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Fetal Kadavralarda Plantaris’in Morfometrik ve Morfolojik Analizi

Yıl 2022, Cilt: 32 Sayı: 3, 245 - 251, 01.08.2022
https://doi.org/10.54005/geneltip.1033580

Öz

Amaç: Musculus plantaris, bacağın arka kısmında yer alan, kısa bir karın ve uzun, ince bir tendona sahip olan bir kastır. Musculus gastrocnemius ile birlikte fonksiyon gösterir. Bu kasın kaldırılması ekstremite fonksiyonunda bir değişikliğe neden olmadığından, potansiyel bir greft kaynağı olarak kullanılır. Çalışmamızda fetal kadavralarda musculus plantaris’in morfolojik özelliklerinin olası varyasyonlarının araştırılması amaçlanmıştır.
Gereç ve yöntemler: Bu çalışma, Necmettin Erbakan Üniversitesi, Tıp Fakültesi, Anatomi Anabilim Dalı’nda yer alan fetal kadavra koleksiyonu üzerinde gerçekleştirilmiştir. Çalışmada gestasyonel yaşları 28 ile 40 hafta arasında değişen 11 erkek ve 9 dişi fetal kadavra kullanılmıştır. Kasın karın uzunluğu (LB), genişliği (WB) ve kalınlığı (TB) ölçüldü. Kas tendonunun sonlanması 4 tip altında sınıflandırıldı. Ayrıca, sonlanma tendonu yelpaze şeklinde ve düz şeklinde olmak üzere 2 grupta sınıflandırıldı.
Bulgular: Çalışmamızda 40 alt ektremitenin 36’sında (%90) musculus plantaris’in var olduğu, 4 (%10) alt ekstremite de ise olmadığı gözlemlendi. Ortalama kas karın uzunluğu, genişliği ve kalınlığı sırasıyla 13.29±3.73 mm, 4.72±1.77 mm ve 3.65±1.17 mm olarak belirlendi. Kasın sıklıkla tendo calcaneus’un anteromedial’ine insersiyo yaptığı (Tip 2, %67.5) belirlendi. Ayrıca, kas tendonunun sıklıkla düz şekilde (%86.11) insersiyo yaptığı gözlemlendi.
Sonuç: Çalışmamızdan elde edilen verilerin bebeklik ve çocukluk döneminde yapılması planlanan fleksör tendinoplastiler, el tendonları ve lateral ayak bileği bağlarının rekonstrüksiyonu, atriyoventriküler kapakların onarımı gibi işlemlerde faydalı olacağını düşünüyoruz.

