Anatomic basis of minimal anterior extraperitoneal approach to the lumbar spine.

Anterior lumbar spine approaches may be indicated for fusion in degenerative lumbar spine disorders or to fill discal and bone gaps after fracture reduction. We present an anterior extraperitoneal approach applicable to any discal and vertebral levels from T12 to S1. The anatomic study, based on 25 cadavers, highlights retroperitoneal dissection principles for easy kidney and duodenopancreatic mobilisation and direct left anterior access to the entire lumbar spine.

Anatomic bases of a new technique of juxta-acetabular osteotomy. Technical principles and performance.

Pelvic osteotomies were developed to increase or restructure the acetabular surface. Periacetabular osteotomies are considered the most difficult from the technical point of view and necessitate sufficient residual cartilaginous surface. Juxta-acetabular osteotomies avoid major disorganization of the pelvic framework and allow easier reorientation of the acetabulum.

Dynamic anatomy of the acetabulum: an experimental approach and surgical implications.

The deformations and stresses acting on the acetabular rim have not been very precisely documented. The authors present a study based on an experimental simulation of hip loading with anatomic correlations. 122 dissections were performed in order to define the anatomic aspect of the roof (and especially of Byers's "area 17") and the intermediate area between the anterior and posterior acetabular cornua.

Standard and high resolution magnetic resonance imaging of glomus tumors of toes and fingertips.

Background: High-resolution magnetic resonance imaging (MRI) of subungual glomus tumors has been recently reported.

Objective: Our purpose was to compare high-resolution MRI and standard MRI for the diagnosis of 44 glomus tumors of the toes and fingertips.

Methods: Glomus tumors (11 cases) were first examined by MRI with a commercial surface coil (set 1).

MR imaging of digital mucoid cysts.

Purpose: To assess the usefulness of magnetic resonance (MR) imaging in the diagnosis and clarification of the physiopathology of digital mucoid cysts.

Materials And Methods: Twenty-three patients (14 women, nine men; aged 52-75 years) with mucoid cysts underwent MR imaging at 1.5 T with a local surface gradient coil.

The lunula: a magnetic resonance imagining approach to the subnail matrix area.

High-resolution sagittal magnetic resonance images depict an oval area in the dermis beneath the nail matrix that gives a particular signal. This study defines the magnetic resonance imaging characteristics of this area and examines its correlation with the lunula. A high-resolution surface gradient coil specially designed for skin imagining was used on a 1.

Subungual glomus tumors: evaluation with MR imaging.

Purpose: To determine the magnetic resonance (MR) imaging features of subungual glomus tumors.

Materials And Methods: Thirty-one patients with a clinical suspicion of glomus tumor and 10 control subjects underwent MR imaging at 1.5 T.

Ultrasono-anatomy of the ankle ligaments.

The ligaments of the ankle are superficial and easily accessible at ultrasonography. Surprisingly, the reliability of this technique has never been proven. With this goal in mind, ten ankles were subjected to a ultrasono-anatomic comparison.

[The frondiformis ligament and stabilization of the posterior tarsus].

The frondiformis ligament is a part of the retinaculum extensorum of the instep. Actuated by the tendons of the extensor digitorum longus, it takes a direct effect on the talus and the calcaneum, induces the valgus of the tarsus and contributes to the stability of the ankle and the foot.

Partial cervicosternotomy: a useful anterior surgical approach to the cervicothoracic junction.

Access to the cervicothoracic junction, whether by lower anterior cervical or transthoracic approach, is particularly difficult. The authors propose partial cervicosternotomy which allows the T3-T4 disk to be reached satisfactorily in 50% of cases and in the remaining 50% allows direct anterior control of the upper two thirds of T3. The advantage of this approach is that it provides direct access to the cervicothoracic junction without leading at the same time to the reconstruction problems caused by the uni- or bilateral sternoclaviculotomies proposed until now.

A study of the orientation of the fibers of the flexor carpi radialis tendon: anatomy and clinical applications.

The authors report a series of 41 dissections of the forearm intended to study the orientation of the fibers of the flexor carpi radialis (FCR). This shows that there is a constant torsion of the fibers of the FCR by an average of 180 degrees. Half of this torsion occurs in the forearm and half in the sheath of the FCR at wrist level.

Anterolateral thoracic fascia: an anatomic and surgical entity.

This anatomic study, based on six subjects, is aimed at a better description of the anterolateral thoracic fascia, not previously studied in its entirety. The literature describes a fascia of the pectoralis major m. continuous with that of the serratus anterior m.

[Extension of the fingers. IV. Morphologic and structural study].

