ObjectiveThe objective of this study was to evaluate the features of flexor hallucis longus (FHL), flexor digitorum longus (FDL) and flexor digitorum accessorius (FDA) muscles with relevance to the tendon grafts and to reveal the location of Master Knot of Henry (MKH).MethodsTwenty feet from ten formalin fixed cadavers were dissected, which were in the inventory of Anatomy Department of Medicine Faculty, Mersin University. The location of MKH was identified. Interconnections of FHL and FDL were categorized. According to incision techniques, lengths of FHL and FDL tendon grafts were measured. Attachment sites of FDA were assessed.ResultsMKH was 12.61 ± 1.11 cm proximal to first interphalangeal joint, 1.75 ± 0.39 cm below to navicular tuberosity and 5.93 ± 0.74 cm distal to medial malleolus. The connections of FHL and FDL were classified in 7 types. Tendon graft lengths of FDL according to medial and plantar approaches were 6.14 ± 0.60 cm and 9.37 ± 0.77 cm, respectively. Tendon graft lengths of FHL according to single, double and minimal invasive incision techniques were 5.75 ± 0.63 cm, 7.03 ± 0.86 cm and 20.22 ± 1.32 cm, respectively. FDA was found to be inserting to FHL slips in all cases and it inserted to various surfaces of FDL.ConclusionThe exact location of MKH and slips was determined. Two new connections not recorded in literature were found. It was observed that the main attachment site of FDA was the FHL slips. The surgical awareness of connections between the FHL, FDL and FDA, which participated in the formation of long flexor tendons of toes, could be important for reducing possible loss of function after tendon transfers postoperatively.

In this study, the location and formation of the sural nerve were examined in 40 legs of new-born cadavers. The sural nerve was formed by the peroneal communicating branch from the common peroneal nerve joining the medial sural cutaneous nerve in 27 of 40 legs (67.5%). It was formed by the peroneal communicating branch from the lateral sural cutaneous nerve joining the medial sural cutaneous nerve in 4 (10%). It was formed by the peroneal communicating branch from the common peroneal nerve and fibers from the posterior femoral cutaneous nerve joining the medial sural cutaneous nerve in 2 (5%). In 5 of 40 legs (12.5%), the medial sural cutaneous nerve was in the place of the sural nerve without joining any other nerve. In one case (5%), the sural nerve was not formed bilaterally.

In this study, we focused on finding out whether branching patterns of the common fibular (CFN) and superficial fibular (SFN) nerves change throughout the early period of life. The popliteal fossa and legs on both sides of 20 fetuses (13 females and 7 males) were dissected. The ages of the fetuses varied between 20 and 36 weeks. The levels where the CFN diverged from the sciatic nerve, the CFN diverged to its terminal branches, and the cutaneous branches of the SFN became superficial and diverged were evaluated, together with the similarity of the patterns of these nerves on both sides. We observed that, comparing with the results of previous studies on adults, both the sciatic and the CFNs in the fetuses were diverging into their terminal branches more distally. Additionally, the SFN appeared to become superficial more proximally in the fetus than in the adult. SFN was piercing the crural fascia before diverging into its terminal branches in 29 legs. Only in 8 of them, it was becoming superficial within the middle one-third of the leg, which was observed more frequently in males (42.9% of 14 legs) than in females (13.3% of 15 legs). But there was no statistically significant gender difference (P = 0.07). The medial dorsal cutaneous (MDCN) and intermediate dorsal cutaneous (IDCN) nerves which were piercing the crural fascia separately were observed in 27.5% of the subjects, all females. In these, MDCN was piercing the fascia superior to the level where the SPN becomes superficial, whereas the IDCN was piercing it to a level lower to this and always in the inferior one-third of the leg. We suggest that the detailed information about the branching patterns of the CPN and SPN in early ages will be beneficial, particularly in tumor and deformity surgery. The reason for different patterns and piercing levels of the nerves may be the effect of the elongating extremity during aging that enforces the fascia and modifies its position with a more stable structure, the nerve.

The aim of this study was to better define the microsurgical anatomy of the supra/parasellar region and describe variations of the anterior clinoid process (ACP). MATERIAL and METHODS:Fifteen formalin-fixed cadaver heads and 25 dry skulls were used to define the microsurgical anatomy of the ACP and related structures. The presence of the caroticoclinoid foramen (CaCF) as well as other relevant measurements were all noted. Radiological examination of the CaCF was also demonstrated on dry skulls. RESULTS:Interosseous bridges, which form between the anterior and middle clinoid processes or connect all three (anterior, middle and posterior) clinoid processes, were found in 30% of the specimens. The average basal width, length and thickness of the ACP were 7.3 mm, 9.7 mm and 5.4 mm, respectively. Length of the optic nerve (ON) up to the falciform ligament (FL) was 10.9 mm; length of the ON under the FL was 2.7 mm; length of ON after removal of the ACP and unroofing the optic canal was 21.1 mm. CONCLUSION:This study contributes to the relationship of important vascular, neural, bone and dural layers of this region and also demonstrates the variations of ACP by means of microsurgical dissections and radiological examinations. BULGULAR: İnterosseöz köprü, anterior ve orta klinoid proçes birleşmesiyle veya diğer 3 klinoid proçesin (anterior, orta, arka klinoid proçes) birleşmesiyle oluşur ve bu varyasyon %30 oranında tespit edilmiştir. Anterior klinoid proçesin bazal genişliği, uzunluğu ve kalınlığı sırası ile 7,3 mm, 9,7 mm ve 5,4 mm olarak bulunmuştur. Optik sinirin falsiform ligamana olan uzaklığı 10,9 mm, falsiform ligaman altındaki uzaklığı 2,7 mm, optik sinirin anterior klinoid proçes alındıktan ve optik kanal açıldıktan sonraki uzunluğu 21,1 mm olarak bulunmuştur. SONUÇ:Çalışmada anterior klinoid proçes varyasyonları ve bu bölge ile ilgili önemli vasküler, nöral ve kemik yapıların ilişkisi mikrocerrahi ve radyolojik çalışma ile yeniden değerlendirilmiştir.

In neonatal and early childhood surgeries such as meningomyelocele repairs, closing deep wounds and oncological treatment, tensor fasciae lata (TFL) flaps are used.However, there are not enough data about structural properties of TFL in fetuses, which can be considered as the closest to neonates in terms of sampling. This study's main objective is to gather data about morphological structures of TFL in human fetuses to be used in newborn surgery. Fifty formalin-fixed fetuses (24 Male -26 Female) with gestational age ranging from 18 -30 weeks (mean 22.94±3.23 weeks) were included in the study. TFL samples were obtained by bilateral dissection and then surface area, width and length parameters were recorded. Digital calipers were used for length and width measurements whereas surface area was calculated using digital image analysis software. No statistically significant differences were found in terms of numerical value of parameters between sides and sexes (p>0.05). Linear functions for TFL surface area, width, anterior and posterior margin lengths were calculated as y = -225.652 + 14.417 x Age (weeks), y = -5.571 + 0.595 x Age (weeks), y = -4.276 + 0.909 x Age (weeks) and y = -4.468 + 0.779 x Age (weeks), respectively. Linear functions for TFL surface area, width and lengths can be used in designing TFL flap dimensions in newborn surgery. In addition, using those described linear functions can also be beneficial in prediction of TFL flap dimensions both in autopsy studies.