Kaynakça

  • 1. Waśniewska A, Olewnik Ł, Diogo R, Polguj M. Morphological variability of the plantaris muscle origin in human fetuses. Ann Anat 2022;239:151794.
  • 2. Dalmau-Pastor M, Fargues-Polo B, Casanova-Martínez D, Vega J, Golanó P. Anatomy of the triceps surae: a pictorial essay. Foot Ankle Clin 2014;19(4):603-35.
  • 3. Spina AA. The plantaris muscle: anatomy, injury, imaging, and treatment. J Can Chiropr Assoc. 2007;51(3):158.
  • 4. Gonera B, Kurtys K, Karauda P, Polguj M. Possible effect of morphological variations of plantaris muscle tendon on harvesting at reconstruction surgery-case report. SRA 2020;42(10):1183-8.
  • 5. Olewnik Ł, Wysiadecki G, Polguj M, Topol M. Anatomic study suggests that the morphology of the plantaris tendon may be related to Achilles tendonitis. SRA 2017;39(1):69-75.
  • 6. Aragão JA, Reis FP, Guerra DR, Cabral RH. The occurrence of the plantaris muscle and its muscle-tendon relationship in adult human cadavers. Int J Morphol 2010;28(1):255-8.
  • 7. Menton DN. The plantaris and the question of vestigial muscles in man. J Creation 2000;14(2):50-3.
  • 8. Spang C, Alfredson H, Docking S, Masci L, Andersson G. The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. Bone Joint J 2016;98(10):1312-9.
  • 9. Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice, 41st Edition. 2016.
  • 10. Shaw HM, Vázquez OT, McGonagle D, Bydder G, Santer RM, Benjamin M. Development of the human Achilles tendon enthesis organ. J Anat 2008;213(6):718-24.
  • 11. van Sterkenburg MN, Kerkhoffs GM, Kleipool RP, Niek van Dijk C. The plantaris tendon and a potential role in mid‐portion Achilles tendinopathy: an observational anatomical study. J Anat 2011;218(3):336-41.
  • 12. Sharma S, Kullar M, Bhardwaj S. Unilateral accessory plantaris muscle: a rare anatomical variation with clinical implications. Glob J Med Res. 2014;14:4H.
  • 13. Joshi MM, Joshi SD, Joshi SS. Morphological variations of muscle plantaris: anatomical and clinical insight. Int J Anat Res 2014;2(4):621-4.
  • 14. Sangeeta M, Varalakshmi K, Naik S. Study of morphometry of plantaris muscle and its clinical relevance. Int J Curr Res 2015;7(11):70.
  • 15. Josipović M, Vlaić J, Serdar J, Šimunović M, Nizić D, Schauperl Z, et al. Plantaris tendon: a novel graft for anterolateral ligament reconstruction and additional reinforcement for anterior cruciate ligament autografts in combined reconstructive procedures. Knee Surg Sports Traumatol Arthrosc 2020:1-5.
  • 16. Dos Santos MA, Bertelli JA, Kechele PR, Duarte H. Anatomical study of the plantaris tendon: reliability as a tendo-osseous graft. SRA 2009;31(1):59-61.
  • 17. Álvarez MF, Bueno CA, Ballesteros LE. Agenesis of the Medial Gastrocnemius and Plantar Muscle. Case Presentation. Int J Morphol 2017;35(1):34-6.
  • 18. Soni S, Saxena A, Ghulyani T, Rani-Das A. A biceps plantaris in the popliteal region-case report. Eur J Anat 2014;18(1):32-3.
  • 19. Kumar A. Bicipital origin of plantaris muscle–a case report. Int J Anat Var 2011;4:177-9.
  • 20. Jakubietz MG, Jakubietz DF, Gruenert JG, Zahn R, Meffert RH, Jakubietz RG. Adequacy of palmaris longus and plantaris tendons for tendon grafting. J Hand Surg Am 2011;36(4):695-8.
  • 21. Herzog RJ. Accessory plantaris muscle: anatomy and prevalence. HSS Journal®. 2011;7(1):52-6.
  • 22. Polin RA, Fox WW, Abman SH. Fetal and Neonatal Physiology: Expert Consult-Online and Print: Elsevier health sciences; 2011.
  • 23. Yammine K, Saghie S, Assi C. A meta-analysis of the surgical availability and morphology of the plantaris tendon. J Hand Surg Am (Asian-Pacific Volume). 2019;24(02):208-18.
  • 24. Boyle EK, Mahon V, Diogo R. Muscles lost in our adult primate ancestors still imprint in us: On muscle evolution, development, variations, and pathologies. Mol Biol Rep. 2020;6:32-50.
  • 25. Diogo R, Siomava N, Gitton Y. Development of human limb muscles based on whole-mount immunostaining and the links between ontogeny and evolution. Development. 2019;146(20):dev180349.
  • 26. Marchi D, Leischner CL, Pastor F, Hartstone‐Rose A. L eg M uscle A rchitecture in P rimates and I ts C orrelation with L ocomotion P atterns. Anat Rec 2018;301(3):515-27.
  • 27. Jayasree K, Ashalatha P, Nair SS, Joy J. Variations of muscle plantaris: anatomical and clinical implications. JEMDS. 2016;5(45):2792-7.
  • 28. Daseler EH, Anson BJ. The plantaris muscle: an anatomical study of 750 specimens. JBJS. 1943;25(4):822-7.
  • 29. Cruveilhier J. Traité d'anatomie descriptive: Béchet jeune; 1834.
  • 30. Prakash S, Ojha P. Morphological study of plantaris muscle in cadavers and its clinical significance. Indian J Clin Anat Physiol 2018;5(1):17-9.
  • 31. Olewnik Ł, Wysiadecki G, Podgórski M, Polguj M, Topol M. The plantaris muscle tendon and its relationship with the achilles tendinopathy. Biomed Res Int 2018;2018.
  • 32. Delgado GJ, Chung CB, Lektrakul N, Azocar P, Botte MJ, Coria D, et al. Tennis leg: clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiology 2002;224(1):112-9.
  • 33. Desdicioglu K, Uguz C, Sakallı B, Koyuncu E, Malas MA. Anatomy and variations of plantaris muscle in fetuses. JASI 2015;64(1):79-86.
  • 34. Yildiz S, Kocabiyik N, Çilingiroğlu S, Ozan H. İnsan fetuslarinda m. plantaris' in morfometrisi. Gulhane Medical J 2011;53(3).
  • 35. Szaro P, Witkowski G, Ciszek B. The twisted structure of the fetal calcaneal tendon is already visible in the second trimester. SRA 2020:1-8.
  • 36. Harvey FJ, Chu G, Harvey PM. Surgical availability of the plantaris tendon. J Hand Surg Am 1983;8(3):243-7.
  • 37. Moss A. Is there an association between an absence of palmaris longus tendon and an absence of plantaris tendon? Eur J Plast Surg 1988;11(1):32-4.
  • 38. Simpson SL, Hertzog MS, Barja RH. The plantaris tendon graft: an ultrasound study. J Hand Surg Am 1991;16(4):708-11.
  • 39. Wehbé MA. Tendon graft donor sites. J Hand Surg Am 1992;17(6):1130-2.
  • 40. Alagoz MS, Uysal AC, Tuccar E, Tekdemir I. Morphologic assessment of the tendon graft donor sites: palmaris longus, plantaris, tensor fascia lata. J Craniofac Surg 2008;19(1):246-50.
  • 41. Köse Ö, Ege T, Demiralp B, Sanal T, Bek D, Başbozkurt M. Prediction of the presence of plantaris tendon through examination of palmaris longus tendon. Is there a link? Int J Morphol 2014;32(2):589-592.

