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Jun 2020 DOI 10.14302/issn.2577-2279.ijha-20-3445
Musa Fadlelmula Awadelseid KhalidCorresponding author
Jazan University, Faculty of Medicine, Anatomy and Embryology Department, Sudan
The passage of the posterior tibial nerve in the tarsal tunnel has a great clinical significance, thus detailed anatomical knowledge is mandatory for safe clinical intervention. This study was to identify the morphological appearance of the tibial nerve and its bifurcation. Sixty lower limbs of formalin embalmed cadavers were randomly selected. Data were collected through the application of standard dissection method of the tarsal tunnel of lower limbs (30 rights and 30 left) of formalin embalmed cadavers. The posterior tibial nerve and its branches were exposed from the distal end of the leg toward plantar surface beyond its bifurcation by resecting the skin and flexor retinaculum. The study triggered several findings: The posterior tibial nerve is flattened shaped in 21 specimens 70% and has a rounded shape in 9 specimens 30%in the right foot. In the left foot it is flattened in 17 specimens 56.7% and rounded shape in 13 specimens 43.3%. Posterior tibial nerve bifurcates into medial and lateral planter nerves inside tarsal tunnel in 20 specimens 66.7% in the right foot and in 21 specimens 70% in the left foot. This study concludes that posterior tibial nerve commonly has flattened shape and divided into medial and lateral planter nerves inside tarsal tunnel.
Nov 2019
Miroslav Budoš MUDr.Corresponding author
Traumatology dep., Bata Hospital Zlín, Chzech Republic.
Modern medicine gives treatment options even in cases, where this has not been possible in the past. We want to present how negative pressure wound therapy (NPWT) helps in limb salvage. The case report brings our insight and experience on how to be successful with NPWT. We present a high-energy injury with an open tibial fracture IIIB according to Gustillo-Anderson classification 11. NPWT is an excellent option to treat extensive soft tissue injury. NPWT is also beneficial in the application of the dermoepidermal graft as we have found. We can confirm that this therapy contributed to a faster healing of soft tissues compared to classical wound healing.
Oct 2019 DOI 10.14302/issn.2577-2279.ijha-19-3053
A TiwariCorresponding author
MBBS II Year, School of Medical Science & Research, Sharda University, Greater Noida.
Introduction The human tibia is a complex anatomical unit and the knowledge of its morphometric values is important in Forensic, Anatomic and Radiological cases in order to identify unknown bodies and stature. Objective It was to analyze the tibia, its morphometry, side difference and to investigate the position of nutrient foramina in tibia. Methods In this study, 60 adult human tibias (30 right and 30 left) were obtained from the Department of Anatomy SMSR SHARDA UNIVERSITY. In the study a total of two parameters i.e. Cross Section Index in the middle and Cnemicus Index of the bones were obtained and evaluated by using two instruments- a Measuring Tape and a Vernier Calipers. All the bones were dry and showed normal anatomical features. Results The mean Cross Section Index in the middle was calculated as 80.42 ± 11.33 on the right side and 78.15± 12.78 on the left side; and the Cnemicus index was 78.40 ± 13.19 on the right side and 70.84 ± 11.38 on the left side Conclusion The two parameters in the North Indian population were compared with other populations. The values were found to be almost comparable however there were subtle differences between different populations. The position of nutrient foramen was also assessed. This knowledge will thus help further researchers and orthopedic surgeons in various procedures like joint replacement therapy, fracture repair, bone grafts and vascularized bone microsurgery as well as in medico‐legal cases.
Sep 2019 DOI 10.14302/issn.2577-2279.ijha-19-3013
Musa Fadlelmula Awadelseid KhalidCorresponding author
Jazan University -Faculty of Medicine, Anatomy &Embryology department, Kingdom of Saudi Arabia –Jazan
The medial calcaneal nerve (MCN) is the first branch of the posterior tibial nerve (PTN) in the porta pedis, enervates the skin of the heel and medial side of the foot. Heel pain is a common condition encountered by physicians, and this may have a significant clinical association with the MCN’s branching pattern. This study was to identify branching pattern variations in the medial calcaneal neurovascular bundle. This study was carried out using 60lower limbs of formalin-embalmed cadavers, using the tarsal tunnel dissection method for 30right and 30 left lower limbs. The medial calcaneal neurovascular bundle course was identified by exposing the PTN and its branches from the distal end of the leg toward the plantar surface beyond its bifurcation and resecting the skin and flexor retinaculum. Many MCN branching pattern variations (specifically concerning origins, numbers, and levels of branching) were observed. In the right foot a single branch was present in 21 specimens (70%), while two branches were observed in nine specimens (30%). In the left foot, a single branch was present in 22 specimens (73.3%) and two branches were present in 8 specimens (26.7%). In this study, two branches originate from lateral planter artery is the most common observation. This study concludes that a single MCN originating from the TN is the most common variant. Two medial calcaneal arteries (MCAs) originating from the LPA is also common.
Sep 2019 DOI 10.14302/issn.2474-3585.jpmc-19-3009
Konadu-Yeboah DominicCorresponding author
Orthopaedic and Trauma Surgeon, Komfo Anokye Teaching Hospital, Kumasi, Ghana, Part-Time Lecturer, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Blount’s disease, also known as tibia vara, is a developmental disorder involving the posteromedial proximal tibial physis resulting in progressive varus, procurvatum and internal torsion of the affected tibia 1. The condition was first published by Blount in 1973 2. The aetiology of this disease is unkown. However, associations exist between blount’s disease and the Afro-Caribbean race, early age of walking and obesity 34. Furthermore, genetic predisposition has been postulated as well as mechanical loading of the physis 456. Affected children are usually overweight and start walking early. It is bilateral in 80% of cases 7.
