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Objectives: The relationship between the mastoid triangle and the localization of the Asterion can be used in craniotomy and posterolateral surgical approaches. Therefore, we aimed to identify the relationship between the localization of the Asterion and mastoid triangle in dry skulls and its effect on surgery. Methods: Our study was performed on 93 adult skulls obtained from bone collections of the Anatomy Departments of Necmettin Erbakan University and Akdeniz University. The mastoid triangle, Asterion and linear distances between them were measured for to determine the localization of the Asterion. Results: The Asterion was located just above the Frankfurt horizontal plane on the left sides of the skulls in 54 (58.1%) specimens and on the right sides of the skulls in 71 (76.3%). It was located below the Frankfurt horizontal plane on the left sides of the skulls in 39 (41.9%) specimens; and on the right sides of the skulls in 19 (20.4%). There was a positive correlation between the distance of Asterion to apex of the mastoid process (r=0.832). Conclusion: The relationship between the mastoid process and the Asterion can be used for determination of the dural venous sinuses and neighboring neurovascular structures, in retrosigmoid posterolateral surgical approaches.

Background/aim The aim of the present study was to determine the course and possible variations of the sural nerve with all anatomical details in human fetal cadavers. Materials and methods This study was performed on 60 fetal cadavers. Formation type and level of the sural nerve was detected. Results According to trimesters, it was determined that the mean transverse and vertical distance between the lowest point of the LM and the SN varied between 1.1 and 2.9 mm and 1.54 and 3.58 mm, respectively. Type 2 was the most common seen type of sural nerve (35.83%). It was determined that the sural nerve was mostly formed at the middle third of the leg (42.5%). Conclusion Sural nerve graft with the knowledge of the anatomical details may be used for peripheral nerve reconstruction is required in congenital lesions, such as facial paralysis, obstetric brachial paralysis, and posttraumatic lesions in infants and children.

Purpose The aim of this study is to evaluate of morphometry of the lateral meniscus (LM) and determine incidence of the LM shapes. Methods This study was performed on fetal cadaver collection of Anatomy Department of Necmettin Erbakan University. Fifty human fetal cadavers (25 female, 25 male human fetal cadavers) were used in this study. Microdissection was performed. Morphometric measurements were performed. LM were classified into four types and five subtypes. Results In this study, it was identified that all parameters which were measured were found to be increased with gestational ages. Four morphological types and five morphological subtypes were determined. It was found that 12% of the LM were crescent-shaped, 66% of the LM were C-shaped, 14% of the LM were incomplete-disc-shaped, 2% of the LM were disc-shaped, 6% of the LM were variant C-shaped. Conclusions A few studies on fetal meniscal anatomy and its development were performed. Each new study is important for having detailed anatomy and development of the fetal menisci which will have both clinical and anatomical impacts during childhood and adulthood for orthopedic surgeons and anatomists, respectively. The most important results of this study were the detailed objective analysis of the macroscopic fetal growth of LM. It was significantly observed that four morphological types and five morphological subtypes of LM. The results of the present study related with both the observation of morphological development of the fetal meniscal anatomy, and its morphological variants, are important in terms of improving our knowledge, and clinical approach on the description, and the management of the symptomatic lateral discoid meniscus tears in children, adolescents, and adults. The clinical relevance of this study was that this classification of fetal menisci could ameliorate our current understanding of the morphology of lateral meniscus in adult, further.

WOS: 000450006500008, PubMed: 28943288, Introduction: The course of the infraorbital canal may leave the infraorbital nerve susceptible to injury during reconstructive and endoscopic surgery, particularly when surgically manipulating the roof of the maxillary sinus. Objective: We investigated both the morphometry and variations of the infraorbital canal with the aim to show the relationship between them relative to endoscopic approaches. Methods: This retrospective study was performed on paranasal multidetector computed tomography images of 200 patients. Results The infraorbital canal corpus types were categorized as Type 1: within the maxillary bony roof (55.3%), Type 2: partially protruding into maxillary sinus (26.7%), Type 3: within the maxillary sinus (9.5%), Type 4: located anatomically at the outer limit of the zygomatic recess of the maxillary bone (8.5%). The internal angulation and the length of the infraorbital canal, the infraorbital foramen entry angles and the distances related to the infraorbital foramen localization were measured and their relationships with the infraorbital canal variations were analyzed. We reported that the internal angulations in both sagittal and axial sections were mostly found in infraorbital canal Type 1 and 4 (69.2%, 64.7%) but, there were commonly no angulation in Type 3 (68.4%) (p < 0.001). The length of the infraorbital canal and the distances from the infraorbital foramen to the infraorbital rim and piriform aperture was measured as the longest in Type 3 and the smallest in Type 1 (p < 0.001). The sagittal infraorbital foramen entry angles were detected significantly smaller in Type 3 and larger in Type 1 than that in other types (p = 0.003). The maxillary sinus septa and the Haller cell were observed in 28% and 16% of the images, respectively. Conclusion: Precise knowledge of the infraorbital canal corpus types and relationship with the morphometry allow surgeons to choose an appropriate surgical approach to avoid iatrogenic infraorbital nerve injury. (C) 2017 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.

WOS: 000489065400003, PubMed: 29859679, Introduction: Radiologic evaluation is mandatory to assess the type of endoscopic approach concerning sinonasal pathology and reconstruction of fractured defects before any treatment modalities are instituted related to medial wall of the orbit. Objective: The goal was to provide improved understanding of the lamina papyracea variations and the relationship with the orbital morphometry. Methods: This retrospective study was performed using computed tomography scans of 200 orbits and results were compared with respect to age, sex, laterality and LP variations. Results: Lamina papyracea variations were categorized as type A, 80.5% (161/200); type B, 16% (32/200); type C, 3.5% (7/200). For medial wall the anterior and posterior lamina papyracea heights and angles were found as 17.14 mm, 147.88 degrees and 9.6 mm, 152.72 degrees, respectively. Also, the length of the lamina papyracea, the mean area of the orbital floor, medial wall, lamina papyracea and orbital entrance were 33.3 mm, 7.2 cm(2), 6.89 cm(2), 4.51 cm(2) and 12.46 cm(2) respectively. The orbital height and width were measured as 35.9 mm and 39.2 mm respectively. The mean orbital cavity depth was 46.3 mm from optic foramen to the orbital entrance and the orbital volume was 19.29 cm(3). We analyzed the morphometric measurements tending to increase with aging and greater in men and the relationship of them with lamina papyracea types. Conclusion: Precise knowledge of the lamina papyracea anatomy using computed tomography is essential for safer and more effective surgery and preforming the dimensions of an implant. In this way, the postoperative complications can be decreased and the best outcome can be provided. (C) 2019 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda.

