Purpose Achilles tendinopathy is a significant clinical lower limb issue observed in recent years. Neither the location nor the mechanism behind the pain has yet been sufficiently explained. Patients frequently experience pain on the medial side of the calcaneal tendon, and between 2 and 7 cm above the calcaneal tuberosity, which may suggests that the plantaris tendon plays an important role. The purpose of this study was to determine the anatomical relationships between the course of the plantaris tendon and the calcaneal tendon, as well as the type of insertion of the plantaris tendon. Methods The tests were carried out on 50 randomized lower limbs (23 left and 27 right) fixed in 10 % formalin solution. Results Five insertion types of the plantaris tendon were identified in relation to the calcaneal tendon: four with their insertion on the calcaneal tuberosity (Types 1, 2, 3, 5), while the fifth (Type 4) had its insertion in the crural fascia. In addition, two variants of the course of the plantaris tendon were identified, the most common being termed Variant A, in which the tendon crosses the space between the gastrocnemius and the soleus muscles, thus reaching the medial crural region, and is located on the medial side of the calcaneal tendon (84 % cases). The course of the Variant B is similar to the course of the Variant A, but upon leaving the space located between the gastrocnemius and soleus muscle, it turned to the medial crural region and ran directly anterior to the calcaneal tendon (12 %). The plantaris muscle was found to be absent in two lower limbs (4 %). The most frequent insertion type of the plantaris tendon into the calcaneal tuberosity is fan-shaped, occurring on the medial side of the Achilles tendon (Type 1–44 % cases). Conclusion The course of the plantaris tendon and its mobility range in relation to the calcaneal tendon may be likely to affect the occurrence of pains in the lower medial part of the leg (Achilles tendinopathy).
Purpose. Although the plantaris muscle (PM) is vestigial in humans, it has a significant clinical role in procedures such as grafting. However, recent reports suggest its potential involvement in the tendinopathy of the midportion of the Achilles tendon. The aim of the study is therefore to evaluate morphological variation of the PM with regard to its potential conflict with the Achilles tendon. Material and Methods. Classical anatomical dissection was performed on 130 lower limbs (71 right, 59 left) fixed in 10% formalin solution. The morphology of the PM was assessed regarding the relationship between the course of the plantaris tendon and the calcaneal tendon. Results. The PM was present in 89.2% of cases. The findings indicate the presence of a new type of PM tendon insertion in which the tendon is inserted into the tarsal canal flexor retinaculum, potentially affecting the tendinopathy of the tibialis posterior muscle. In 26 cases (22.4%), insertion blended with the Achilles tendon (Type II), which may increase the risk of Achilles tendinopathy. Conclusion. The anatomical variation of PM tendon morphology may create a potential conflict with the Achilles tendon and the tibialis posterior tendon, thus increasing the possibility of tendinopathy.
Background. This study thoroughly analyzes the anatomic variations of the brachioradial artery (radial artery of high origin) based on the variability of its origin, the presence and types of anastomosis with the brachial artery in the cubital fossa (“cubital crossover” or “cubital connection”), and the pattern of radial recurrent arteries, as well as the vascular territory within the hand. Material and Methods. One hundred and twenty randomly selected, isolated upper limbs fixed in 10% formalin solution were dissected. Results. The radial artery was found to have a high origin in 9.2% of total number of the limbs: two cases from the axillary artery; nine cases from the brachial artery. Anastomosis between the brachioradial and “normal” brachial arteries in the cubital fossa was also frequently observed (54.6%). The anastomosis (“cubital crossover”) was dominant in one case, balanced in three cases, minimal in two cases, and absent in five cases. Conclusions. The brachioradial artery may originate from the brachial and, less frequently, from the axillary artery. Anastomosis between the brachioradial and “normal” brachial arteries in the cubital fossa may be dominant, balanced, minimal, or absent. A complete radioulnar arch was found more often when the brachioradial artery was present as a variant.
Renal vascularization variants vastly differ between individuals due to the very complex embryogenesis of the kidneys. Moreover, each variant may have implications for clinical and surgical interventions. The number of operating procedures continues to grow, and includes renal transplants,...
The aim of this paper is to comprehensively analyze the literature focused on frequency of the presence of the accessory renal arteries in the human body. A systematic analysis of papers has been made. With regard to ethnicity, the incidence of accessory renal arteries fluctuates from 4% in a Malaysian population to 61.5% in a Brazilian population. The frequency is lowest in eastern and southern Asia (from 4% to 18.4%). In some, not ethnically homogenous populations, wide span of occurrence of accessory renal arteries is described (e.g. American – averaging from 18% to 28.8%). A higher frequency of accessory renal arteries was observed in fetuses compared to adults. Moreover, differences in the presence and number of accessory renal arteries reported in different papers are a consequence of type of visualizing technique used in research – especially when computed tomography and anatomical dissection were compared. The increasing number of surgical interventions, especially where laparoscopic methods are concerned, underlines the importance of such knowledge especially to surgeons, interventional radiologists, nephrologists, and vascular surgeons.