Is there something new regarding triceps brachii muscle insertion?

Akamatsu, Flávia Emi; Negrão, José Renato; Bordalo-Rodrigues, Marcelo; Itezerote, Ana María; Saleh, Samir; Hojaij, Flávio; Andrade, Mauro; Jácomo, Alfredo Luiz

doi:10.1590/s0102-865020200100000007

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…Second, we found the that there was a space between the deep and superficial layer (the lacuna) which presented higher (36.3%) at the specimens evaluation compare to those at the MRI evaluation (26.4%). Previous study from Akamatsu et al 13 dissected 41 en-balmed elbow specimens and found a space at the distal triceps brachii tendon insertion. Belentani et al 7 reported a split distal triceps insertion with an MRI observation which was not confirmed with histological evaluation.…”

Section: Discussionmentioning

confidence: 97%

The anatomic – magnetic resonance imaging study of distal triceps brachii tendon

Kwak

Heo

Hwang

2022

J Orthop Surg (Hong Kong)

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Purpose The study aimed to describe the distal triceps brachii insertion on the olecranon and to correlate the findings with those seen in normal MR (Magnetic Resonance) anatomy of the triceps brachii insertion. Materials and methods 14 un-paired fresh frozen elbows were included according to the institution guidelines and dissected. Histologic examination was performed to the distal triceps brachii insertion. The dimension of the distal triceps brachii tendon insertion was measured and defined based on its layer. The measurement of distal triceps brachii insertion was performed with image processing program (Image J, National Institute of Health, Bethesda, Maryland). T1-weighted elbow MR images (3.0 T) of a 102 patients were acquired and analyzed according to its sagittal plane. Results All specimens shows that distal triceps brachii tendon is with three distinct insertional areas in the olecranon which are: (1) capsular, (2) deep muscular, (3) superficial tendinous insertion with the areas of 80.7 mm2, 56.4 mm2, and 175.2 mm2, respectively. The superficial tendinous insertion was observed with a thickened portion, the “central cord” with 0.5 occupation ratio. MR analysis showed that 30% (31/102) of the distal biceps brachii insertion was with a cleft between the bipartite insertion of the superficial tendinous and the deep muscular insertion on olecranon which designated as the “lacuna” which was also found in 35% (5/14) of the specimens. Conclusions The distal triceps brachii has three distinct insertion on the olecranon. The superficial tendinous layer was separated with the deep muscular layer by a cleft in one third of the cases. Knowledge of this anatomy will help surgeon to understand the partial triceps injury and to avoid iatrogenic injury to the distal triceps tendon during surgery.

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Section: Discussionmentioning

confidence: 97%

The anatomic – magnetic resonance imaging study of distal triceps brachii tendon

Kwak

Heo

Hwang

2022

J Orthop Surg (Hong Kong)

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“…The medial head forms the deep portion of the triceps inserted into the olecranon [85] and is mainly muscular at its insertion [86]. Some authors describe the space filled with fatty tissue between these attachments like "distal pretricipital space" on MRI sections and cadaver specimens [87]. The triceps muscle is innervated by the radial nerve.…”

Section: Essential Anatomymentioning

confidence: 99%

Ultrasound-Guided Procedures in Common Tendinopathies at the Elbow: From Image to Needle

et al. 2021

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Elbow pain is a prevalent condition in musculoskeletal physicians’ settings. The majority of cases present with periarticular pathologies (varying from tendinopathy to nerve entrapment syndrome). Nevertheless, in some cases, the underlying cause can be intra-articular, e.g., loose bodies or rheumatic disease. Progress in ultrasound (US) technology has yielded high-resolution assessment of the elbow and, importantly, allows real-time, radiation-free guidance for interventions. Particularly in ambiguous cases, US imaging is necessary to arrive at the correct diagnosis. The following four clinical conditions are covered: tennis elbow, golfer’s elbow, distal biceps, and distal triceps tendinopathy. The present review illustrates cadaveric elbow anatomy, corresponding US images, and exemplary pathologies. Additionally, the authors also discuss the existing evidence on ultrasound-guided procedures in the conditions mentioned above.

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“…Several clinically oriented anatomical studies aimed to define the architecture and insertional points of the tendon of the triceps brachii muscle (Akamatsu et al, 2020 ; Barco et al, 2017 ; Belentani et al, 2009 ; Madsen et al, 2006 ; Negrao et al, 2020 ; Wegmann et al, 2022 ). Such knowledge is highly appreciated in the surgical management of injuries to the tendon or other interventions concerning the elbow joint, such as fractures of the distal humerus and olecranon, elbow arthroplasty, and harvest of the olecranon graft in recurrent elbow instabilities (Barco et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Does the articularis cubiti muscle really exist? Anatomical, histological, and magnetic resonance imaging study with a narrative review of literature

et al. 2023

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Although the term articularis cubiti muscle is incorporated in the official anatomical nomenclature, only sparse data about its appearance are available. It is usually described as few fibres originating from the medial head of the triceps brachii muscle and inserting to the capsule of the elbow joint. However, the most recent observations regarding the morphological relations in the posterior elbow region point towards the absence of a well‐defined muscle. Therefore, this study was designed to verify the existence of the articularis cubiti muscle in question and to compile more data on the topographical features of the subtricipital area near the posterior aspect of the elbow. To address these questions, 20 embalmed upper limbs were dissected, and seven samples were collected for histological analysis. The laboratory findings were then correlated with 20 magnetic resonance imaging (MRI) scans of the elbow. Consequently, a narrative review of literature was performed to gain more information on the discussed muscle in a historical context. Upon the anatomical dissection, muscular fibres running from the posterior aspect of the shaft of the humerus to the elbow joint capsule and olecranon were identified in 100% of cases. Histologically, the connection with the joint capsule was provided via winding bands of connective tissue. On MRIs, the muscular fibres resembled a well‐demarcated thin muscle located underneath the medial head of the triceps brachii muscle. Combined with the review of literature, we concluded that the constant articularis cubiti muscle originates from the posterior shaft of the humerus and attaches indirectly to the posterior aspect of the elbow joint capsule and directly to the superior portion of the olecranon. The obtained results slightly differ from the modern description, but are in agreement with the original publication, which has become misinterpreted throughout time. Presumably, the misused description has led to questioning the existence of an independent muscle. Moreover, our findings attribute to the articularis cubiti muscle, a function in pulling on the posterior aspect of the elbow joint capsule to prevent its entrapment, and possibly also a minor role in extension of the forearm. The presented results should be taken into consideration when intervening with the posterior aspect of the elbow joint because the articularis cubiti muscle poses a consistently appearing landmark.

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Is there something new regarding triceps brachii muscle insertion?

Cited by 3 publications

References 15 publications

The anatomic – magnetic resonance imaging study of distal triceps brachii tendon

The anatomic – magnetic resonance imaging study of distal triceps brachii tendon

Ultrasound-Guided Procedures in Common Tendinopathies at the Elbow: From Image to Needle

Does the articularis cubiti muscle really exist? Anatomical, histological, and magnetic resonance imaging study with a narrative review of literature

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