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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. [ABSTRACT FROM AUTHOR]

Suprascapular notch is characterized by variable morphology. However, its development is not well studied. We hypothesize that it proceeds postnatally. Thus, the aim of this research was to characterize the morphology of the suprascapular notch in a pediatric population based on computed tomography. A retrospective analysis was performed of 291 chest computed tomography examinations of patients under 18 years old taken following other clinical indications. The inclusion criteria were as follows: both scapulae encompassed in a field of view; no artifacts; no pathologies concerning the scapulae. Based on visual assessment and measurements, the suprascapular notch was classified according to a fivefold classification (type I, deeper than wider; type II, equally deep and wide; type III, wider than deeper; type IV, bony foramen; type V, discreet notch). In all, 173 examinations were included (60 females and 113 males). The most common suprascapular notch types were discreet notch (type V, 225 scapulae; 65.0 %) and type III (114 scapulae; 32.9 %). Children with type V suprascapular notch were significantly younger than children with other types (26.1 ± 42.4 months vs. 111.2 ± 66.7 months; p < 0.05). In types I-III, a positive correlation was found between age and dimensions of the suprascapular notch ( p < 0.05). This study provides the first description of the suprascapular notch in a pediatric population based on computed tomography. It confirms that morphology of the suprascapular notch undergoes postnatal development. [ABSTRACT FROM AUTHOR]

Purpose: The suprascapular region is the most common place for suprascapular nerve entrapment. The purpose of this research was to investigate the influence of the superior transverse scapular ligament (STSL) on the reduced space for suprascapular nerve passage at the suprascapular notch. Additionally, we precisely described other structures that seem important during arthroscopic and open procedures in this region.Methods: The study was carried out on 96 formalin-fixed cadaveric shoulders. After dissection of the suprascapular region the superior transverse scapular ligament was visualised. Measurements of the ligaments and area of the opening for the passage of the suprascapular nerve were taken using two independent methods: MultiScanBase v.14.02 software and electronic digimatic caliper.Results: In three of 96 dissected shoulders (3.1 %), a bifid superior transverse scapular ligament was discovered. Morphologically, two subtypes of bifid STSL were distinguished. The first has medially separate superior and inferior bands and a common lateral attachment. In the second subtype, independent anterior and posterior parts are fixed to the lateral border of the suprascapular notch with a common medial attachment. Singular STSL in 93 of 96 shoulders was found. The mean area of the suprascapular opening in the specimens with singular STSL was larger than in the first subtype of bifid STSL and in the second subtype of bifid STSL with anterior coracoscapular ligament.Conclusion: Knowledge of the variations of the superior transverse scapular ligament is important for better understanding of the possible anatomical conditions that can promote suprascapular nerve entrapment. Its morphology should also be taken into particular consideration during surgical and arthroscopic procedures. [ABSTRACT FROM AUTHOR]

The suprascapular notch (SSN) is the most common site of compression and injury of the suprascapular nerve (SN), which results in a neuropathy known as SN entrapment. The SSN is enclosed from the top by the superior transverse scapular ligament (STSL), creating a tunnel for the SN. On both sides of the SSN, below the STSL, the anterior coracoscapular ligament is found. This fibrous band can potentially narrow the opening and contribute to the occurrence of suprascapular entrapment syndrome. This study presents the first case of a bifid anterior coracoscapular ligament coexisting with an atypical SN course, which has never been described in the literature before. Knowledge of such anatomical variations can be helpful in arthroscopic and open procedures of the suprascapular region and confirms the safety of operative decompression for entrapment of the SN. [ABSTRACT FROM AUTHOR]

Background: Although the lateral compartment of the leg is characterized by a high degree of morphological variation, very little information exists on the morphological variability of the fibularis brevis muscle (FBM) and fibularis digiti quinti (FDQ). The main aim of the study was to characterize the morphology of the FBM tendon and its accessory bands, to classify them and to determine the incidence of FDQ. The work attempts to determine the relationship between the types of the insertion of the FBM tendon and the occurrence of FDQ., Methods: Classical anatomical dissection was performed on 102 lower limbs fixed in 10% formalin solution. The morphology of the insertion of the FBM and of the FDQ was evaluated., Results: The FBM was present in all specimens. Two types of insertion were observed, the most common being Type I (70.6%): a single distal attachment in which the tendon inserts into the tuberosity at the base of the fifth metatarsal bone. The second most common was Type II (29.4%); this group was divided into three subtypes (A-C). The FDQ was present in 17.7% of specimens and always with Type I FBM., Conclusion: Both the FBM tendon and FDQ present significant morphological variation. Two main types of the FBM tendon determine the presence of the FDQ., Level of Evidence: II Basic Science Research., (Copyright © 2019 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.)

