Morphology of the bicipital aponeurosis: a cadaveric study

Joshi, S. D.; Yogesh, AS; Mittal, P.S.; Joshi, S.S.

doi:10.5603/fm.2014.0011

Cited by 22 publications

(15 citation statements)

References 9 publications

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“…Dirim et al 12 reported that the BA consists of fibers from the short and long heads of the biceps brachii muscle; in one of 17 dissected limbs, these authors observed that only the short head contributed to BA formation. Joshi et al 13 studied 30 cadaveric limbs, 16 from the right side and 14 from the left. These authors observed that the fibers that formed the distal portion of the BA originated from the short head, while those that formed the proximal portion of the BA originated from the long head of the biceps brachii muscle.…”

Section: Discussionmentioning

confidence: 99%

Bicipital aponeurosis. Anatomical study and clinical implications

Caetano

Vieira

Almeida

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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ObjectiveThe aim of this study was to analyze the anatomic variations of the bicipital aponeurosis (BA) (lacertus fibrosus) and its implications for the compression of the median nerve, which is positioned medially to the brachial artery, passing under the bicipital aponeurosis.MethodsSixty upper limbs of 30 cadavers were dissected, 26 of which were male and four, female; of the total, 15 had been previously preserved in formalin and glycerine and 15 were dissected fresh in the Laboratory of Anatomy.ResultsIn 55 limbs, short and long heads of the biceps muscle contributed to the formation of the BA, and the most significant contribution was always from the short head. In three limbs, only the short head contributed to the formation of the BA. In two limbs, the BA was absent. The length of the bicipital aponeurosis from its origin to its insertion ranged from 4.5 to 6.2 cm and its width, from 0.5 to 2.6 cm. In 42 limbs, the BA was thickened; of these, in 27 it was resting directly on the median nerve, and in 17 a high insertion of the humeral head of the pronator teres muscle was found, and the muscle was interposed between the BA and the median nerve.ConclusionThese results suggest that a thickened BA may be a potential factor for nerve compression, by narrowing the space through which the median nerve passes.

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Section: Discussionmentioning

confidence: 99%

Bicipital aponeurosis. Anatomical study and clinical implications

Caetano

Vieira

Almeida

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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“…Overall, we found only five anatomical studies with more than 10 cadavers. In the largest series with 50 cadavers, Joshi found an average tendon length of 7.6cm and no side difference [ 14 ]. But he did not distinguish between sex and body size, as almost all other anatomical studies [ 12 , 13 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

et al. 2021

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Chronic musculotendinous retraction, shortening and fibrosis after distal biceps tendon tears makes a primary reconstruction often difficult or even impossible. Interposition reconstruction with allograft provides a solution, however there is no consensus about appropriate intraoperative graft length adjustment. Therefore, the purpose of this study was to find a practical reference value for distal biceps tendon length adjustment. Three-dimensional surface models of healthy distal biceps tendons were created based on 85 MRI scans. The tendon length was measured from the myotendinous junction to the insertion on the bicipital tuberosity. Inter-epicondylar distance (IED) and radial head diameter (RHD) were measured on antero-posterior radiographs as a surrogate for patient size. Correlations between the tendon length and IED, RHD and patient’s height (PH) were calculated. Mean length of the external part of the distal biceps tendon was 69mm (female 64mm, male 71mm). The tendon length in mm was on average 1.1 times of the IED (mm), 3 times of the RHD (mm) and 0.4 times of PH (cm). Herewith, the tendon length could be predicted within a narrow range of +/-1cm in 84% by using IED, 82% by using RHD and 80% by using PH. Intra- and inter-reader reliabililty of IED and RHD was excellent (R2 = 0.938–0.981). The distal biceps tendon length can be best predicted within 1cm with an accuracy of 82–84% using the IED and RHD with an excellent intra- and inter-reader reliability.

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“…Snoeck et al [7] measured the mean width as 0.9±0.4 cm superiorly, 1.2±0.4 cm centrally and 1.0±0.4 cm inferiorly. Joshi et al [10] dissected 30 cadaveric upper limbs (16 right, 14 left side) and measured the mean width of bicipital aponeurosis 15.74 mm on the right and 17.57 mm on the left side. In this study, the mean superior, central and inferior width of the bicipital aponeurosis were found to be 1.5±0.7 cm, 1.5±0.6 cm and 1.8±0.8 cm, respectively.…”

Section: Discussionmentioning

confidence: 99%

An anatomical study of the bicipital aponeurosis in embalmed and fresh frozen cadavers

Aktaş

Akkaşoğlu

Farımaz

et al. 2021

Anatomy

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Objectives: The bicipital aponeurosis is a fascial expansion which arises from the distal tendon of biceps brachii muscle. It is an important structure for protecting the median nerve and brachial artery. The aim of this study was to analyze the morphometry and shape of the bicipital aponeurosis and its implications for the protection of the median nerve and brachial artery. Methods: Upper extremities of two fresh frozen and seven embalmed cadavers (five right, four left sides) were dissected. The ages of the cadavers varied between 60–86 years. The central length, superior width, central width, inferior width and the shape of bicipital aponeurosis were evaluated. All measurements were performed by using digital caliper. Results: The central length of the bicipital aponeurosis was measured 3.6±1.2 cm. The superior, central and inferior width of the bicipital aponeurosis were found 1.5±0.7 cm, 1.5±0.6 cm and 1.8±0.8 cm, respectively. Through the examination of upper extremities; two different shapes of bicipital aponeurosis were observed. In type I; the bicipital aponeurosis was fusiform in shape and observed in four upper extremities. In five extremities, it was found as quadrangular in shape and classified as type II. Conclusion: The morphometry and shape of bicipital aponeurosis have a clinical importance to protect the median nerve and brachial artery or to reduce compression of these neurovascular structures. A better understanding of bicipital aponeurosis morphometry is important in assessment of biomechanical properties of biceps brachii.

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Morphology of the bicipital aponeurosis: a cadaveric study

Abstract: The bicipital aponeurosis (BA) is a fascial expansion which arises from the tendon of biceps brachii and dissipates (Folia Morphol 2014; 73, 1: 79-83)

Cited by 22 publications

References 9 publications

Bicipital aponeurosis. Anatomical study and clinical implications

Bicipital aponeurosis. Anatomical study and clinical implications

Indirect markers for length adjustment in distal biceps tendon allograft reconstruction

An anatomical study of the bicipital aponeurosis in embalmed and fresh frozen cadavers

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