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Skeletal Radiology May 2016Athletic pubalgia, or "sports hernia", represents a constellation of pathologic conditions occurring at and around the pubic symphysis. These injuries are primarily seen... (Review)
Review
Athletic pubalgia, or "sports hernia", represents a constellation of pathologic conditions occurring at and around the pubic symphysis. These injuries are primarily seen in athletes or those involved in athletic activity. In this article, we review the sonographic appearance of the relevant complex anatomy, scanning technique for ultrasound evaluation of athletic pubalgia, and the sonographic appearances of associated pathologic conditions.
Topics: Adult; Athletic Injuries; Diagnosis, Differential; Female; Hernia, Inguinal; Humans; Image Enhancement; Male; Middle Aged; Multiple Trauma; Patient Positioning; Soft Tissue Injuries; Tendon Injuries; Ultrasonography; Young Adult
PubMed: 26861161
DOI: 10.1007/s00256-016-2340-8 -
Journal of Biomechanics Jan 2023Experimental observations and theoretical models suggest that the loading of muscular aponeuroses is complex, causing strain patterns that are not reconcilable with the...
Experimental observations and theoretical models suggest that the loading of muscular aponeuroses is complex, causing strain patterns that are not reconcilable with the frequently assumed mechanical "in series" arrangement of aponeuroses with muscles and tendons. The purpose of this work was to measure the in-vivo longitudinal strains of the distal and proximal aponeuroses and force of the unipennate Medial Gastrocnemius (MG) muscle during locomotor activities. Sonomicrometry crystals and a force buckle transducer were implanted to measure aponeurosis strains and MG forces in the left hindlimb of four healthy female sheep while walking at different speeds and inclination angles on a motorized treadmill. The resulting aponeurosis strains versus the corresponding muscle forces resulted in a complex interaction that is not reconcilable with a mechanical "in series" arrangement of aponeuroses with either the free tendon or muscle, as has frequently been assumed when trying to determine the storage and release of mechanical energy in muscles or the stiffness and elastic modulus of in-vivo aponeurosis tissues. We conclude that the interaction of muscle tissue with aponeuroses in the sheep MG allows for elongation of the aponeuroses at low forces in the passive muscle, while elongation in the active muscle is greatly reduced possibly due to the complex shear forces and pressures produced when the muscle is activated. It is likely that the observed aponeurosis mechanics are similar in other unipennate skeletal muscles, but the current study was limited to a single muscle and therefore does not allow for such extrapolation at this time.
Topics: Female; Animals; Sheep; Aponeurosis; Muscle, Skeletal; Tendons; Elastic Modulus; Models, Biological
PubMed: 36640614
DOI: 10.1016/j.jbiomech.2022.111430 -
Journal of Electromyography and... Feb 2016The purpose of this study was to quantify strain and elongation of the long head of the biceps femoris (BFlh) and the semitendinosus (ST) tendon/aponeurosis. Forty...
The purpose of this study was to quantify strain and elongation of the long head of the biceps femoris (BFlh) and the semitendinosus (ST) tendon/aponeurosis. Forty participants performed passive knee extension trials from 90° of knee flexion to full extension (0°) followed by ramp isometric contractions of the knee flexors at 0°, 45° and 90° of knee flexion. Two ultrasound probes were used to visualize the displacement of BFlh and ST tendon/aponeurosis. Three-way analysis of variance designs indicated that: (a) Tendon/aponeurosis (passive) elongation and strain were higher for the BFlh than the ST as the knee was passively extended (p<0.05), (b) contraction at each angular position was accompanied by a smaller BFlh tendon/aponeurosis (active) strain and elongation than the ST at higher levels of effort (p<0.05) and (c) combined (passive and active) strain was significantly higher for the BFlh than ST during ramp contraction at 0° but the opposite was observed for the 45° and 90° flexion angle tests (p<0.05). Passive elongation of tendon/aponeurosis has an important effect on the tendon/aponeurosis behavior of the hamstrings and may contribute to a different loading of muscle fibers and tendinous tissue between BFlh and ST.
Topics: Female; Humans; Isometric Contraction; Knee; Knee Joint; Leg; Male; Muscle Strength Dynamometer; Muscle, Skeletal; Range of Motion, Articular; Sprains and Strains; Tendons; Thigh; Young Adult
PubMed: 26710667
DOI: 10.1016/j.jelekin.2015.11.007 -
The Journal of Foot and Ankle Surgery :... 2022The objective of this investigation was to analyze the surgical anatomy of the endoscopic gastrocnemius recession procedure with reference to the curved nature of the...