Background: The levator palpebrae superioris muscle (LPS) acts as the upper eyelid's major elevator and retractor and is innervated by the oculomotor nerve. The muscle's paralysis is manifested by ptosis., Material and Methods: 70 orbits were dissected. After removing the orbital roof, the LPS' shape and anatomical variations (i.e., the presence of accessory muscular bands or atypical formation of the muscle) were assessed. To visualize the distribution of the oculomotor nerve's intramuscular sub-branches, the isolated levator palpebrae superioris muscles were stained using Sihler's staining technique., Results: Several LPS anatomical variations were observed in the specimens examined, in seven of which (7/70; 10%) additional delicate muscular slips arose from the LPS' lateral border and reached the lacrimal gland. Histological examination confirmed the presence of striated skeletal muscle fibers in all those cases. In three other specimens (3/70; 4.28%), supernumerary muscular bands ("tensor trochleae") were found that linked the levator with the superior oblique muscle's trochlea. In the next case, the LPS' origin was double and the muscle was bipartite on its proximal half. In most cases (55/70; 78.6%), muscular branches formed a single bundle that wrapped around the superior rectus muscle's medial border to reach the levator's inferior surface. Intramuscular sub-branches were distributed largely within the proximal two-thirds of the LPS and formed an irregular, tree-like pattern. However, thin sub-branches and small retrograde sub-branches extended as far as the muscle's insertion., Conclusions: Plastic surgeons and ophthalmologists should be aware of the levator palpebrae superioris muscle's anatomic variations both in planning and conducting surgeries on the upper eyelid., (Copyright © 2019 Elsevier GmbH. All rights reserved.)

Introduction: Identifying the branching pattern of the popliteal artery (PA) is a vital step in planning radiological and surgical procedures involving the anterior and posterior tibial and fibular arteries. The aim of this study was to characterize the course and morphology of the terminal branches of the PA., Materials and Methods: The anatomical variations in the branching patterns of the anterior and posterior tibial and fibular arteries were examined in 100 lower limbs fixed in a 10% formalin solution. A dissection of the popliteal region of the leg was carried out according to a pre-established protocol, using traditional techniques. Morphometric measurements were then obtained twice by two researchers., Results: In most cases (72%) the PA divides to form the anterior tibial artery (ATA) and a common junction for the posterior tibial and fibular arteries (type I), which further splits into the fibular artery and the posterior tibial artery (PTA). This type was subdivided into two subgroups according to whether the ATA (subgroup a) or the common junction of the posterior tibial and fibular arteries (subgroup b) had the larger diameter. Other identified variations included division of the PA into the ATA and PTA-8% (type II), trifurcation-12% (type III), the division of the PTA into the ATA and FA-8% (type IV), and aplasia of the PTA-8% (type IV)., Conclusion: Although the typical PA branching type was observed, it can be classified further into two additional sub-types based on the diameter of the ATA and the common junction of the posterior tibial and fibular arteries.

The superficial veins of the forelimb show high variability, both in man and in other primates, regarding the number of main venous trunks, their course, as well as the origin and location of openings. The distinction between two venous systems-the superficial and deep was made based on the relation of specific venous channels to the deep fascia; both groups of veins anastomose to each other through perforators piercing the deep fascia. In our work, we paid special attention to the organization of the venous system within the forelimb of the Anubis baboon ( Papio anubis ), as well as communications between the superficial and deep venous system. The main aim of the study was a detailed examination of the location of venous valves and perforating veins in forelimb of Anubis baboon. In the Anubis baboon, we observed the absence of the basilic vein. The main vessel within the forelimb, in the superficial venous system, was a well-developed cephalic vein. In all the cases, the cephalic vein opened into the external jugular vein. Also, in all of the examined specimens, there was an additional anastomosis connecting the cephalic and external jugular vein, i.e., persistent jugulocephalic vein located anterior to the clavicle. The venous vessels in the Anubis baboon were arranged in two main layers: superficial and deep, with both systems being connected by perforators located at the level of the carpus and cubital fossa. The number of venous valves within the cephalic vein was greater on the forearm the same as the mean intervalvular distance., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2019 Robert Haładaj et al.)