WOS: 000444118400005, Background: The relationship between the intraorbital structures and medial wall of the orbit is essential for surgical approaches. Objective: The goal was to provide an improved understanding of the dimensions of extraocular muscles and the approximate location of the intraorbital structures with respect to the lamina papyracea (LP). Material and Methods: This retrospective study was performed using the multiplanar reconstruction of Computed Tomography (CT) scans of 200 orbits. Results: We measured the mean diameters of intraorbital structures. The mean horizontal distances from LP to medial and inferior rectus muscles, globe, and infraorbital canal were found as 3.9 +/- 1.2 mm, 11.5 +/- 1.6 mm, 7.8 +/- 1.5 mm and 16.1 +/- 2.0 mm and as 0.6 +/- 0.4 mm, 4.7 +/- 1.3 mm, 7.2 +/- 1.8 mm, 12.5 +/- 2.3 mm at the depth of the anterior (AEF) and posterior ethmoidal foramen, respectively. All morphometric results were compared with respect to age, sex and laterality and higher in males than females. The measurement results indicated that subjects in first and second age groups showed statistically significant differences in distances from the LP to the globe, medial and inferior rectus muscles at the depth of AEF (p

Introduction: Piriform aperture (PA) and nasal bone (NBs) are important structures that contribute to the formation of the nose. Both anatomic structures show differences based on ethnicity, gender, and age. Hence, it is widely used to determine sex in science branches such as anthropology and forensic medicine. Furthermore, morphometry of the PA and choana is an important criterion for physiological nasal respiration of individuals. Recognition of structural differences of PA, NB, and choana along with all this information becomes important during maxillofacial procedures to be performed especially in plastic and reconstructive surgery. The aim of the present study is to determine the individual differences in NBs, PA, and choana. Material and Methods: This study was conducted on 83 Turkish dried skulls and PA, NBs, and choana was examined as morphometrically. PA was classified into seven types and NB was classified into eight subtypes. Results: The most common type of PA was found type 5 (20%-24.1%) and the least most common type of PA was type 7 (4%-4.8%). Type 1 was determined as the most common observed shape of the NB. The mean width of the choana on the right and left sides was found 13.21 +/- 1.4 and 13.98 +/- 1.81 mm, respectively. Moreover, the mean height of the choana on the right and left sides was found 25.56 +/- 3.06 and 26.1 +/- 2.5 mm, respectively. Discussion and Conclusion: We believe that obtained data from our study will constitute a morphometric data set and will be useful in a wide range of fields from forensic science to reconstructive surgery.

La determinacion de los valores normales de las areas de superficie de la seccion transversal y las proporciones del canal vertebral de la medula espinal en los individuos sanos es de gran importancia para los medicos, para realizar un diagnostico patologico correcto y un tratamiento mas adecuado. Este estudio se llevo a cabo para determinar las respectivas proporciones entre el canal vertebral y la medula espinal a traves de la medicion transversal de areas de superficie, entre los niveles de las vertebras C3­C6. El estudio se realizo atraves de imagenes de resonancia magnetica (IRM) de la columna vertebral cervical de individuos sanos en el Departamento de Radiologia, de la Facultad de Medicina de Meram, Universidad de Necmettin Erbakan. En el estudio participaron 67 sujetos (50 mujeres, 17 hombres) entre 14 y 59 anos de edad. Los sujetos fueron divididos en dos grupos, menores y mayores de 40 anos de edad. Durante el examen de IRM cervical, se evaluaron imagenes axiales y sagitales, estas mediciones se realizaron en las imagenes axiales no patologicas. El canal vertebral y las areas de superficie de la medula espinal fueron calculados en milimetros cuadrados entre los niveles C3­C6. Ademas, se calculo el cociente entre el area de superficie de la medula espinal y la superficie del canal vertebral. Los datos obtenidos de superficie del canal vertebral, fueron transferidos al equipo y el analisis estadistico se implemento a traves del programa SPSS (para Windows, 15.0). El resumen de los datos fue declarado como Media±DE. Tambien fueron comparados grupos entre ambos sexos y por edad (menores y mayores de 40 anos de edad) atraves de la prueba t de Student. La relacion entre los parametros fue evaluada mediante la prueba de correlacion de Pearson. No se observo discrepancia significativa (P>0,05) entre hombres y mujeres en terminos del canal vertebral, y los valores de la columna vertebral de la zona de superficie dorsal. Por otro lado, a nivel C4, C5 y C6, se observo una discrepancia significativa (P

WOS: 000400464600020, The aim of our study are to determine the shape, vertebrae level, height, volume, corpus medial and lateral branch thicknesses of AG and the distance from some neighboring structures on multidetector computed tomography (MDCT) images and also to determine the relationship between these data and gender, age, height, weight and body mass index (BMI). The study was conducted on a total of 420 MDCT images consisted of 220 male (mean age 63.44 +/- 8.00, 50-81 years), 200 female (mean age 61.23 +/- 7.95, 50-84 years) healthy individuals. Vertebrae level of AG (VLAG), height of AG (HAG), adrenal gland volume (VAG), corpus thickness of AG (CTAG), medial section thickness of AG (MTAG) and lateral section thickness of AG (LTAG) were investigated. In our study, RAG were observed on T12 vertebrae level in 38.19 % of males and 42.5 % of females and LAG were also observed at that level in 39.55 % of the male and 51 % of the female individuals. RAG were observed in all males and 98.5 % of the females and LAG were observed 88.63 % of the males and 94 % of the females "Y" shaped. VAG were observed lower in males compared to females in age groups and VAG was observed increasing with age in males; decreased in 60-69 age group of females and increased again in 70 and plus age group. The aim of this study is to determine normal ranges of AG sizes and the relationship of each one with sex, age, height, weight and BMI.

Humerus is the longest and thickest bone of the upper limb. As a long bone, it has two epiphysis and diaphysis. In this study, we aimed to conduct morphometric measurements belonging to human humerus. This study was conducted on 60 humerus (28 right, 32 left) in collections of Necmettin Erbakan University Meram Medicine Faculty Anatomy Laboratory. Digital calipers, osteometric board and precision scales for humerus bone measurements were used. Measurements were classified as measurements of diaphysis and proximal and distal epiphysis of humerus. Each bone weight was determined. Also nutrient foramen number and localization was determined. In this study, it was determined that mean right humerus length 30.41 +/- 1.73 mm, mean left humerus length 30.04 +/- 2.39 mm. It was identified that mean right humerus weight was 115.05 +/- 28.06 g, mean left humerus weigh twas 111.63 +/- 33.34 g. In 9 humerus (15 %), supratrochlear foramen has been observed. 6 of these were oval and 3 of them were round. Nutrient foramen has not been observed in two humerus (3.3 %). Also, medium and weak correlation was identified between many parameters. We believe that the obtained data from this study may be qualities of reference for sex determination from humerus.