The objective of this investigation was to analyze the surgical anatomy of the endoscopic gastrocnemius recession procedure with reference to the curved nature of the aponeurosis. A consecutive series of 34 magnetic resonance imaging scans were evaluated under the direction of a musculoskeletal radiologist. An angular calculation of the effective curvature of the aponeurosis was measured 2 cm distal to the musculotendinous junction based on the maximal posterior excursion and terminal medial and lateral edges. A frequency count was additionally performed of the number of deep intramuscular septa extending from the aponeurosis, as well as a description of the location of the neurovascular bundle in this location. The mean effective curvature was 126.5 degrees (standard deviation [SD] = 6.3 degrees, range 115-143 degrees, 95% confidence interval 124.3-128.7 degrees). We observed an average of 1.2 (SD = 0.5, range = 0-2) deep intramuscular septa extending from the aponeurosis, and that 20.6% of neurovascular bundles were located superficial to the aponeurosis in this location. In conclusion, we found that a straight cannula needs to be navigated around an approximate 125-degree angle during performance of the EGR procedure. We think that this information provides evidence of potentially unrecognized complications of this procedure and leads to future investigations demonstrating anatomic and procedural outcomes.
Topics: Endoscopy; Humans; Muscle, Skeletal; Orthopedic Procedures; Tendons
PubMed: 34848108
DOI: 10.1053/j.jfas.2021.10.030 -
Frontiers in Surgery 2022Among the few studies that have examined the development of the anterior abdominal wall, several are based on incomplete "series", substituted in many cases by non-human...
PURPOSE
Among the few studies that have examined the development of the anterior abdominal wall, several are based on incomplete "series", substituted in many cases by non-human specimens.
MATERIAL AND METHODS
In total, 19 human embryos corresponding to Carnegie stages 15-23, 36 fetuses with estimated gestational ages ranging from 9 weeks to term, and eight neonates were included in this study. All specimens belong to the collection of the Department of Anatomy and Embryology at the Complutense University of Madrid.
RESULTS
The muscles of the anterior abdominal wall appear in the dorsal region at stages 15 and 16 (33-37 days). At stages 17 and 18 (41-44 days), this muscular mass grows ventrally and splits into two sheets: the external abdominal oblique muscle and the common mass of the internal abdominal oblique, and the transversus abdominis muscles, all of which end ventrally in the primitive condensation of the rectus abdominis. In embryos at stages 19 and 20 (48 days), the anterior abdominal wall continues to show an umbilical hernia in the amniotic cavity. However, a narrow neck is apparent for the first time and there is a wider anterior abdominal wall below the hernia made up of dense mesenchyme tissue without layers and showing the primordia of the umbilical canal. In embryos at stages 21, 22, and 23 (51-57 days), the abdominal muscles and aponeuroses cross the midline (linea alba) covering the rectus abdominis and pyramidalis muscles while the umbilical hernia has shrunk. In fetuses during the 9th and 10th weeks, the umbilical hernia becomes encircled by the rectus abdominis muscle, its aponeurosis, and the three layers of lateral abdominal muscles, which are more developed and covered by Camper's and Scarpa's fasciae. The inguinal canal has a course and relationships like those described in adults, with Hesselbach's ligament.
PubMed: 35433819
DOI: 10.3389/fsurg.2022.863679 -
Indian Dermatology Online Journal Oct 2014Malignant melanoma (MM) of soft tissue, also called clear cell sarcoma (CCS) of tendons and aponeuroses, derives from the neural crest. CCS is similar morphologically to...
Malignant melanoma (MM) of soft tissue, also called clear cell sarcoma (CCS) of tendons and aponeuroses, derives from the neural crest. CCS is similar morphologically to MM but has no precursor skin lesion, and instead, has a characteristic chromosomal translocation. Prognosis is related to the tumor size. Early recognition and initial radical surgery is the key to a favorable outcome. The tumor has to be differentiated from other benign and malignant lesions of the soft tissues, such as fibrosarcoma. The demonstration of melanin and a positive immunohistochemical reaction for S-100 protein and HMB-45 can assist in the differential diagnosis. We report the case of a 58-year-old woman with CCS arising from the soft tissue of her little finger.
PubMed: 25396137
DOI: 10.4103/2229-5178.142515 -
Journal of Applied Physiology... Jun 2019During human movement, the muscle and tendinous structures interact as a mechanical system in which forces are generated and transmitted to the bone and energy is stored...
During human movement, the muscle and tendinous structures interact as a mechanical system in which forces are generated and transmitted to the bone and energy is stored and released to optimize function and economy of movement and/or to reduce risk of injury. The present review addresses certain aspects of how the anatomical design and mechanical and material properties of the force-transmitting tissues contribute to the function of the muscle-tendon unit and thus overall human function. The force-bearing tissues are examined from a structural macroscopic point of view down to the nanoscale level of the collagen fibril. In recent years, the understanding of in vivo mechanical function of the force-bearing tissues has increased, and it has become clear that these tissues adapt to loading and unloading and furthermore that force transmission mechanics is more complex than previously thought. Future investigations of the force-transmitting tissues in three dimensions will enable a greater understanding of the complex functional interplay between muscle and tendon, with relevance for performance, injury mechanisms, and rehabilitation strategies.