A Morphometric and Morphological Analysis of Plantaris in Fetal Cadavers

Yıl 2022, Cilt: 32 Sayı: 3, 245 - 251, 01.08.2022
https://doi.org/10.54005/geneltip.1033580

Öz

Objective: The plantaris is a muscle in the back of the leg that has a short body and a long, thin tendon. The muscle acts functionally with the gastrocnemius. Due to removal of the muscle does not cause a change in limb function, it is used as a potential source of graft. The aim of the present study was to investigate the morphological features and possible variations of plantaris in fetal cadavers.
Methods: This study was carried out on the fetal cadaver collection of University of Necmettin Erbakan, Faculty of Medicine, Anatomy Department. 11 male and 9 female fetal cadavers (ages range: 28 to 40 weeks) were used. The muscle belly length (LB), width (WB) and thickness (TB) were measured. The plantaris insertion was classified into 4 types. Furtermore, the distal part of the tendon was classified as the fan-shaped and flat-shaped.
Results: It was determined that plantaris was present in 36 of 40 (90%) lower extremities and absent in 4 (10%). The average muscle belly length (LB), width (WB) and thickness (TB) was found 13.29±3.73 mm, 4.72±1.77 mm and 3.65±1.17 mm, respectively. It was observed that the plantaris tendon often (Type 2, 67.5%) inserts in the anteromedial of the calcaneal tendon. Furthermore, the most common insertion type was observed as flat-shaped (86.11%).
Conclusion: We believe that the data obtained from our study will be useful in procedures such as flexor tendinoplasties, reconstruction of hand tendons and lateral ankle ligaments, and repair of atrioventricular valves, which are planned to be performed in infancy and childhood.