Introduction Sciatic nerve is the longest and thickest nerve of the human body which divides into two branches in popliteal fossa. Variations of sciatic nerve can be observed during the course of the nerve. These anatomical variations contribute to some clinical manifestations such as piriformis syndrome, sciatalgia. Methods This study was conducted on 60 aborted fetuses aged between 9 and 40 gestational weeks and with no gross anomalies. Morphometrical measurements related to the nerve and the neighboring structures were performed and also incidence of anatomical variations was determined. Results All parametric data were seen increased with gestational age ( p p > 0.05). The sciatic nerve division was observed in 99 (82.5%) lower extremities in the popliteal fossa, 19 (15.83%) at a level above the popliteal fossa, and in 2 lower extremities (1.67%), high division was observed. Also, the status of sciatic nerve was assessed in regard to piriformis muscle. In 118 of the lower extremities (98.3%), sciatic nerve was observed leaving from underneath the piriformis muscle as one piece and the remaining 2 (1.67%) were observed as giving division at higher levels. In one of these lower extremities of the right side, tibial nerve branch was observed following a path under piriformis muscle and common peroneal nerve was observed passing through the piriformis nerve. Discussion We believe that our study will provide data regarding the development of sciatic nerve in fetal period and that data will contribute to related clinical studies and applications.

WOS: 000302190500034, The aim of this study was to investigate the anatomy of the maxillary artery (MA) and its branches. Fourteen sides of Turkish adult cadavers were dissected. The specimens were classified according to the relation between MA and the lateral pterygoid. After the removal of the lateral pterygoid, parts and branches of MA were exposed. We classified the branching patterns of MA in the pterygopalatine fossa. The calibers and lengths of the arteries, and the distance between the zygomatic arch and MA, and between the infratemporal crest and MA were measured. The MA was found superficial to the lateral pterygoid in 57.2%. The inferior alveolar artery (IA) was arisen from MA before the middle meningeal artery (MM) in 35.7%, after MM in 35.7%. The IA and MM were arisen from the same area of MA in 14.3 %. In other two cases IA was arisen from the beginning of MA (14.3%). According to the contours of third portion of MA, we classified "Y" type (50%), "intermediate-T" type (14.3%), and "M" type (35.7%). This reinvestigation of the clinical anatomy of MA may provide useful information to the head and neck surgeons, dentists, neurosurgeons and radiologists related with this region.

The horizontal third segment (V3h) of the vertebral artery (VA) in 7 cadavers (14 sides) was dissected and the anatomical measurements recorded. Measurements from 24 healthy individuals (48 sides) were taken for comparison using multislice CT scanning. The distance between the medial tip of the VA V3h and the line passing through the mid point of the posterior tuberculum of the atlas was marked as length A. The distance between the medial tip of the VA V3h and the point penetrating the dura mater was classified as length B. The angle between these lines was the alpha (alpha) angle. Measurements were taken when the head was in a neutral position, as well as in maximum right and left rotation, extension and flexion. In cadavers, the mean alpha angle (+/-S.D.) was 82.42+/-10.34 degrees and 83.21+/-10.81 degrees on the right and left side, respectively. On multislice CT scanning, the mean alpha angle was 81.64+/-10.15 degrees on the right and 83.77+/-10.65 degrees on the left. These angles varied with the position of the head.

The course and branches of the musculocutaneous nerve (MCN) were dissected in 140 human fetal arms. The MCN entered the superior, middle, and inferior part of coracobrachialis in 43%, 37%, and 17% of arms, respectively, and the remaining 3% did not pierce coracobrachialis. The motor branches to biceps were classified as follows: Type 1 (83.6%): a single branch that bifurcated to supply the two heads of biceps; Type 2 (14.3%): two separate branches each innervating one head of biceps; Type 3 (2.1%): a single branch that bifurcated to supply each head of biceps plus an additional branch that innervated the distal part of biceps. The motor branches to brachialis were classified as follows: Type 1 (93.6%): a single branch to brachialis; Type 2 (6.4%): a single branch that bifurcated into two branches both supplying brachialis. Communications between the MCN and the median nerve (MN) were observed in 10% of specimens, of which three types (A, B, C) could be identified depending on their origin and union. In the most frequently observed type (B, 50% of cases) the communicating branch arose from the proximal part of the MCN and joined the MN in the middle or distal part of arm. The data presented here will be of use to surgeons, especially pediatric surgeons who undertake surgical procedures in the axilla and arm.

Conclusions. Our results support the proposition that bypass between the external carotid artery (ECA) and proximal posterior cerebral artery (PCA) can be achieved by using a short saphenous venous graft. The diameters of the ECA and vein graft may provide an increased blood flow with a straighter course. This technique may be helpful for management of patients with vertebrobasilar insufficiency or those requiring a high volume blood flow to the posterior circulation. Objectives. We aimed to describe a modified technique using a short saphenous vein graft for bypass between the ECA and the PCA in order to use a small length of graft material and increase the patency of the anastomosis. Materials and methods. Ten sides of five cadavers were dissected bilaterally. After a frontotemporal craniotomy and zygomatic arch osteotomy, the middle cranial fossa was exposed. A hole located approximately 2/3 cm posterolateral to the foramen rotundum was created extradurally. The sylvian fissure and the interpedincular and ambient cisterns were opened. The proximal P2 segment of the PCA was identified. The ECA was found through a cervical incision. A short interposition saphenous vein graft was conducted to pass just behind the ramus mandible to the infratemporal fossa. The bypass between the ECA and P2 segment of the PCA was performed by using a short saphenous vein graft. The diameters of the ECA, P2 segment of PCA and both ends of the saphenous vein graft and its length were measured using an electronic micrometer. Results. The mean cross-clamping time of the PCA was 10.49 /1.8 min. The mean diameters of the P2 segment of the PCA and ECA were 2.29 /0.15 mm and 3.839 /0.28 mm, respectively. The mean length of the saphenous vein graft was 88.89 /3.8 mm.