Purpose: The pes anserinus (PA) is characterized by high morphological diversity. As the semitendinosus and gracilis muscle tendons are routinely harvested for the reconstruction of other tendons, especially the anterior cruciate ligament (ACL), it is of clinical importance. The presence of accessory bands within PA tendons can handicap the harvesting process. Therefore, the purpose of the study was to suggest a new morphological classification of the PA morphology., Methods: Classical anatomical dissection was performed on 102 lower limbs (56 right, 46 left) fixed in 10% formalin solution. The morphology and insertion of the PA (including accessory bands) were assessed, and morphometric measurements were taken., Results: In all cases, the PA was present and composed of the sartorius, gracilis and semitendinosus tendons. Six types of PA were distinguished based on the presence of accessory bands. The most common composed of monotendinous sartorius, gracilis and semitendinosus-54 limbs (52.9%). Additionally, three types of insertion were noted (short, band-shaped and fan-shaped). The mean length between the insertion and the origin of the accessory bands to the fascia of the gastrocnemius muscle was 63.5 mm., Conclusion: The morphology of the PA was highly variable. The gracilis and semitendinosus tendons often had accessory bands that would complicate the harvesting process. The planning of surgical procedures may be improved by our proposed classification.

BACKGROUND This study aimed to describe the topographical anatomy of the supraorbital and supratrochlear nerves. Anatomical variations of both the intraorbital course of the 2 nerves and their relation to the supraorbital margin were analyzed. MATERIAL AND METHODS The research material involved 50 isolated adult cadaveric hemi-heads and 25 macerated adult skulls. All studied specimens were of Caucasian origin. RESULTS Taking into account the location of the frontal nerve division, 2 main variants of the intraorbital course of the supraorbital and supratrochlear nerves were distinguished. The first variant (variant I, 42%) involved cases in which the supraorbital and supratrochlear nerves branched off from the frontal nerve in the distal half of the length of the orbit. In the second variant (variant II, 58%), the frontal nerve branched into the supraorbital and supratrochlear nerves in the proximal half of the orbit. Variant II was characterized by the presence of a thick supraorbital nerve and a long, tiny supratrochlear nerve. For variant I, 27.8% of the supraorbital nerves were divided into the medial and lateral branch within the orbit, whereas, for variant II, 75% of nerves were divided into the medial and lateral branch within the orbit (before crossing the supraorbital margin). Single passage was observed on the supraorbital margin in 80% of wet specimens and in 78% of orbits examined on the macerated skulls. CONCLUSIONS Both the intraorbital and extraorbital course of the branches of the supraorbital and supratrochlear nerves were highly diverse. These variations should be taken into account during medical procedures performed within the orbital and frontal regions.

Background: Morphological variations of the EHL concern mainly the accessory tendons and the site of their insertion. The aim of our study is to present a new classification of the EHL., Methods: Classical anatomical dissection was performed on 104 lower limbs (51 right, 53 left, fixed in 10% formalin solution)., Results: In the cadavers, three types of morphology (insertion and addidtional band) were observed. Type I, the most common type, was characterized by a single tendon that ends as an extensor hood on the dorsal aspect of the base of the distal phalanx of the big toe (57.7%). Type II was characterized by two distal tendons and was subdivided into three subtypes according to (A-29.9%, B-4.8% and C-5.7%). Type III was characterised by three distal tendons (two cases - 1.9%)., Conclusion: The EHL presents high morphological variability. Knowledge of particular types of insertion is essential for both clinicians and anatomists.

Purpose: Our aim was to characterize the morphology of the proximal attachment of the biceps brachii short head. We hypothesize that it has an aponeurotic component that may affect shoulder joint biomechanics., Methods: The coracoacromial region and the biceps brachii muscle were dissected in 30 cadaveric shoulders. The course and dimensions of the tendon and aponeurosis were evaluated. The cross-sectional area of the belly of the short head and the length of the whole muscle were measured. Correlations between the aponeurosis and dimensions of the muscle were tested with the Spearman's rank correlation coefficient., Results: Aponeurosis was present in all specimens, although in 10 cases it was vestigial. The aponeurotic part of the muscle (mean length 90.7 ± 16.3 mm, mean width 12.5 ± 2.9 mm) branched off laterally and traveled to the acromion, blending with the coracoacromial ligament creating the aponeurotic membrane. We named this structure the "superior biceps aponeurosis". The mean length of the biceps brachii was 31.3 ± 2.1 cm and the mean cross-sectional area of the short head was 210.7 ± 54.3 mm 2 . The dimensions of the "superior biceps aponeurosis" correlated positively with the cross-sectional area of the muscle (R 2 from 0.37 to 0.52, p from 0.014 to 0.001)., Conclusion: The origin of the short head of the biceps brachii muscle has a varied aponeurotic component combining the aponeurotic part of the muscle and the aponeurotic membrane. Together, they create the "superior biceps aponeurosis"., Clinical Relevance: The morphology of the origin of the biceps brachii short head is relevant in Bristow/Latarjet procedures. This aponeurotic component may affect the shoulder joint biomechanics after the coracoid process transfer., (Copyright © 2019 Elsevier GmbH. All rights reserved.)