Apr 2018 DOI 10.14302/issn.2577-2279.ijha-18-2030
A. Kiryanov N.Corresponding author
Izhevsk State Medical Academy, Russia.
Introduction: The use of non-medicinal facilities for correcting processes in various pathological conditions is one of the most urgent problems of modern medicine. Purpose of the Work: To study the effect of low-intensity infrared laser radiation on reparative bone formation and angiogenesis in bone regeneration which is formed in treatment of fractures under conditions of transosseous osteosynthesis. Material and Methods: A tibia fracture was modeled experimentally in rats in the control and experimental groups. Reposition and fixation of fragments were performed. The fracture zone in the experimental group animals was exposed to the impact of pulsed infrared laser irradiation of low intensity. Animals from the control group underwent the impact simulation. The operated bones were investigated using the methods of X-ray, light and electron microscopy, X-ray electron probe microanalysis. Results: It was established that laser radiation exposure sessions activated fibrillogenesis and angiogenesis, accelerated compacting of newly formed bone tissue and increased its maturity while primary fracture healing occurred. Prolonged capillary dilatation and endothelium-dependent vasodilation, intensive capillarogenesis were noted after sessions of laser therapy in bone regeneration. Endothelial outgrowth was formed in the lumen of the vessels forming capillary buds that propagate along the “mother” vessels (endovascular capillarogenesis). Conclusion: The data obtained revealed a possible mechanism of laser radiation exposure at the level of a whole organism and proved the effectiveness of its application in clinical practice at the early stages of patient rehabilitation under conditions of transosseous osteosynthesis.
Sep 2017 DOI 10.14302/issn.2832-4048.jsm-17-1621
A. Koryak YuriCorresponding author
SSC of the Russian Federation − Institute of Biomedical Problems of the RAS
The effects of long-term space flight on human triceps surae (TS) muscle function and electromechanical delay (EMD) have been investigated. Voluntary and electrically evoked contractions of the TS were obtained from 7 male cosmonauts 30 days before and 3 days after landing. For all cosmonauts the isometric maximal voluntary contraction was reduced by 41.7 % (p < 0.01), whereas the electrically evoked maximal tetanic contraction force (Po) was found to decrease by 25.6 % (p < 0.05). Force deficit increased by 50 % (p < 0.001). This suggests that most of the force loss is due to a reduction in motor drive (motor control). The decrease in Po was associated with a significant increase of the corresponding maximal rates of tension development (43.7 %). The twitch tension (Pt) was not significantly changed and the Pt/Po ratio was increased by 46.7 % (p < 0.05) after space mission. The twitch time-to-peak tension of the TS increased by 7.7 %, but half-relaxation time decreased by 20.6 %. Force-velocity properties of the TS calculated according to a relative scale of voluntary contraction development significantly decreased. The calculations of the same properties of electrically evoked contraction development did not differ substantially from the initial physiological state. Total reaction time (TRT), pre-motor time (PMR) and motor time or EMD were determined. In response to a supramaximal single electrical pulses applied to the tibial nerve, the latent period between the M-wave and Рt beginning was determined. The voluntary contraction EMD increased by 34.1 %; but PMR and TRT decreased by 19.0 and 14.1 %, respectively. The EMD of electrically evoked contraction did not significantly change. Thus, the comparison of the mechanical alterations recorded during voluntary contractions and in contractions evoked by electrical stimulation of the motor nerve, suggests that weightlessness not only modifies the peripheral processes associated with contractions, but also changes central and/or neural command of the contraction.
Aug 2016 DOI 10.14302/issn.2470-5020.jnrt-15-750
Adam Thrasher TimothyCorresponding author
Center for Neuromotor and Biomechanics Research, University of Houston, Houston, TX, USA
Background To quantify the underlying rhythmic patterns observed in surface electromyography (SEMG) in patients with Parkinson’s Disease (PD), to compare rhythmicity of PD gait with normal gait, and to compare overground walking to treadmill gait. Methods Eight individuals with idiopathic PD, and ten individuals with no history of neurological disorders participated. SEMG was recorded from the vastus lateralis, tibialis anterior, lateral gastrocnemius and biceps femoris muscles bilaterally. Each participant performed two trials of overground walking and two trials of treadmill walking at a self-selected comfortable walking speed. SEMG was analyzed using a non-linear statistical model that identified underlying recurrent locomotor patterns, which estimated the relative contribution of central pattern generators to the observed muscle activation signals. An index of rhythmicity was determined from the statistic, R2. Results The rhythmicity of PD gait was significantly higher than that of normal gait (p = .0458). There was also a significant difference between the rhythmicity of overground walking and treadmill walking (p = .0097). Conclusions Individuals with PD appear to walk with muscle activation patterns that are more rhythmic than normal. This suggests that there is more stride-to-stride consistency, and there are fewer postural adjustments and responses to perturbations. We also found that treadmill gait was more rhythmic than overground walking. These findings, although preliminary, challenge the paradigm and current approach to gait retraining of patients with PD.