We investigated the origin, localizations and anatomic variations of the renal artery (RA) in human fetuses with the aim of determining the distribution of these variations according to lateralization and gender. In total, 90 fetuses of spontaneous abortion (45 males, 45 females) with no congenital malformations were included to the study. The abdominal aorta and its branches were dissected after latex solution colored with red ink had been injected into the vessels from the thoracic aorta. In all, 180 RA dissections were performed bilaterally in 90 cases and the anatomic variations were photographed. Right and left RAs were found to originate from the following levels according to the columna vertebralis, respectively: 3.8% and 1.9% lower T12, 67.3% and 25.0% upper L1, 9.6% and 28.8% mid L1, 15.3% and 40.3 lower L1, 3.8% and 3.8% upper 1/3 part of L2 vertebra. The right RA originated from the lateral part and anterolateral wall of the abdominal aorta in 73.0% and 26.9% of cases while the lateral and anterolateral wall origin percentages of left RA were 90.3% and 9.6%, respectively. The origin site of the right RA from the abdominal aorta was superior to, at the same level with, and inferior to that of the left RA in 53.8%, 34.6% and 11.5% of the cases, respectively. There were no variations in 75% of the cases whereas the remaining 25% had several variation patterns. The presented morphological results are as follows: A single hilar artery in 75% of the cases, double hilar arteries in 11.1%, an inferior polar artery in 10.5%, and a superior polar artery in 3.3% of specimens studied. Anatomical variations were observed more frequently among male fetuses and on the right side. Knowledge of RA variations is important for surgeons in performing many procedures and may help to avoid clinical complications, especially, during radiological examination and/or surgical approaches in the abdominal region.

Objective: This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to the supraclinoid internal carotid artery (ICA) in treating ICA occlusions.Study design and setting: This method was carried out on five adult cadaver sides. The MA was reached 1–2 cm inferior to the crista infratemporalis, following a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2–3 cm lateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4 mm tipped drill. A radial artery graft was passed through the hole to the inside of the dura. Before giving the infraorbital artery branch, the MA was dissected from the surrounding tissue and transected. The proximal end of the graft was anastomosed end-to-end with the MA and the distal end of the graft end-to-side with the supraclinoid ICA.Results: The mean calibre of the MA was 2.6 ± 0.3 mm. The mean calibre of the proximal end of the radial artery graft was 2.5 ± 0.25 mm and the distal end was 2.35 ± 0.2 mm. The mean length of the radial artery graft was 4.0 ± 0.5cm.Conclusion: This study suggested that the cases with ICA occlusion, which require high blood flow, may be treated as an alternative to current bypass methods requiring long vein grafts.

Lumbar arteries are in series with the posterior intercostal arteries. The aim of this study has been to investigate the morphometric data on the abdominal aorta of the human fetus and define different types of origin variations of the lumbar artery. Initially, the latex solution colored with red ink was injected into the thoracic aorta. The abdominal aorta and its branches were dissected and examined bilaterally in 120 fetuses (ranging between 16 and 32 post-menstrual weeks) and the anatomic variations recorded. Fourteen fetuses with variations were studied and photographed. The origins and morphologic variations of the lumbar arteries were defined and classified. The morphological relationship of the lumbar arteries to the abdominal aorta and the length and width (diameter) of the vessels were investigated by performing measurements using a digital calliper (mm). The frequency and the types of the different variations determined in the present study have been listed. Abdominal aortic branches and Lumbar artery aneurysms are rare lesions with potentially life-threatening consequences and they are difficult to access anatomically and formidable to manage operatively. During the performance of conventional or open surgical replacement of an abdominal aortic aneurysm with prosthetic grafts, the surgeon needs precise knowledge of the anatomy of the abdominal aortic branches and immediate retroperitoneal structures. The variations on the lumbar arteries may have clinical importance. When this region is under diagnostic and/or surgical investigation using computed tomography scan or diagnostic angiography, the possibility of these variations should be take into consideration to avoid complications.

Using a transantral approach, we examined a new bypass of the maxillary artery (MA) to proximal middle cerebral artery (MCA). The caliber of the MA was suitable to provide sufficient blood flow. The length of the graft was shorter and it had a straighter course in the new technique than in previously described techniques.To examine a new bypass of the MA to proximal MCA using a transantral approach as an alternative to other forms of anterior circulation bypass surgery.The method was applied to five adult cadavers bilaterally. The MA and its branches were easily found after removal of the posterior sinus wall using a transantral approach. Then, a hole was created in the sphenoid bone 5-6 mm lateral to the posteroinferior edge of the superior orbital fissure extradurally. After the carotid and sylvian cisternae had been opened, the M2 segment of the MCA was exposed. The MA was transected just before the origin of the descending palatine artery branch. After opening the dura over the hole, the MA was passed through the hole to reach the intracranial cavity. The proximal side of the superficial temporal artery graft was anastomosed end-to-end with the MA and the distal side was anastomosed end-to-side with the M2 segment of the MCA.The mean caliber of the MA was 2.4+/-0.3 mm before the origin of the descending palatine artery branch. The mean caliber of the largest trunk of the M2 segment of the MCA was 2.3+/-0.3 mm. The average length of the graft was 24+/-3 mm.

To investigate the use of a saphenous vein graft for bypass of the external carotid artery (ECA) to supraclinoid internal carotid artery (ICA) when the proximal middle cerebral artery (MCA) is not suitable for a bypass procedure.Five adult cadaver sides were used. Dissection required a frontotemporal craniotomy and a zygomatic arch osteotomy, with a hole being opened 2-3 mm lateral to the foramen rotundum extradurally. The ECA was found easily via a second incision in the cervical region. The ophthalmic segment of the ICA was exposed by removal of the anterior clinoid process intradurally. After the dura over the hole was opened, the 7-8-cm long bypass graft was passed just behind the mandibula and through the hole inside the dura to reach the ICA. The ECA was then transected proximal to the occipital artery (OA) branch and the distal side of the vein graft was anastomosed end-to-end with the ECA and end-to-side with the supraclinoid ICA.The mean diameter of the ECA proximal to the OA was 3.75+/-0.4 mm (range 3.35-4.15 mm) and that of the supraclinoid ICA was 3.4+/-0.5 mm (range 2.9-3.9 mm). The mean length of the venous graft was 7.5+/-0.5 cm (range 7-8 cm).When high blood flow is needed and the proximal MCA is not suitable for a bypass, the bypass described herein may be an alternative to a superficial temporal to MCA bypass as well as to extracranial carotid artery to MCA or ICA bypasses, which both need long vein grafts.

