"Fetal Anatomical Variability of Muscles and Neurovascular Bundles of the Anterior Brachial Region"

Хмара, Т. В.; KOVAL, Oleksandr A.; ILIKA, Vitalii V.; Kryvchanska, М. І.

doi:10.31688/abmu.2022.57.3.05

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…У цій статті ми докладно не описуватимемо особливості поза-і внутрішньом'язового розподілу артерій і нервів у кожному м'язі плеча, оскільки ці дані опубліковані нами раніше [10,11], а обмежимося лише характеристикою топографоанатомічних взаємовідношень судинно-нервових структур у м'язах передньої та задньої груп плеча та узагальненням їхньої концентрації на різних рівнях плечової ділянки.…”

Section: вступunclassified

Topographic and Anatomical Relationships of Intramuscular Arteries and Nerves in the Shoulder Region of Human Fetuses

Koval

2023

Act. Probl. of the Modern Med.

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In modern surgical practice, there is a growing need to improve techniques of operative interventions. Despite advancements in diagnosis and treatment, combined shoulder injuries remain a pressing problem. In the past, surgical intervention for combined trauma primarily focused on saving the patient's life. However, today it is essential not only to preserve life but also to restore the function of the injured structures. Humerus fractures are observed in 27.9% of polytrauma cases, significantly complicating urgent diagnostic and treatment procedures and worsening the patient's condition. A comprehensive study of the topographical and anatomical relationships of intramuscular arteries and nerves at the shoulder level can facilitate the selection of optimal surgical approaches, prevent iatrogenic damage, and contribute to the patient's rapid rehabilitation. The objective of this study was to identify the distribution patterns of arteries and nerves at different levels of the shoulder in human foetuses. Materials and Methods. The study involved the examination of upper limb preparations from 48 human foetuses, ranging from 81.0 to 370.0 mm in parietal-caudal length without external signs of anatomical deviations or anomalies in the development of the skeletal and muscular structures of the upper limbs. Macromicroscopic dissection, vessel injection, and morphometry techniques were employed. Results and Discussion. In human foetuses, the upper and middle thirds of the shoulder were found to have the highest concentration of intramuscular arteries and nerves. The entry points of arteries and nerves, their topography and branching patterns within the shoulder muscles did not always align. Arterial branches generally entered the muscles at slightly more distal locations than the nerve trunks, following the shortest path to reach the muscles. The levels at which arteries and nerves start branching to supply and innervate the muscles of the anterior and posterior shoulder groups, vary in human foetuses. This variation depends on the individual anatomical variability of the major vascular and nerve trunks. Conclusion: The levels of arterial and nerve abduction are related to the topographic and anatomical features of a particular shoulder muscle. Considering the topography of intramuscular arteries and nerves, it is advisable to perform incisions along the direction of muscle bundles, particularly near the lower border of the neurovascular unit of the brachial biceps. This approach can offer higher clinical and surgical effectiveness.

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Section: вступunclassified

Topographic and Anatomical Relationships of Intramuscular Arteries and Nerves in the Shoulder Region of Human Fetuses

Koval

2023

Act. Probl. of the Modern Med.

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“…При цьому трансплантація м'язів верхньої кінцівки та їхніх сухожилків без знання варіантів будови кожного окремого м'яза передньої і задньої груп плеча та передпліччя, а також топографо-анатомічних взаємовідношень їхніх судин і нервів є проблематичною. Ця публікація є продовженням проведених раніше нами досліджень, присвячених фетальній анатомічній мінливості м'язів, судин і нервів верхньої кінцівки [8][9][10].…”

Section: оригінальні дослідженняunclassified

Variants of the Structure, Innervation, and Blood Supply of the Extensor Carpi Radialis Longus and Brevis in the Human Fetus

Koval¹,

Khmara²,

Слободян³

2022

CAOS

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In modern orthopedic practice, some diseases do not cause pronounced functional disorders in the anatomical segments of the limbs but are accompanied by persistent pain syndrome. Among such diseases is lateral epicondylitis, or «tennis elbow». The superﬁ cial extensor muscles of the posterior group of the forearm begin in the region of the lateral epicondyle of the humerus, in particular the extensor carpi radialis longus and brevis. The deepening of knowledge about the typical and variant structure, topography, blood supply, and innervation of the extensor carpi radialis longus and brevis in human fetuses will allow for improving the approach to carrying out existing fetal surgical techniques, as well as to creating foundation for the development of modern surgical approaches.The study aimed to determine the anatomical variability of the extensor carpi radialis longus and brevis in human fetuses.The study was conducted on preparations of the upper limbs of 36 human fetuses aged 4-10 months using macromicroscopic preparation, vascular injection, and morphometry. The topographical and anatomical features of the extensor carpi radialis longus and brevis in human fetuses are elucidated: variability and bilateral asymmetry of the external shape and size, variability of the places of origin and attachment, variants of blood supply and innervation, patterns of intramuscular distribution arteries and nerves in these muscles. It was found that the zone of the greatest concentration of intramuscular nerves and arteries is the upper and middle third of the bellies of the extensor carpi radialis longus and brevis.Despite the good blood supply of the extensor carpi radial muscles, the relatively small size of their muscle bellies and the transverse course of the intramuscular nerves result in limited opportunities for cutting out muscle ﬂ aps from them. To cut the ﬂ aps on the leg from these muscles, the most rational cuts are in the ascending (transverse) direction, coinciding with the course of the main intramuscular nerves and arteries. Thus, it is possible to use the extensor carpi radialis longus and brevis only for plastic ﬁ lling of the remaining bone cavities of the upper third of the posterior- lateral surface of the radius.The movement of the extensor carpi radialis longus and brevis is also complicated by the fact that their tendons cross the abductor pollicis longus muscle, extensor carpi radialis longus and brevis, and create serious obstacles for the mobilization of these tendons.Knowledge of the classic and variant anatomy of the arteries of the upper limb, and in particular the described topographic and anatomical features of the right brachial radial artery in a 6-month-old fetus, will allow choosing the correct treatment tactics and avoiding iatrogenic injuries during manipulations, diagnostic and surgical interventions.

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"Fetal Anatomical Variability of Muscles and Neurovascular Bundles of the Anterior Brachial Region"

Cited by 2 publications

References 17 publications

Topographic and Anatomical Relationships of Intramuscular Arteries and Nerves in the Shoulder Region of Human Fetuses

Topographic and Anatomical Relationships of Intramuscular Arteries and Nerves in the Shoulder Region of Human Fetuses

Variants of the Structure, Innervation, and Blood Supply of the Extensor Carpi Radialis Longus and Brevis in the Human Fetus

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