Blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site seems anatomically possible without injuring any neurovascular structures.
Aim: Foot morphology and anthropometry are known to be associated with biomechanical measurements of foot. The medial longitudinal arch (MLA), which is the main arch contributing to the foot morphology, provides an elastic connection between the forefoot and hindfoot. Problems and alignment disorders, specifically caused by MLA, such as pes cavus and pes planus, ultimately affect the functions of the muscles and joints of the lower extremity. In this study, we aimed to investigate the relation between MLA and bony-length of foot by making measurements on radiographs. Material and Method: 212 (106 right and 106 left sides) weightbearing lateral x-ray images of 106 patients (36 females, 70 males) aged between 18-80 (m: 18-75, f: 18-80) were evaluated. Images of the patients aged under 18 or above 80, with any sign of trauma or surgery, space-occupying lesion of foot or deformity of foot bones were excluded. The maximal bony-length of the foot and in order to evaluate the medial longitudinal arch (MLA) the angle between the calcaneus and the 1st metatarsal bone and calcaneal inclination angle were measured on the x-ray images. The results were evaluated statistically.
Objectives: Botulinum toxin is frequently applied to the sternocleidomastoid muscle (SCM) for torticollis treatment. During this application, bulb of the jugular vein located under SCM makes the interventions unsafe. Also, injecting the botulinum toxin into the infrahyoid muscles which lie under SCM may cause hoarseness and swallowing disorders. The aim of this study was to describe the most reliable and appropriate botulinum toxin injection sites to the SCM to avoid injury to neighboring neurovascular structures and adjacent muscles. Methods:In ten male cadavers, SCM was evaluated in three equal segments (upper, middle and lower). Muscle width and thickness at the center of each segment were measured. In one male cadaver, colored latex was injected according to the results of the measurements. Results:The respective mean width of upper, medial and lower segments were 33.15 (23-41) mm, 36.45 (28-45) mm and, 39.35 (15-50) mm, respectively. The mean thickness of upper, medial and lower segments were 5.29 (3.87-7.68) mm, 5.89 (3.56-8.32) mm and 3.60 (0.69-7.75) mm, respectively. There was no significant difference between the right and left sides. The thickest part of the muscle was the middle part, and the lower part was the thinnest. When the colored latex injected cadaver was dissected, the center of the muscle was observed as colored, while the neighboring structures were avoided. The thickest and safest part of SCM for the botulinum toxin injections was the middle part. Conclusion:Knowing the thickness of SCM will make the botulinum toxin applications to this muscle safer and easier.
The bicipital aponeurosis (BA) is the distal aponeurosis of the biceps brachii which usually covers the median nerve (MN), and the brachial artery (BrA) and sometimes causes compression of these structures. Since these situations are rarely reported in the literature, BA frequently does not come to mind as a cause of such compression.Therefore, the diagnosis may be delayed. In this study, we aimed to investigate the morphometry of BA and its relationship with the surrounding neurovascular structures and to draw attention to BA as a structure that can cause entrapment of the MN and rarely, the BrA. We examined the MRIs of the elbow of 279 patients (107 women, 172 men) aged between 18 and 72 years. We measured the thickness, length and width of BA, and investigated the anatomical relationship between BA, BrA, and MN. The respective median thickness, width, and length of BA were 0.7 (0.4-1.8 mm), 18.0 (6.0-34.0 mm), and 32.0 (18.0-50.0 mm), respectively. In all sections examined, the BA covered the BrA and MN, and was located immediately anterior to the BrA. In 225 (80.6%) of 279 MRIs, the BrA was located anterior to the MN and posterior to the BA. In the remaining 54 (19.4%) MRIs, the MN was located anterior to the BrA and posterior to the BA. The respective median thickness, width, and length of the BA were 0.7 mm, 18.0 mm, and 32.0 mm, respectively. It covered the BrA and MN and was located immediately anterior to the BrA. The BA sometimes causes compression syndromes of these structures, therefore, for physicians, it is important to understand the anatomy of the BA.
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