- High-resolution ultrasound in the assessment of the distal biceps brachii tendinous complex. [Journal Article]Skeletal Radiol 2019; 48(3):395-404SR
- CONCLUSIONS: Using the systematics hereby proposed, high-resolution US is reliable for the morphometric assessment of the distal biceps brachii tendinous complex. The external bicipital aponeurosis is morphometrically the most variable structure.
- Muscles and fascial elements of the antebrachium and manus of the African elephant (Loxodonta africana, Blumenbach 1797): starring comparative and functional considerations. [Journal Article]Anat Histol Embryol 2018; 47(3):195-205AH
- The structure of the limbs of elephants is unusual among mammals. In African elephants (Loxodonta africana, Blumenbach 1797), the front limbs serve to support the greatest part of the body mass of the largest land animal. In this study, we present new and detailed anatomical data regarding muscular and specific fascial structures of the lower front limb which were examined by means of standard an…
The structure of the limbs of elephants is unusual among mammals. In African elephants (Loxodonta africana, Blumenbach 1797), the front limbs serve to support the greatest part of the body mass of the largest land animal. In this study, we present new and detailed anatomical data regarding muscular and specific fascial structures of the lower front limb which were examined by means of standard anatomical and histological techniques. The muscles and tendons of the forearm (antebrachium) and hand (manus) are tightly surrounded by thick, highly elastic fascial layers which fuse with the lacertus (lac.) fibrosus and the so-called ligamentum (lig.) humeroulnare. A well-developed musculus (m.) brachioradialis occupies the proximolateral aspect of the forearm and its tendon inserts together with the lac. fibrosus on the os carpi intermedium. The lac. fibrosus, the lig. humeroulnare and the m. flexor carpi radialis reveal a large proportion of elastic fibres. These three structures may play an important role in storing strain energy thus promoting energy-saving locomotion. On the palmar aspect of the carpus, metacarpus and digits, short flexor, abductor, adductor, lumbricales and interossei muscles are present, whereas supinator muscles are absent in all specimens. The short muscles of the hand together with specific dorsal tendons enable precise movements of specific toes.
- Bicipital aponeurosis. Anatomical study and clinical implications. [Journal Article]Rev Bras Ortop 2018 Jan-Feb; 53(1):75-81RB
- CONCLUSIONS: These results suggest that a thickened BA may be a potential factor for nerve compression, by narrowing the space through which the median nerve passes.
- Lacertus Fibrosus Versus Achilles Allograft Reconstruction for Distal Biceps Tears: A Biomechanical Study. [Randomized Controlled Trial]Am J Sports Med 2017; 45(14):3340-3344AJ
- CONCLUSIONS: The mean stiffness and load-to-failure values were not significantly different between a lacertus fibrosus construct and Achilles tendon allograft.Use of the lacertus fibrosus may be a potential alternative to Achilles tendon allograft reconstruction of chronic distal biceps tears when primary repair is not possible.
- Ultrasound visualization of an underestimated structure: the bicipital aponeurosis. [Journal Article]Surg Radiol Anat 2017; 39(12):1317-1322SR
- CONCLUSIONS: With the described sonographic approach, it should be feasible to detect alterations and unusual ruptures of the BA. Therefore, we suggest additional BA scanning during clinical examinations of several pathologies, not only for BA augmentation procedures in distal biceps tendon tears.
- Lacertus fibrosus augmentation for distal biceps brachii rupture repair: surgical technique. [Journal Article]Musculoskelet Surg 2016; 100(Suppl 1):85-88MS
- CONCLUSIONS: With this study we want to present our experience in the treatment of retracted distal biceps tendon tear with lacertus fibrosus augmentation. Our surgical technique is an effective and cheap option for chronic-retracted distal biceps tendon lesions. Recovery time is quicker, and integration is faster due to the use of an autologous vascularized graft. Preoperative ultrasound scan is mandatory in order to evaluate LF integrity, thickness and size.
- Role of pronator release in revision carpal tunnel surgery. [Journal Article]SICOT J 2016; 2:9SJ
- CONCLUSIONS: Intraoperative findings from our study confirmed that there were pathology in both carpal tunnel and pronator area in failed primary CTR with suspected PTS. Our study showed that combined PTR with revision CTR provided higher chance of completely recovery from numbness and pain more than redo CTR alone.
- Distal biceps repair using the lacertus fibrosus as a local graft. [Journal Article]J Shoulder Elbow Surg 2016; 25(7):1189-94JS
- CONCLUSIONS: When operative treatment is chosen for biceps tendon injuries and if the lacertus fibrosus is intact, transfer of the lacertus to augment repair of the distal biceps provides predictable outcomes without the potential complications associated with allograft or autograft tendon reconstruction.
- Brachialis syndrome: a rare consequence of patient positioning causing postoperative median neuropathy. [Journal Article]J Shoulder Elbow Surg 2016; 25(5):797-801JS
- CONCLUSIONS: This is the first description of the brachialis syndrome. During surgery, arms were placed into full extension, compressing the brachialis against the trochlea. The brachialis reliably developed necrosis, resulting in swelling, compressing the median nerve against the lacertus fibrosus. Two patients with delayed decompression had poor neurologic outcomes. This supports modification of patient positioning, postoperative vigilance, and timely surgical management of brachialis syndrome.
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- The Supination-Pronation Test for Distal Biceps Tendon Rupture. [Journal Article]Am J Orthop (Belle Mead NJ) 2015; 44(10):E361-4AJ
- Prompt diagnosis of a distal biceps tendon complete rupture increases the ability to perform a primary repair and to restore motion and strength. When examining an acute injury, it is important to isolate the biceps brachii tendon from the lacertus fibrosus and the brachialis because the examiner may mistakenly miss a distal tendon rupture by not isolating supination and pronation. The supination…
Prompt diagnosis of a distal biceps tendon complete rupture increases the ability to perform a primary repair and to restore motion and strength. When examining an acute injury, it is important to isolate the biceps brachii tendon from the lacertus fibrosus and the brachialis because the examiner may mistakenly miss a distal tendon rupture by not isolating supination and pronation. The supination-pronation test can be performed easily in the acute setting and confirms attachment of the biceps tendon distally to the bicipital tuberosity of the radius. If the distal biceps tendon is intact, there is substantial change in the shape of the biceps as the arm is supinated (the biceps moves proximally), then pronated (the biceps moves distally). Clinically, the supination-pronation test has been found to be a reliable, pain-free test that should be incorporated in the physical examination to evaluate patients for distal biceps injury.