To examine the use of a radial artery graft for bypass of the maxillary artery (MA) to proximal posterior cerebral artery (PCA) as an alternative to the external carotid artery (ECA) to PCA anastomosis used in posterior circulation bypass surgery.The method was applied to five adult cadaver sides bilaterally. The MA was easily found 1-2 cm beneath the infratemporal crest after a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally, 2-3 cm posterolateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4-mm tipped drill. After sylvian fissure, the interpedincular and ambient cisternae were opened and the P2 segment of the PCA appeared. The graft was passed through the hole and dura to reach the P2 segment. Proximal to the infraorbital artery branch, the MA was freed from the surrounding tissue and transected. The proximal side of the radial artery graft was anastomosed end-to-end with the MA and the distal side was anastomosed end-to-side with the P2 segment of the PCA.The average diameter of the MA proximal to the infraorbital artery branch was 2.6+/-0.3 mm. The average diameter of the P2 was 2.2+/-0.2 mm. The average length of the graft was 47+/-5.2 mm.As MA to proximal PCA bypass uses a short radial graft and as the calibers of the MA and PCA are2 mm such a bypass may provide sufficient blood flow and represents a reasonable alternative to "ECA to PCA" bypass.

OBJECTIVE In this study, we aimed to investigate the use of a radial artery graft for bypass of the maxillary artery (MA) to the proximal middle cerebral artery (MCA) as an alternative to superficial temporal artery-to-MCA anastomosis or extracranial carotid-to-MCA bypass using long grafts. METHODS Five adult cadavers were used bilaterally. After a frontotemporal craniotomy and a zygomatic arch osteotomy, the MA was found easily 1 to 2 cm inferior to the infratemporal crest. A hole was created with a 4-mm-tip drill in the sphenoid bone 2 to 3 mm lateral to the foramen rotundum extradurally, and the dura over the hole was opened. After the carotid and sylvian cisterns had been opened, the M2 segment of the MCA was exposed. The graft was passed through the hole to reach the M2 segment. Then, the MA was freed from the surrounding tissue and was transected before the infraorbital artery branch. The radial artery graft was anastomosed end-to-end to the MA proximally and end-to-side to the M2 segment of the MCA distally. RESULTS The mean thickness of the MA before the infraorbital artery branch was 2.6 +/- 0.3 mm. The mean thickness of the largest trunk of the MCA was 2.3 +/- 0.3 mm. The average length of the graft was 36 +/- 5.5 mm. CONCLUSION MA-to-MCA bypass is as feasible as proximal MCA revascularization using long vein grafts. The thickness of the MA provides sufficient flow; the length of the graft is short, and it has a straight course. MA-to-proximal MCA bypass may be an alternative to superficial temporal artery-to-MCA as well as extracranial carotid-to-MCA bypasses.

The possibility for maxillary artery (MA) to petrous internal carotid artery (ICA) bypass was investigated. Five adult cadavers were dissected bilaterally. After zygomatic arch osteotomy, the coronoid process was sectioned at its base. An extensive infratemporal craniotomy was performed at the level of foramina ovale, rotundum and spinosum. The petrous portion of the ICA was exposed by drilling away the floor of the middle fossa, posterior to the foramen ovale and medial to the foramen spinosum. The MA was identified medial to the infratemporal crest and was followed in the pterygopalatine fossa, then transected at the origin of the infraorbital artery. The MA graft was brought posteromedially to reach the petrous ICA. The mean caliber of the MA before the origin of the infraorbital artery was 2.54+/-0.31 mm, 2.76+/-0.14 mm at the site of anastomosis, and 3.46+/-0.32 mm after giving off the middle meningeal artery. The average length of the MA between the middle meningeal artery and the infraorbital artery was 43.4+/-2.35 mm, and up to the site of anastomosis was 37.64+/-1.68 mm. We conclude that the length and diameter of the MA are sufficient for a tension-free anastomosis between MA and petrous ICA, and such a procedure could be used in the treatment of patients with tumors of the infratemporal fossa invading the high cervical ICA.

We present the use of radial artery graft for bypass of the proximal superficial temporal artery to the proximal middle cerebral artery. Six adult cadaver sites were used bilaterally. After apterional incision, 2x2-cm minicraniectomy was performed which began 2 cm behind the zygomatic process of the frontal bone. The superficial temporal artery was transsected before exposing the zygomatico-orbital artery branch. The proximal side of the radial artery graft was anastomosed end-to-end to the proximal superficial temporal artery and the distal side end-to-side to the proximal middle cerebral artery. The mean calibers of the proximal superficial temporal artery and largest trunk of the middle cerebral artery were 2.25+/-0.35 mm and 2.3+/-0.3 mm, respectively. The average graft length was 85+/-5.5 mm. We conclude that such bypasses are simpler than proximal middle cerebral artery revascularization using long vein grafts. This method proves that the caliber of the proximal superficial temporal artery is more suited to providing sufficient flow than the distal superficial temporal artery, and the graft is short. Such bypasses to the middle cerebral artery may be an alternative to those from the distal superficial temporal artery or extracranial carotid artery.

OBJECTIVEWe examined the anatomic variations of the brachial plexus (BP) in human fetuses.METHODSThis study was performed with 200 BPs from spontaneously aborted fetuses without detectable malformations. The plexuses were dissected, and the normal position and/or morphological variations of the BP were determined and photographed.RESULTSThere were no variations in 93 plexuses, and 107 plexuses were observed to have different variations. Morphological variations were observed more frequently among female fetuses and right sides. The BPs were composed mostly of the C5, C6, C7, and C8 nerves and the T1 nerve (71.5%). A prefixed plexus was observed in 25.5% of cases, and a postfixed plexus was observed in 2.5% of cases. In one case (0.5%), the C4 and T2 nerves joined the formation. The inferior trunk was not formed in 9% of cases. The superior trunk was not formed in 1% of cases. In one plexus, the superior trunk was formed by the ventral rami of the C4 and C5 nerves. In one case, the inferior trunk was formed by the ventral rami of the T1 and T2 nerves. Division variations were observed most frequently. There were also variations in the terminal branches, such as the roots of the median nerve joining in the distal part of the arm (8.5%), the axillary nerve being separate from the posterior division of the superior trunk (2.5%), and a connection existing between the median and musculocutaneous nerves (1%).CONCLUSIONKnowledge of BP variations is important for surgeons who perform surgical procedures in the cervical and axillary regions.

