial fibular nerves) around the fibular neck in order to describe a convenient method for applying the lower extremity casts with low risk of fibular nerve entrapment. Methods: Fifty lower extremities of 26 cadavers were examined. The point where common fibular nerve itself or its branches (deep and superficial fibular nerves) crossed over the fibular neck were dissected. The points where the nerve or its branches have risk of compression between the fibula and the cast were investigated in relation to fibular length. Results: The average fibular length was 356.9±26.4 mm. The common fibular nerve did not pass over the fibular neck in any specimen, instead, its branches crossed over it. The average distance from the tip of the fibular head to deep fibular nerve and superficial fibular nerve were ...
Introduction Classically, a single renal artery supplies each kidney. However, renal artery varia... more Introduction Classically, a single renal artery supplies each kidney. However, renal artery variations are very common. The most common one is the presence of an additional vessel. According to Satyapal et al., the frequency of the additional renal arteries displays a wide range ...
During routine dissections at the Anatomy Department of the Istanbul Faculty of Medicine, the aut... more During routine dissections at the Anatomy Department of the Istanbul Faculty of Medicine, the authors encountered a bony structure in the right soleus muscle of a 78 year old male cadaver. The bony structure was not associated with any bones or capsular or ligamentous structures. In order to prove that this structure was a real bone but not a bony segment that was broken from the bones of the leg, first we took a radiograph of this region. In the radiograph, there was no evidence for broken leg bones. Moreover the bony structure had plainly normal trabecular bony scene. Secondly we took out this structure, then a propriate section from it was made and it was examined microscopically. As mature bony lamellae were observed microscopically, at last we felt certain that this was a real bone. There were two possibilities for this unusual structure. It could be an accessory bone that was stated in the soleus muscle like the fabella that can be stated in the gastrocnemius muscle or this ca...
Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepat... more Transcatheter arterial chemoembolization is a common treatment for patients with inoperable hepatocellular carcinoma. If the carcinoma is advanced or the main arterial supply, the hepatic artery, is occluded, extrahepatic collateral arteries may develop. Both, right and left inferior phrenic arteries (RIPA and LIPA) are the most frequent and important among these collaterals. However, the topographic anatomy of these arteries has not been described in detail in anatomy textbooks, atlases and most previous reports. To investigate the anatomy and branching patterns of RIPA and LIPA on cadavers and compare our results with the literature. Descriptive study. We bilaterally dissected 24 male and 2 female cadavers aged between 49 and 88 years for this study. The RIPA and LIPA originated as a common trunk in 5 cadavers. The RIPA originated from the abdominal aorta in 13 sides, the renal artery in 2 sides, the coeliac trunk in 1 side and the left gastric artery in 1 side. The LIPA originated from the abdominal aorta in 9 sides and the coeliac trunk in 6 sides. In 6 cadavers, the ascending and posterior branches of the LIPA had different sources of origin. As both the RIPA and LIPA represent the half of all extrahepatic arterial collaterals to hepatocellular carcinomas, their anatomy gains importance not only for anatomists but interventional radiologists as well.
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2009
The aim of this study was to assess the course of the superficial branch of the radial nerve (SBR... more The aim of this study was to assess the course of the superficial branch of the radial nerve (SBRN) at the level of the wrist and its branches in relation to wrist arthroscopy portals. Dissections were performed on 11 hands from 6 cadavers in the section starting from the point where the SBRN begins to emerge and ending at the terminal branches of the dorsal hand. The distribution of the SBRN, the distance from the superficial branch to the dorsal portals used in wrist arthroscopy, and the distance from the superficial branch to the anatomic determinants (styloid process of the radius, Lister tubercle) were studied. At the level of the wrist, the nerve bifurcated into 2 branches in 8 of 11 wrists (73%) and into 3 branches in 3 of 11 wrists (27%). The mean distance from the SBRN where it was first detected proximal to the Lister tubercle was 73 mm. The mean distance between the styloids was 52 mm; the distance between the Lister tubercle and styloid process of the radius was 23 mm. At the wrist level, the distance from the branch closest to the radial side to the Lister tubercle was 28 mm (L-D1), 21 mm (L-D2/3), and 7 mm (RS-D1). The distance of the closest nerve branch to the 3-4 portal was 9 mm. The distances of the other portals were 5 mm (1-2RMC-D1), 8 mm (1-2RMC-D2/3), 8 mm (1-2P-D1), and 9 mm (1-2P-D2/3). The limited size of the area where portals can be positioned and the anatomic variations between individuals are major obstacles in developing a guideline for reducing the risk of SBRN injury in wrist arthroscopy. Great care must be taken when using the 1-2 portal. We suggest making a skin-only incision for this portal and then using blunt dissection to help prevent injury to the SBRN.
To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) a... more To determine not only the vertical but also horizontal localization of the adductor hiatus (AH) and classify its shape and structure macroscopically. Forty lower extremities were dissected to expose the AH. Its shape and structure were macroscopically noted, and the AH was classified into four types. For determining the localization, measurements were made with digital calipers. Twenty-four oval fibrous types, 12 oval muscular types, 2 bridging fibrous types and 2 bridging muscular types of AH were determined. For the horizontal localization of AH, the apex of the AH was determined to be located medial to the vertical line between the midpoint of the interepicondylar distance and the line which was drawn transversely from the apex of the AH, in all of the cadavers. For the vertical one, the apex of the AH was located in the middle third of the femur length in 14 thighs, and in the remaining 26 ones, the apex of the AH was located in the distal third of the femur length. Adductor hiatus was classified according to its shape and structure for the first time. Moreover, the localization of the AH was practically defined, in order not to harm the popliteal artery and vein.
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