Łukasz Olewnik

The report on the co-occurrence of two different rare anatomic variations of the plantaris muscle tendon on both sides of an individual.

The plantaris muscle usually begins with a short and small muscle belly on the popliteal surface of the femur and on the knee joint capsule. It continues distally to form a long and thin tendon typically fixed to the calcaneal tuberosity. However, the course and the insertion of the plantaris muscle is variable, which may influence the development of Achilles tendinopathy. The plantaris tendon may also be used for reconstruction of tendons and ligaments, such as talofibular and calcaneofibular ligament. In literature review no data concerning the co-occurrence of anatomic variations of the plantaris muscle tendon in different individuals has been found. This report presents a rare variant of the plantaris muscle insertion into the deep crural fascia on the left leg and absence of the plantaris muscle on the right leg of the same individual.

Morphological variations of intra-testicular arterial vasculature in bovine testis - a corrosion casting study

BackgroundProper blood supply is necessary for the physiological function of every internal organ. The article offers the first classification of the bovine intra-testicular arteries. A corrosive study focused on the intra-testicular arterial vasculature was performed on 40 bovine testes. The vessels were analyzed accurately using MultiScanBase v.18.02 software.MethodsA corrosive study focused on the intra-testicular arteries was performed on 40 bovine testes. The vessels were analyzed accurately using MultiScanBase v.18.02 software.ResultIn bulls, the centripetal arteries tended to run straight to the mediastinal region, where they form knot-like vascular structures. Those structures are the origin for centrifugal recurrent branches, running peripherally. However, three basic types of intra-testicular arterial vasculature were noted. Type I had centrifugal, recurrent branches, running peripherally towards the surface of the testis but did not reach the tunica albuginea. Type II exhibited centrifugal, recurrent branches running more horizontally than type I. Type III is the most heterogeneous type, composed of other variform types of arteries not classified as type I or type II. Type II was most commonly observed as a vascular conglomerate of intra-testicular arteries within the arterial network of the mediastinum testis. In type III, artery diameter was significantly smaller than observed in types I and II (p < 0.01). Types I and II did not differ between each other regarding artery diameter (p > 0.05).ConclusionVariations of the intra-testicular arterial vasculature in bovine testis may suggest that particular types of vessels play different physiological roles. The most common type of intra-testicular artery comprising the arterial network of the mediastinum testis was type II.

Types of coeliac trunk branching including accessory hepatic arteries: a new point of view based on cadaveric study

The coeliac trunk is major visceral branch of the abdominal aorta. Familiarity with anatomic variations of the coeliac trunk is relevant for planning radiological and surgical procedures. The aim of our research was determining variations of the coeliac trunk, including the occurrence of accessory hepatic arteries. 40 cadavers were studied. Six patterns of coeliac trunk branching were observed in this study. Accessory hepatic arteries were observed in seven specimens (17.5%). The most prevalent variation was normal trifurcation, accounting for 62.5% of cases. The rarest variation was absence of the coeliac trunk, with an incidence of 2.5%. In this variant the left gastric artery, the common hepatic artery, and the splenic artery branched directly off the abdominal aorta. The study material allowed to distinguish two coeliac tunk branching patterns which, to the best of our knowledge, have not been reported before. It was a type with four branches originating from the coeliac trunk: the left gastric artery, the common hepatic artery, the splenic artery, and right accessory hepatic artery. The other previously unreported pattern variant was also a coeliac trunk which gave off the coeliac trunk gave off three branches: the common hepatic artery, the splenic artery and right accessory hepatic artery. The average distance between the aortic hiatus and the coeliac trunk calculated for all the cadavers amounted to 54 mm (SD = 11.85 mm). The average distance between the coeliac trunk and the superior mesenteric artery was 11.1 mm (SD = 7.7 mm).

The anterolateral ligament of the knee: a proposed classification system: The anterolateral ligament of the knee: a proposed classification system

The anterolateral ligament (ALL) is a potential stabilizer of the knee and cooperates with the anterior cruciate ligament (ACL). It originates on the lateral epicondyle of the femur, to which it is mainly posterior and proximal; insertion is posterior to Gerdys tubercle. Its anatomical characteristics vary. Recent publications have focused on morphological variations concerning mainly the femoral and tibial attachments, and on morphometric measurements. Histological and cystochemical examinations have also been performed. Classical anatomical dissection was performed on 111 lower limbs (25 isolated and 86 paired) fixed in 10% formalin. The knee region was dissected using traditional techniques and the morphological features of the ALL were assessed: morphometric measurements and the types of ALL. The ALL was present in 70 individuals (37 woman and 33 men). In 30 cases, it was absent symmetrically, and in 11, it was present on just one side (P = 0.0011). The ALL was morphologically very variable. In type I (the most common form – 64.3%), a single band traveled parallel to the fibular collateral ligament (FCL); in type II the band crossed it. In type III, the origin was located on the lateral epicondyle of the femur and also on the lateral–posterior surface of the joint capsule, and the insertion was in the deep fascia of the leg: this type could be called a capsule. Type IV was characterized by a double ALL, type IIb by ligaments that bifurcated, and type V by the ALL starting directly from the FCL rather than the femoral epicondyle. The ALL is characterized by high morphological variability, both in its femoral and in its tibial attachments and in its course. Clin. Anat. 31:966–973, 2018.

The Plantaris Muscle Tendon and Its Relationship with the 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.

Rotator cable in pathological shoulders: comparison with normal anatomy in a cadaveric study

The rotator cable is a semicircular thickening of the glenohumeral joint capsule. It travels between tubercles of the humerus and interweaves with the supra- and infraspinatus muscle tendons. The rotator cable anchors these tendons to the tubercles, playing the role of a suspension bridge. However, little is known about the modifications of this cable that result from pathologies to the rotator cuff tendons. Thus, we aim to compare the morphology of the normal rotator cable with cables in specimens with rotator cuff injuries. The glenohumeral joint was dissected in 30 cadaveric shoulders. The supra-, infraspinatus and teres minor muscles were inspected for injuries and the rotator cable was visualised. The cables course was determined and the width, length and thickness were measured. The rotator cable was found present in all cadavers dissected. In three specimens there was a partial injury of the supraspinatus tendon (two from capsular side and one from bursal side). The rotator cable was thickened in the cases of capsular tears. In another two specimens the supraspinatus and infraspinatus muscles were torn completely and in these cases the rotator cable was blended with retracted stumps and elongated to the level of the glenoid rim. The rotator cable creates a functional complex with the supra- and infrasinatus muscles. The morphology of the cable differs in cases of rotator cuff injury.

The plantaris muscle — rare relations to the neurovascular bundle in the popliteal fossa

The plantaris muscle is characterised by morphological variability, both for origin and insertion, and may sometimes be absent. Its strength allows the ligament to be used for reconstruction of other tendons and ligaments. This report presents the rare placements and course of the plantaris muscle in relation to the neurovascular bundle. In this case, the hypertrophy of this muscle might cause pressure on the tibial nerve and produce symptoms similar to sciatica.