Purpose: Racial morphometric differences in the pedicular structure of the vertebrae must be taken into account when using international transpedicular screw systems. In this study, we tried to figure out the differences, if any, in the size of the pedicles in a sample of the Turkish population. Methods: The horizontal and vertical diameters of the pedicles of the lumbar vertebrae were measured from the standardized anteroposterior radiographs of the lumbar spine in 100 subjects, aged from 20 to 40 years. Results: The mean horizontal width of the pedicles in our sample of the Turkish population was smaller than the subjects in other studies. The vertical diameter did not differ widely. There was a cephalocaudal increase in the horizontal diameters in both sexes. The vertical diameters did not increase. Significant differences between the pedicle diameters of the males and the females were noted at L2, L3 and L4 levels. No significant age-related variations were observed. Conclusion: Awareness of the racial variations in the size of the pedicles is very important when using international transpedicular screw systems. Preoperative determination of especially the horizontal diameter of the pedicles to be used for screw implantation from standardized anteroposterior X-rays is the easiest way.

Joint Meeting of the Anatomical-Society-of-Great-Britain-and-Ireland / Anatomical-Society-of-Southern-Africa / Nederlandse-Anatomen-Verenigin -- APR 15-17, 1998 -- ROLDUC, NETHERLANDS, WOS: 000080162900016, PubMed: 10337964, Neurotisation involves transfer of nerves for the restoration of function following injury. A number of nerves have been used in different part of the peripheral nervous system. This study was undertaken to develop a practical and relatively safe surgical approach to the treatment of L4 root lesion's. We examined the effectiveness and safety of neurotisation of the deep peroneal nerve and its branches by the superficial peroneal nerve. Twelve legs of dissected cadavers provided for teaching purposes in the anatomy laboratory were used to display the common peroneal nerve and its branches. Each branch was measured using calipers and analysed to investigate the possibility of neurotisation of the deep peroneal nerve by the superficial peroneal nerve and its branches. It was found that of the measured branches, transposition was possible between those to peroneus longus and tibialis anterior on the basis of their diameter and length. In recent decades, advances in microsurgical reconstruction and understanding of the microanatomy have played major roles in improving the results of surgical treatment of nerve injuries. There is a need for further experimental studies on the feasibility of this surgical approach., Anatom Soc Great Britain & Ireland, Anatom Soc So Africa, Nederlandse Anatomen Verenigin

La escapula tiene tres margenes y tres angulos, y se encuentra en la region posterolateral del torax. Una de las estructuras anatomicas de la escapula es la incisura supraescapular situada medial a la base del proceso coracoides. La incisura supraescapular puede tener diferentes formas y profundidad. Esta rodeada por el ligamento escapular transverso, un ligamento corto y fuerte. Con esta estructura, crea un pasaje osteofibroso por el cual pasa el nervio supraescapular. Se ha reportado que esta estructura osteofibrosa se puede osificar completa o parcialmente. Todas las lesiones de los nervios ocurren en su trayecto como resultado de la exposicion a compresion, tension y flexion, lo que se denomina neuropatia por atrapamiento. El nervio supraescapular puede estar expuesto a compresion al pasar por la incisura supraescapular, generando neuropatia por atrapamiento. Su etiologia puede ser por traumatismo directo, microtraumatismo repetitivo y lesiones compresivas progresivas. Una incisura supraescapular de forma oval puede ser un factor predisponente para la neuropatia por atrapamiento. En un estudio retrospectivo realizado en la Universidad Necmettin Erbakan, Facultad de Medicina de Meram, Departamento de archivo de Radiologia, se observo la imagen de un varon de 68 anos con variacion en la incisura supraescapular derecha, la cual se transformo en un foramen por un puente oseo. Los diametros del foramen fueron 5,27 mm transversales y 6,48 mm verticales. Creemos que el conocimiento detallado de la incisura supraescapular es necesario en el diagnostico y posible curso de dolor del hombro, debido al atrapamiento del nervio supraescapular en la incisura y la posible paralisis nerviosa, dando una guia a los clinicos en las practicas quirurgicas.

Background: Nasal bone aplasia and hypoplasia have been reported on fetuses with aneuploidy. Trisomy 21 is one of the most common chromosomal abnormality detected in new-borns. The purpose of our study is to obtain data of some face parameters in Turkish fetal population and to contribute creation of reference ranges that may be used for prenatal diagnosis.Methods: This study was performed in 66 spontaneously aborted fetuses (47 second trimester and 19 third trimester) (28 male and 38 female) with no detectable external pathology or anomalies. Measurements were designed as nasal bone length (NBL), nose length (NL), nose width (NW), nostril width (NsW), intraocular distance (IOD), innercanthal distance (ICD), outercanthal distance (OCD), orbital diameter (OD), biparietal diameter (BPD).Results: In comparison between genders, ICD and BPD averages were found significantly higher in male fetuses than female fetuses (P

The modified medial Stoppa approach is an alternative and new surgical approach to access to the internal pelvis and medial wall of the acetabulum. There is little information about the clinical anatomic specifications of exposure in the literature. In this study, the pertinent surgical anatomy that involved the modified medial Stoppa approach was further defined and the anatomic positions and variations of the structures seen in the surgical site were analyzed.We dissected five formalized cadavers to present structures at risk in a standard modified medial Stoppa approach. The internal iliac artery and branches were colored with latex injection in formalized cadavers. Morphometrical measurements of the neurovascular structures adjacent to quadrilateral surface and their anatomic variations were noted.It was detected that the obturator vessels and nerve and the iliolumbar vessels were primarily the structures at risk. Obturator vessels and nerve were the most important structures to pay attention because of their direct contact to quadrilateral surface. There was communication (corona mortis) between obturator and inferior epigastric veins in 4 (40%) of 10 hemipelvises.Before clinical applications, performing cadaver dissection is important to minimize intraoperative complications. This study was the first anatomic study in the literature that reveals the structures that are at risk during surgical treatment of acetabular fractures, which was treated with the modified medial Stoppa approach.

In this study, a modified surgical method was carried out to repair large nasal septal perforations with a galeal pericranial flap using endoscopic technique.Six adult human cadavers were dissected by applying the classic open rhinoplasty technique. Large perforations were created in the septal cartilages. To repair the perforations, we prepared galeal pericranial flaps with supraorbital neurovascular pedicles and calvarial bone grafts under endoscopic visualization. The flaps were inserted between the upper lateral cartilages and folded into three layers. The flaps were sutured to the nasal mucosa with absorbable sutures. The length, the width, the size of the flaps and the perforations were measured using an electronic caliper and a flexible ruler.The mean length and width of the flap pedicles were measured as 26.8±5.1 mm (range 20 to 32 mm) and 19.3±2.6 mm (range 15 to 23 mm), respectively. In addition, the mean length and the width of the flaps were 54.1±4.9 mm (range 50 to 60 mm) and 51.6±7.8 mm (range 45 to 63 mm), respectively. All of the nasal septal perforations were repaired with a galeal pericranial flap.The galeal-pericranial flap is well-vascularized and similar to the nasal mucosa for tissue thickness. Therefore, reconstruction with galeal-pericranial flaps can be an alternative surgical technique for repair of large nasal septal perforations.