Topics: Animals; Aponeurosis; Collagen; Humans; Movement; Muscle, Skeletal; Tendons
PubMed: 30946635
DOI: 10.1152/japplphysiol.00671.2018 -
Factors Influencing the Lagophthalmos and Lid Lag After Simple Congenital Blepharoptosis Correction.The Journal of Craniofacial SurgeryLagophthalmos and lid lag is the most common complication after ptosis correction. Great efforts had been made to control it, but little was known about the factors...
BACKGROUND
Lagophthalmos and lid lag is the most common complication after ptosis correction. Great efforts had been made to control it, but little was known about the factors influencing it. So we ran this research to explore the possible mechanisms underlying it. This would be beneficial to solving this problem.
MATERIALS AND METHODS
In this cohort study, patients treated with the forked frontalis muscle aponeurosis suspension and levator aponeurosis-Muller's muscle complex resection were identified. Lagophthalmos height and lid lag was measured at the postoperative week 1 visits. The Spearman correlation test was run to test whether lagophthalmos was related to patients' age, levator function, and severity of ptosis. Then we measured the contents of collagen and elastin fibers of frontalis muscle fascia and levator aponeurosis from the patients and levator aponeurosis from cadaver heads histologically and compared the contents in these 3 groups.
RESULTS
No correlation was found between patients' age, levator function, the severity of ptosis, and with lagophthalmos height. However, the contents of collagen and elastic fibers were both higher in the frontalis fascia than in the normal aponeurosis tissues. The difference in collagen fibers content between frontalis muscle fascia and patients' aponeurosis was statistically insignificant.
CONCLUSIONS
The severe lagophthalmos and lid lag may be caused by the poor mechanical features of the frontalis muscle. A better source of motive force to elevate the eyelids and a novel sling material with proper elasticity and stiffness would be the solution to improve the lagophthalmos and lid lag after ptosis correction.
Topics: Humans; Blepharoptosis; Lagophthalmos; Cohort Studies; Eyelids; Fascia
PubMed: 36857565
DOI: 10.1097/SCS.0000000000008838 -
Ophthalmic Plastic and Reconstructive... 2017To investigate biomechanical properties of the levator aponeurosis.
PURPOSE
To investigate biomechanical properties of the levator aponeurosis.
METHODS
Patients undergoing external levator resection for primary or revision correction of acquired ptosis were analyzed as primary and revision groups. Immediately postoperatively, the resected segments of the levator aponeurosis were stressed by adding sequential masses to the tissue. Specimen length was recorded at each stress level. Stress-strain diagrams were used to summarize how the tissue elongated in response to the external forces, because these diagrams correct for differences in specimen size. Representative specimens were analyzed histologically.
RESULTS
Twenty-two specimens from 14 patients in the primary group and 10 specimens from 7 patients in the revision group met inclusion criteria. In the primary group, the mean age was 66 years; 8 patients were women. In the revision group, the mean age was 69 years; 6 patients were women. Levator aponeurosis specimens in both the primary and revision group demonstrated proportional increases in length with increasing stress, demonstrating that the levator aponeurosis is extensile. Given the same amount of stress, the levator aponeurosis from primary specimens elongated more than revision specimens. Histologically, revision specimens exhibited increased collagen and haphazard, tangled elastin fibers.
CONCLUSIONS
The levator aponeurosis obtained during surgical correction of acquired ptosis elongates in response to nominal external forces. This biomechanical property is important because the length of the aponeurosis may vary intraoperatively if variable forces are applied to the eyelid. This property might be related to connective tissue architecture and, specifically, fibrosis. Surgeons performing levator aponeurosis resection should be mindful to maintain a consistent amount of force on the levator aponeurosis when performing the resection to maximize intercase consistency.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Aponeurosis; Biomechanical Phenomena; Blepharoplasty; Blepharoptosis; Eyelids; Female; Humans; Male; Middle Aged; Young Adult
PubMed: 27517973
DOI: 10.1097/IOP.0000000000000731 -
Hand Clinics Aug 2018A comparison is provided between minimally invasive techniques and limited fasciectomy (LF) in the treatment of Dupuytren disease. A technique called percutaneous needle... (Review)
Review
A comparison is provided between minimally invasive techniques and limited fasciectomy (LF) in the treatment of Dupuytren disease. A technique called percutaneous needle aponeurotomy and lipofilling is described. In a randomized controlled trial, there is no significant difference between this technique and LF after 1 year in contracture correction and recurrent contractures. At 5 years postoperative, however, there is a significant change in recurrence rates in favor of LF. Patients with moderate diathesis should choose between minimally invasive technique with early recurrence, fast recovery, and few complications versus late recurrence, slower recovery, and more complications, as observed with LF or dermofasciectomy.
Topics: Adipose Tissue; Ambulatory Surgical Procedures; Aponeurosis; Clostridium histolyticum; Dupuytren Contracture; Fasciotomy; Humans; Injections, Intralesional; Microbial Collagenase; Minimally Invasive Surgical Procedures; Needles; Orthopedic Procedures
PubMed: 30012301
DOI: 10.1016/j.hcl.2018.03.010