The plastination methods were excellent methods to analyze the arterial supply. In addition arterial damage after forefoot surgeries could be analyzed with these methods.
The aim of this study was to analyze the arterial supply of the sesamoid bones of the hallux. Twenty-two feet from adult cadavers were injected with epoxide resin or an acrylic polymer in methyl methacrylate (Acrifix) and subsequently processed by two slice plastination methods and the enzyme maceration technique. Afterwards, the arterial supply of the sesamoid bones was studied. The first plantar metatarsal artery provided a medial branch to the medial sesamoid bone. The main branch of the first plantar metatarsal artery continued its course distally along the lateral side of the lateral sesamoid and supplied it. The supplying arteries penetrated the sesamoid bones on the proximal, plantar, and distal sides. The analysis and cataloging of the microvascular anatomy of the sesamoids revealed the first plantar metatarsal artery as the main arterial source to the medial and lateral sesamoid bones. In addition, the first plantar metatarsal artery ran along the lateral plantar side of the lateral sesamoid bone, suggesting that this artery is at increased risk during soft-tissue procedures such as hallux valgus surgery.
Although the clinical and functional importance of gliding and connective tissue spaces has been repeatedly emphasized (e.g. their role in the spreading of suppurative phlegmonic inflammation) only few literary findings can be presented dealing with the connective tissue spaces in the finger in the metacarpo-phalangeal transition region. Three separate gliding spaces of the finger above the dorsal aponeurosis and their various regional connections can be displayed by means of a plastic injection technique followed by plastination and production of sectional series. These gliding spaces were also examined on fixed and unfixed hands using plastic injection and subsequent dissection. A space was depicted between the proximal interphalangeal joint and the insertion of the dorsal aponeurosis on the distal phalanx of the finger, as well as a further bursa-like space over the proximal interphalangeal joint. A third space was also depicted between the metacarpophalangeal joint and the proximal interphalangeal joint, which displays a variable connection to the gliding canal of the respective extensor tendons. Methodical, functional and clinical aspects will be discussed.
The implantation of an interspinous "stand-alone" spacer significantly minimises the force necessary to disrupt the ISL/SSL complex. After posterolateral percutaneous IPD implantation, the thoracolumbar fascia and associated musculature, which act in synergy with the ISL/SSL complex to stabilise the vertebral column, remain intact.
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