WOS: 000283274500043, A rare case of unilateral third head of sternocleidomastoid and an extra muscle levator claviculae were determined unilaterally in a 70-year-old male cadaver during the routine dissections. In the left neck side, it was observed that the sternocleidomastoid muscle also had a third part in addition to known sternal and clavicular heads and levator claviculae muscle which arose from the posterior tubercle of the transverse process of the 3rd cervical vertebra and attached to the posterior margin of the clavicle. An awareness of this variations may be important because of its close relationship with neurovascular structures during neck operations.

WOS: 000283061000004, PubMed: 21772798, This article investigates the possibility for the distal superficial temporal artery (STA) to proximal posterior cerebral artery (PCA) direct bypass by subtemporal oblique posterior transzygomatic approach. Five adult cadaveric specimens were dissected. Cadeveric dissection protocol was approved by the Research Ethics Committee. A preauricular vertical skin incision was made, the trunk of STA was identified, and bifurcation, frontal, and parietal branches of the STA were followed distally. Posterior zygomatic arch osteotomy and microcraniotomy were then performed, and the dura was opened. The temporal lobe was retracted, interpeduncular and ambient cisterns were opened, and the P2 segment of the PCA was exposed. Parietal branch of STA and P2 segment of the PCA was anastomosed. The average length of the transected STA from the bifurcation and the zygomatic arch were 47.3 +/- 2.1 mm and 71.4 +/- 2.3 mm, respectively. The mean calibers of the parietal and frontal branch of the STA at this distance were 1.6 +/- 0.1 and 1.4 +/- 0.2, respectively. The mean diameter of the P2 was 2.1 +/- 0.2 mm. Because of the calibers of the parietal branch of the STA and proximal PCA are over 1.5 mm and 2.0 mm, respectively, this direct end-to-side bypass technique may be a reasonable alternative in suitable cases.

WOS: 000237956600007, PubMed: 16880900, We evaluated the use of a bypass between the middle meningeal artery (MMA) and P2 segment of the posterior cerebral artery (PCA) as an alternative to an external carotid artery (ECA-to-PCA) anastomosis. Five adult cadaveric heads (10 sides) were used. After a temporal craniotomy and zygomatic arch osteotomy were performed, the dura of the floor of the middle cranial fossa was separated and elevated. The MMA was dissected away from the dura until the foramen spinosum was reached. Intradurally, the carotid and sylvian cisterns were opened. After the temporal lobe was retracted, the interpeduncular and ambient cisterns were opened and the P2 segment of the PCA was exposed. The MMA trunk was transsected just before the bifurcation of its anterior and posterior branches where it passes inside the dura and over the foramen spinosum. It was anastomosed end to side with the P2 segment of the PCA. The mean caliber of the MMA trunk before its bifurcation was 2.1 +/- 0.25 mm, and the mean caliber of the P2 was 2.2 +/- 0.2 mm. The mean length of the MMA used to perform the bypass was 32 +/- 4.1 mm, and the mean length of the MMA trunk was 39.5 +/- 4.4 mm. This bypass procedure is simpler to perform than an ECA-to-P2 revascularization using long grafts. The caliber and length of the MMA trunk are suitable to provide sufficient blood flow. Furthermore, the course of the bypass is straight.

Summary The hepatic, splenic and left gastric arteries are considered as the “main classic branches” of the coeliac trunk. During the routine dissections in the laboratory of the Anatomy Department in a 62-year-old male cadaver, a rare variation, a coeliacomesenteric trunk was observed. This trunk gave rise to the left gastric, the common hepatic, the splenic, the left gastro-epiploic, the right and left inferior phrenic arteries. The developmental and clinical significance of this anomalous vessel is discussed.

WOS: 000223570700006, PubMed: 16145598, The possibility of creating a middle meningeal. artery (MMA)-to-petrous internal carotid artery (ICA) bypass was investigated in si cadavers (bilaterally). Such a procedure could be used to treat patients with high cervical vascular lesions and those with tumors of the infratemporal fossa invading the high cervical ICA. After a frontotemporal craniotomy, the foramen spinosum and foramen ovale were exposed extradurally. Immediately posterior to the foramen ovale and medial to the foramen spinosum, the petrous portion of the ICA was exposed with a diamond-tipped drill. The MMA was lifted from its groove, and a sufficient length was transected to perform a bypass with the petrous ICA medially. The mean width of the MMA at the site of anastomosis was 2.3 +/- 0.35 mm. The mean length of MMA from the foramen spinosum to the site of the anastomosis was 9.6 +/- 1.7 mm. Based on these measurements, width and length of MMA appear to be sufficient for a bypass with petrous ICA.

In this study we aimed to investigate the normal developmental pattern of the human fetal heart in second and third trimester, and to evaluate the correlation of the values with the gestational age (GA).Seventy spontaneously aborted human fetuses with no external malformations were investigated and 11 parameters from each were assessed. The relationship of these parameters with the GA was evaluated by linear regression and correlation analyses using statistical methods. In addition, the values were compared to the gender and sides of the heart using Student t-test. This study was performed at the Department of Anatomy, Meram Medical Faculty, Selcuk University, Konya, Turkey, during the period from 2000 to 2004.There was a statistically significant linear relationship between the heart wall thicknesses, the development of the valves of the heart and GA. The mean values of the right side of the heart were found to be higher than those of the left side, and differences were statistically significant (p0.05). Although, most of the parameters were found to be higher in females, only 2 of them were statistically significant. All parameters of the cardiac valves measured were significantly higher in the second trimester. There was no difference regarding the correlation ratio of the trimesters between the pulmonary valve diameter and GA. The measurement of the cardiac valves did not show any differences regarding the gender.This study presents the normal values of the development of the fetal heart in second and third trimester that may provide useful background information for clinical approaches.

