Tendon Insertion (tendon + insertion)

Distribution by Scientific Domains

Selected Abstracts

Fibularis tertius: Revisiting the anatomy

K. Rourke
Abstract Fibularis tertius (FT) may be used during reconstructive surgery and muscle transposition with retention of function. The muscle was examined in both lower limbs of 41 cadavers. Measurements were made of muscle belly length and width, tendon length and width, and the size of the origin on the fibula. Tendon insertion, nerve and blood supplies were also examined. FT was absent in five (6.1%) lower limbs of three (7.3%) subjects. The size of its origin demonstrated inter- and intra-individual variation. FT arose from the distal fibula and on average occupied (28.4 ± 9.1)% (mean ± S. D.) of the total shaft length. In all cases the tendon inserted into the dorsal surface of the shafts of both the fourth and fifth metatarsals. A small nerve branch consistently arose from the deep fibular nerve near the origin of extensor digitorum longus. The nerve ran parallel to the length of this muscle, between it and extensor hallucis longus, before piercing FT. Anatomy textbooks describe FT as inserting into the fifth metatarsal only. This study, supported by data from previous reports, suggests that the "textbook" accounts of FT should be updated to record that most commonly its tendon reaches both the fourth and fifth metatarsals. Clin. Anat. 20:946,949, 2007. © 2007 Wiley-Liss, Inc. [source]

Sonoanatomy of the Achilles tendon insertion in children

Wolfgang Grechenig MD
Abstract Purpose The aim of this study was to describe typical age-related sonographic features of the Achilles tendon and calcaneal apophysis in children, providing a reference for the assessment of heel pathologies during the growth period. Methods The calcaneal apophysis and Achilles tendon insertion of 100 children 2 months to 18 years old were examined by high-frequency gray-scale and color Doppler sonography along both the longitudinal and transverse planes. The thicknesses of the apophyseal cartilage at the calcaneal tuberosity and of the Achilles tendon were measured. Also, the sonographic appearance of the bone-cartilage interface was studied. Results In children 2 months to 3 years old, the cartilage of the calcaneal tuberosity apophysis was anechoic, with small scattered echoes. In 19 of these 25 children (76%), the echogenic areas contained at least 1 small vessel, visualized on color Doppler sonography. In 15 of 25 children (60%) 4,6 years old, a wavy interface was noted at the junction of the calcaneus and the apophyseal cartilage. Conclusions High-frequency sonography can yield reliable information about the bone-cartilage interface and the Achilles tendon insertion site at the calcaneal tuberosity in children. The sonographic features of the normal heel described here may contribute to improved assessment of pathologies in this anatomic region. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:338,343, 2004 [source]

A histomorphological study of tendon reconstruction to a hydroxyapatite-coated implant: Regeneration of a neo-enthesis in vivo

C. J. Pendegrass
The attachment of tendons and ligaments to massive endoprostheses remains a clinical challenge due to the difficulty in achieving a soft tissue implant interface with a mechanical strength sufficient to transmit the forces necessary for locomotion. We have used an in vivo animal model to study patellar tendon attachment to an implant surface. The interface generated when the patellar tendon was attached to a hydroxyapatite (HA) coated implant was examined using light microscopy and a quantitative histomorphological analysis was performed. In the Autograft Group, the interface was augmented with autogenous cancellous bone and marrow graft, and at six weeks an indirect-like insertion was observed. At twelve weeks, the interface was observed to be a layered neo-enthesis, whose morphology was similar to a normal direct tendon insertion. In the HA Group, the tendon,implant interface was not augmented, and the implant was enveloped by a dense collagenous fibrous tissue. This study shows that a tendon,implant neo,enthesis can develop in situ by employing a suitable implant surface in association with biological augmentation. © 2004 Orthopaedic Research Society. Published y Elsevier Ltd. All rights reserved. [source]

Neurokinin 1-receptors and sensory neuropeptides in tendon insertions at the medial and lateral epicondyles of the humerus Studies on tennis elbow and medial epicondylalgia

Björn-Ove Ljung
Abstract There is no information on the sensory innervation at the flexor muscle origin at the medial epicondyle of the humerus and it is not known if substance P receptors (Neurokinin 1-receptors, NK1-R) are present in tendon insertions in general. In the present investigation, we have studied the muscle origin in patients suffering from medial epicondylalgia and tennis elbow. Immunohistochemistry and antibodies to substance P (SP) and CGRP as well as the general nerve marker PGP 9.5 were used. Specific immunoreactions were observed in nerve bundles and as free nerve fibers. The immunoreactive structures were partly seen in association with some of the blood vessels. The observations constitute a morphological correlate for the occurrence of nerve mediated effects in this region. By using immunohistochemistry and antibodies to NK1-R, the distribution of this receptor was studied at the insertion of the proximal tendon of the extensor carpi radialis brevis muscle at the lateral epicondyle. Specific immunoreactions were seen as varicose fibers occurring as single fibers or grouped into bundles, indicating that SP has effects in the nerves in this region. The results give further evidence for a possible neurogenic involvement in the pathophysiology of tennis elbow and in medial epicondylalgia. © 2003 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source]