The putting in tension of the dorsal aponeurosis of the digits induces its retraction and the nearness of its insertions on the basis of the 3 phalanges. It depends on the extensor digitorum, interosseous and lumbrical muscles. The aponeurosis is not a single driving belt, but set off in itself 3 types of reaction: 1) The gliding on the sides of the pyramid, which constitute the proximal epiphyses of the phalanges.

[Extension of the fingers. III. Morphologic and structural study].

The volar fascicles of the interosseous muscles possess two separate components: the proximal and glenoidal one, the distal and aponeurotic other. The armature of the dorsal aponeurosis is constituted the deep, the central and the collateral expansions of the extensor digitorum muscles, and the interosseous muscles, whom are added the lumbrical muscles. The deep expansions are constant and are fixed respectively at the basis of the first phalanx.

[The intermetatarsal transverse ligaments and their connections with the tarsometatarsal articulations].

The authors have performed 20 systematical dissections of the distal part of the foot, conserved in the Toulon's liquor and 3 dissections of fresh cadavers. The last ones have been submitted at different puttings in charge before and after the resection of the intermetatarsal transverse ligament. The intermetatarsal transverse ligament is supple, extensible, but very strong.

[The posterior interosseous artery. Descriptive anatomy. Possibilities of clinical and orthopedic applications].

Study of 25 forearms of fresh cadavers, whose the arteries have been injected with colored latex. The posterior interosseous artery is known for its superficial branches, which allow to autonomise cutaneous dorsal flaps. Its way, along the ulna allows to imagine other possibilities by use of the constant branches of this artery, which supplies the proximal and the distal extremities of the bone.

[Validity of the Pauwels theory: Focus on experimental methods for studying deformations of the hip joint during unilateral and bilateral weight-bearing].

A critical analysis is proposed between two experimental studies of the hip joint. Is it very important to respect the PAUWELS theory? The authors try to answer this question.

[Finger extension. II. Materials and methods].

The study of the extensor apparatus through different methods concerns 200 fingers, the most of fresh cadavers. The dissection through direct observation or with surgical microscope of the dorsal aponeurosis of 30 fingers has been completed by an histological study of 10 fingers. The mechanic properties of each dorsal aponeurotic structure has been tested by extensometry on 12 fingers.

[Finger extension. I. History. State of knowledge].

Recapitulation of the principal stages concerning the descriptive and the functional anatomy of the extensor apparatus of the ulnar digits. They can be written in the following frame: The Gálien's theories of the exclusive role of the extensor digitorum muscles prevail during more as a millenium. The indispensable conjoined action of the interosseus muscles through the collateral tendon is demonstrated by Duchene in 1867.

[The carpal synovial sheaths and their vascularization].

The synovial sheaths of the flexor digitorum of 70 pieces of fresh cadavers have been studied on the whole of their length as far as the basis of the fingers: 20 have been injected with a latex or a physiologic solution, after the ablation of the palmar aponeurosis and of the superficial palmar arch. The arteries of the 50 other pieces have been injected with coloured latex solution from humeral artery. The proximal limit of the superficial sheaths is located 5 centimetres above the radiocarpal articular line and this of the deep sheaths 7 centimetres.

Frequency and size of ossifications in the caudal attachments of the ligamentum flavum of the thoracic spine. Role of rotatory strains in their development. An anatomic study of 121 spines.

Ossifications in the caudal attachments of the ligamentum flavum were studied on 121 dried thoracic spines. Most of them were aged. Frequency increased in a caudal direction.

The meniscofemoral ligaments: magnetic resonance imaging and anatomic correlations.

Examination of the knee joint by magnetic resonance imaging (MRI) is a noninvasive technique of proven reliability as regards lesions of the menisci and ligaments. It provides good definition of the different anatomic structures. The meniscofemoral ligaments have been observed with varying frequency and may be responsible for false images.

Anatomic and radiologic bases of surgery of the thoracic aorta.

Lesions of the thoracic aorta create problems related to their site and relations with the main aortic branches. The aim of surgery must be to treat the lesion while ensuring perfusion of the tissues excluded by clamping during the operation. Anatomic study of the aortic lesions is based on imaging.

Arterial supply of the acetabulum in the fetus: application to periacetabular surgery in childhood.

The need to perform triple osteotomies of the pelvis passing very close to the articular surface leads to the isolation of bony fragments whose vascularisation may be precarious. To assess the risks of such surgery, we undertook an anatomic study of the vascularisation of the acetabulum in the fetus. 53 specimens were injected to study the vessels to the acetabulum and their distribution within the osteocartilaginous specimen.