Objectives: Patients complaining with vertigo or dizziness, the pathology may be originated from central or peripheric compartment. These cases frequently apply to the Neurology, Neurosurgery, or ENT Clinics. The vertebro-basilar insufficiency is one of the most common pathologic causes of central vertigo or dizziness. This study aims to examine the use of a radial artery graft for bypass of the maxillary artery (MA) to proximal posterior cerebral artery (PCA) as an alternative to external carotid artery (ECA) to PCA anastomosis used for posterior circulation bypass surgery.Methods: This method was applied to 5 adult cadaver sides bilaterally. The MA was easily found 1−2 cm beneath to infratemporal crest, after a frontotemporal craniotomy and a zygomatic arch osteotomy. Extradurally 2−3 cm posterolateral to the foramen rotundum, a hole was drilled in the sphenoid bone with a 4−mm tipped drill. After sylvian fissure, interpedincular and ambient cisterns were opened, the P2 segment of the PCA appeared. The ...

The aim of our study was to identify congenital morphological abnormalities of distal vertebral arteries (CMADVA) and their association with cerebral hypoperfusion leading to vertigo, and the role of MR and MRA in the diagnosis of vertebrobasilar (VB) abnormalities.768 patients who complained of dizziness and/or vertigo were included in the study and evaluated by MR and MRA. CMADVAs were determined in 88 of the cases with no other explanation for vertigo and dizziness. 150 patients without dizziness or vertigo were used as a control group. The 3D TOF (Time- of- flight) MR angiographic technique was used.CMADVAs were detected in 88 of 768 patients (11.5%) with vertigo and/or dizziness. We also detected CMADVAs in 4 (2.7%) of 150 persons in the control group. The patients with abnormal vertebral artery findings were classified into ten categories. Lacunar infarcts in the brain stem were found in 8 patients after long-duration vertigo attacks. There was significant correlation between the control and vertigo groups in terms of CMADVA (p=0.0001). After excluding the control group, there was a significant relationship between CMADVA and vertigo and/or dizziness symptoms (p=0.0001).We believe that vertigo and dizziness associated with CMADVA is a real entity that deserves greater attention. For this reason, the vertebrobasilar system in these patients should be examined for CMADVA with MRA. This would enable us to take preventive measures against brainstem ischemia or at least elucidate the etiology of vertigo in these patients.

Testicular arterial anatomy has been well studied because of its importance in testicular physiology, as well as testicular and renal surgery. In contrast to classical anatomical descriptions, it may originate from the suprarenal or lumbar arteries or a high-positioned origin, course behind the inferior vena cava or be doubled or arise from an inferior polar renal artery. Different developmental patterns as variations in relation to origin, course and number of the renal and gonadal arteries have been reported and discussed. This study was performed on 90 spontaneously aborted fetuses obtained from two different hospitals in Konya. The study was carried out on the testicular or ovarian arteries of fetuses fixed by immersion in 10% formalin. In all, 180 gonadal arteries were studied and 16 of them were found to have variations in their origin (8.8%). The variations of the gonadal artery origins could be classified into four types. The gonadal artery variations were more commonly found in male than the female fetuses and on the right side rather than the left. In the present study, it is clear that these variations are important not only from the developmental point of view or research interest, but they also may explain some pathological conditions. Knowledge of these variations may help to avoid the clinical complications especially during radiological examinations and/or surgical approaches in this region.

Object. In cases of irreparable injuries to the radial nerve or in cases in which nerves are repaired with little anticipation of restoration of function, tendon transfers are widely used. In this study, the authors searched for a more natural alternative for selectively restoring function, with the aid of a motor nerve transfer. Methods. Ten arms from five cadavers were used in the study. The posterior interosseous nerve and the median nerve together with their motor branches were exposed in the proximal forearm. The possibility of posterior interosseous nerve neurotization via the median nerve through its motor branches leading to the pronator teres, flexor pollicis longus, flexor digitorum profundus, and pronator quadratus muscles was investigated. The lengths of the nerves from points of divergence and their widths were measured using calipers, and the means with standard deviations of all nerves were calculated. Motor branches to the pronator teres, flexor pollicis longus, and pronator quadratus muscles were found to be suitable for neurotization of the posterior interosseous nerve at different levels and in various combinations. The motor nerve extending to the flexor digitorum profundus muscle was too short to use for transfer. Conclusions. These results offer a suitable alternative to tendon transfer for restoring finger and wrist extension in cases of irreversible radial palsy. The second step would be clinical verification in appropriate cases.

WOS: 000169339500012, PubMed: 11430702, Opposition, one of the most important functions of the hand, is lost or impaired after median nerve injury. Complete recovery does not always occur after treatment, and various techniques of opponensplasty are used for restoring opposition. This study was performed in order to develop an alternative method for selective restoration of thenar muscle function. Ten arms from 5 cadavers were used. The median nerve with its thenar motor branch (Tb) and the anterior interosseous nerve with its motor branch to pronator quadratus (PQb) were prepared in the distal forearm. The mean widths and the number of myelinated fibres of these nerves were: PQb 1.3 +/- 0.10 mm, Tb 1.4 +/- 0.12 mm and PQb 912 +/- 88 mm, Tb 1020 +/- 93 mm. The minimum necessary distance from the distal flexor crease of the wrist for neurotisation of the Tb by the PQb was 60 +/- 5.41 mm. It was concluded that PQb-Tb neurotisation would be possible anatomically. The advantages are that motor function is reestablished with a motor nerve, the diameters and the number of myelinated fibres of both nerves are similar, the loss of function after denervation of the pronator quadratus is slight and opponensplasty still remains as a final option.

Background: Proximal ulnar-nerve lesions have an unfavorable prognosis. The goal of the present study was to evaluate the feasibility of selective restoration of motor function of the ulnar nerve by the transfer of the anterior interosseous nerve or one of its branches to the motor branch of the ulnar nerve. Methods: Ten cadaveric arms were used in the present study. The ulnar nerve and its motor and sensory branches as well as the anterior interosseous nerve and its branches were dissected. The widths of the motor branch of the ulnar nerve and the anterior interosseous nerve and its motor branches as well as the relevant distances from the points of divergence were measured. The axons were counted, and the distances from the end of the main anterior interosseous nerve, its motor branches, and the motor branch of the ulnar nerve to the level of the dorsal sensory branch of the ulnar nerve were measured. Results: Our results indicate that the length, width, and number of axons of the branch of the anterior interosseous nerve to the pronator quadratus make it suitable for transfer to the motor branch of the ulnar nerve. The use of the main anterior interosseous nerve or its motor branches to the flexor pollicis longus and the flexor digitorum profundus is less feasible because of the need to graft a long segment and the longer distance from the level of transfer to the motor end points. Conclusions: The findings of the present study confirm the feasibility of motor-nerve transfer for reconstruction after an injury of the ulnar nerve. Nerve-grafting would be needed for injuries distal to the level of the dorsal sensory branch of the ulnar nerve.