The main traumatic deformities of the extensor expansion (EE) are the boutonnière lesion (BL) and the mallet finger (MF). The classical BL is characterized by flexion deformity at the proximal interphalangeal joint, with hyperextension of the metacarpophalangeal and terminal interphalangeal joint, caused by the rupture or division of the central slip of the EE in a finger. The MF is defined as a deformity resulting from loss of EE continuity to the distal finger joint. We analyzed the frequency of location for the two hands and for fingers II–V, on 2 consecutive series of 100 cases each. We noticed a slight predominance in the right hand fingers for both types of lesions: 54% for BL, and 57% for MF. Location of BL was as follows: 8% index finger (II); 42% middle finger (III); 29% ring finger (IV) and 21% little finger (V). There was no multidigital involvement in cases of traumatic BL. Location of MF was as follows: 34% index finger (II); 23% middle finger (III); 17% ring finger (IV) and 26% little finger (V). In three clinical cases there were two fingers involved (fingers IV and V). Traumatic lesions of the EE are more frequent in the dominant hand. The BL involve most often the fingers II and III (index and middle fingers), and MF lesions are more often located in fingers III and IV (middle and ring fingers). (Supported by CNMP 62054/2008).
The group of small hepatic veins form the lower group of hepatic veins ‐ participating in the venous drainage (VD) of the caudate lobe (CL) ‐ and the lower portions of right and left hepatic lobes. VDCL was examined by a number of 150 hepatic corrosion casts; the pieces were made by injecting plastic mass in the vascularductal elements of the liver, followed by corrosion of the parenchyma with hydrochloric acid. The number of the CL veins varies from four to fifteen (average of 8.77 veins/piece). The analysis of VDCL depending collector hepatic veins (HV) demonstrates that: the left HV participates in VDCL 17.33% by the tail vein 1.3 (mean 1.80 veins/piece); the middle HV participates in VDCL 100% through the tail vein 4.8 (mean 5.2 veins/piece); the common trunk formed from the middle and left HV participates in the VDCL as a percentage of 11.11%; the right superior HV participates in VDCL as a percentage of 62.67% through the tail vein 2.4 (mean 2.75 veins/piece); the right inferior HV participates in VDCL as a percentage of 12% CL by the tail vein 1.3 (mean 2.22 veins/piece); the Inferior Vena Cava (IVC) venous drainage involved in the CL in 100% of cases, 1.4 veins (veins averaging 1.77 veine/piece). CL main venous drainage is done mainly to the Middle Hepatic Vein (98.46% of the parts) and to the retrohepatic portion of the IVC (84.09%) (Supported by CNMP 41092/2007).
Terminologia Anatomica (1998) homologates 2 ducts of caudate lobe (CLD): right (RCLD) and left (LCLD), each originating from the homonym hepatic duct (right ‐ RHD and left ‐ LHD). Our previous work evidenced variability both in origin and in number of the CLD. We analyzed on 150 hepatic corrosion casts the types of spatial distribution of CLD according to the number of ducts and the drainage level. The corrosion casts were made by injecting with plastic (AGO II paste and TECHNOVIT 7143) of the vasculo‐ductal systems, followed by parenchyma corrosion with hydrochloric acid. At first we analyzed the formation of the intrahepatic bile ducts system (IHBDS) and found 3 distinct aspects: Type I (modal, 84.67%) confluence of RHD with LHD; Type II (6%) confluence of LHD with the anterior branch (ABr) and the posterior branch (PBr); Type III (9.33%) confluence of LHD with ABr. We found 307 CLD, their number varying between 1‐3/cast (1 CLD in 13.33%; 2 in 68.67% and 3 in 18%). According to the number and drainage level of CLD we found 21 morphological types. RHD collects 32.90% of all CLD and LHD 54.72%. We found also CLD that drain into: lateral branch (1.30%) medial branch (0.32%), anterior branch (0.98%) and posterior branch (9.77%). In cases when the posterior branch drains into LHD, the number of collected CLD increases. Knowledge of CLD drainage in other elements of IHBDS than RHD and LHD is useful when planning and performing caudate lobe parenchyma surgery (Supported by CNMP 41092/2007).
Terminologia Anatomica (1998) homologates the caudate branches (CBr) of the portal hepatic vein (PHV) originating from the transverse portion of the left branch of the PHV. Our previous papers described the presence of CBr originating from other segments of the PHV. We analyzed the types of spatial distribution of CBr of the PHV according to their origin, on a number of 150 corrosion casts. The corrosion casts were made by injecting with plastic (AGO II paste and TECHNOVIT 7143) of the vasculo‐ductal systems, followed by parenchyma corrosion with hydrochloric acid. At the beginning we analyzed the branching modalities of the PHV trunk, finding three different aspects: Type I (modal, 97.33%), PHV forking into the right branch (RBr) and the left branch (LBr); Type II (2%), trifurcation of the PHV into LBr, anterior branch (ABr) and posterior branch (PBr); Type III (0.67%) bifurcation of PHV in LBr and PBr. On the study material we noticed the presence of 390 CBr, between 1‐6/cast. We found three morphological aspects of CBr: elongated (80%), forked (19.49%), in "bouquet" (0.51%). According to their number and origin, we found 23 morphological types of intraparenchymal spatial distribution of CBr of PHV. LBr is the origin of 75.39% CBr. We also found CBr from: RBr, trunk and bifurcation of the PHV, ABr and PBr. Knowledge about the CBr origin from other portions of the PHV than the transverse portion of the LBr is useful when planning and performing surgical approach of caudate lobe parenchyma (Supported by CNMP 41092/2007).
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