Kaynakça

  • 1. Waśniewska A, Olewnik Ł, Diogo R, Polguj M. Morphological variability of the plantaris muscle origin in human fetuses. Ann Anat 2022;239:151794.
  • 2. Dalmau-Pastor M, Fargues-Polo B, Casanova-Martínez D, Vega J, Golanó P. Anatomy of the triceps surae: a pictorial essay. Foot Ankle Clin 2014;19(4):603-35.
  • 3. Spina AA. The plantaris muscle: anatomy, injury, imaging, and treatment. J Can Chiropr Assoc. 2007;51(3):158.
  • 4. Gonera B, Kurtys K, Karauda P, Polguj M. Possible effect of morphological variations of plantaris muscle tendon on harvesting at reconstruction surgery-case report. SRA 2020;42(10):1183-8.
  • 5. Olewnik Ł, Wysiadecki G, Polguj M, Topol M. Anatomic study suggests that the morphology of the plantaris tendon may be related to Achilles tendonitis. SRA 2017;39(1):69-75.
  • 6. Aragão JA, Reis FP, Guerra DR, Cabral RH. The occurrence of the plantaris muscle and its muscle-tendon relationship in adult human cadavers. Int J Morphol 2010;28(1):255-8.
  • 7. Menton DN. The plantaris and the question of vestigial muscles in man. J Creation 2000;14(2):50-3.
  • 8. Spang C, Alfredson H, Docking S, Masci L, Andersson G. The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. Bone Joint J 2016;98(10):1312-9.
  • 9. Standring S. Gray's Anatomy: The Anatomical Basis of Clinical Practice, 41st Edition. 2016.
  • 10. Shaw HM, Vázquez OT, McGonagle D, Bydder G, Santer RM, Benjamin M. Development of the human Achilles tendon enthesis organ. J Anat 2008;213(6):718-24.
  • 11. van Sterkenburg MN, Kerkhoffs GM, Kleipool RP, Niek van Dijk C. The plantaris tendon and a potential role in mid‐portion Achilles tendinopathy: an observational anatomical study. J Anat 2011;218(3):336-41.
  • 12. Sharma S, Kullar M, Bhardwaj S. Unilateral accessory plantaris muscle: a rare anatomical variation with clinical implications. Glob J Med Res. 2014;14:4H.
  • 13. Joshi MM, Joshi SD, Joshi SS. Morphological variations of muscle plantaris: anatomical and clinical insight. Int J Anat Res 2014;2(4):621-4.
  • 14. Sangeeta M, Varalakshmi K, Naik S. Study of morphometry of plantaris muscle and its clinical relevance. Int J Curr Res 2015;7(11):70.
  • 15. Josipović M, Vlaić J, Serdar J, Šimunović M, Nizić D, Schauperl Z, et al. Plantaris tendon: a novel graft for anterolateral ligament reconstruction and additional reinforcement for anterior cruciate ligament autografts in combined reconstructive procedures. Knee Surg Sports Traumatol Arthrosc 2020:1-5.
  • 16. Dos Santos MA, Bertelli JA, Kechele PR, Duarte H. Anatomical study of the plantaris tendon: reliability as a tendo-osseous graft. SRA 2009;31(1):59-61.
  • 17. Álvarez MF, Bueno CA, Ballesteros LE. Agenesis of the Medial Gastrocnemius and Plantar Muscle. Case Presentation. Int J Morphol 2017;35(1):34-6.
  • 18. Soni S, Saxena A, Ghulyani T, Rani-Das A. A biceps plantaris in the popliteal region-case report. Eur J Anat 2014;18(1):32-3.
  • 19. Kumar A. Bicipital origin of plantaris muscle–a case report. Int J Anat Var 2011;4:177-9.
  • 20. Jakubietz MG, Jakubietz DF, Gruenert JG, Zahn R, Meffert RH, Jakubietz RG. Adequacy of palmaris longus and plantaris tendons for tendon grafting. J Hand Surg Am 2011;36(4):695-8.
  • 21. Herzog RJ. Accessory plantaris muscle: anatomy and prevalence. HSS Journal®. 2011;7(1):52-6.
  • 22. Polin RA, Fox WW, Abman SH. Fetal and Neonatal Physiology: Expert Consult-Online and Print: Elsevier health sciences; 2011.
  • 23. Yammine K, Saghie S, Assi C. A meta-analysis of the surgical availability and morphology of the plantaris tendon. J Hand Surg Am (Asian-Pacific Volume). 2019;24(02):208-18.
  • 24. Boyle EK, Mahon V, Diogo R. Muscles lost in our adult primate ancestors still imprint in us: On muscle evolution, development, variations, and pathologies. Mol Biol Rep. 2020;6:32-50.
  • 25. Diogo R, Siomava N, Gitton Y. Development of human limb muscles based on whole-mount immunostaining and the links between ontogeny and evolution. Development. 2019;146(20):dev180349.
  • 26. Marchi D, Leischner CL, Pastor F, Hartstone‐Rose A. L eg M uscle A rchitecture in P rimates and I ts C orrelation with L ocomotion P atterns. Anat Rec 2018;301(3):515-27.
  • 27. Jayasree K, Ashalatha P, Nair SS, Joy J. Variations of muscle plantaris: anatomical and clinical implications. JEMDS. 2016;5(45):2792-7.
  • 28. Daseler EH, Anson BJ. The plantaris muscle: an anatomical study of 750 specimens. JBJS. 1943;25(4):822-7.
  • 29. Cruveilhier J. Traité d'anatomie descriptive: Béchet jeune; 1834.
  • 30. Prakash S, Ojha P. Morphological study of plantaris muscle in cadavers and its clinical significance. Indian J Clin Anat Physiol 2018;5(1):17-9.
  • 31. Olewnik Ł, Wysiadecki G, Podgórski M, Polguj M, Topol M. The plantaris muscle tendon and its relationship with the achilles tendinopathy. Biomed Res Int 2018;2018.
  • 32. Delgado GJ, Chung CB, Lektrakul N, Azocar P, Botte MJ, Coria D, et al. Tennis leg: clinical US study of 141 patients and anatomic investigation of four cadavers with MR imaging and US. Radiology 2002;224(1):112-9.
  • 33. Desdicioglu K, Uguz C, Sakallı B, Koyuncu E, Malas MA. Anatomy and variations of plantaris muscle in fetuses. JASI 2015;64(1):79-86.
  • 34. Yildiz S, Kocabiyik N, Çilingiroğlu S, Ozan H. İnsan fetuslarinda m. plantaris' in morfometrisi. Gulhane Medical J 2011;53(3).
  • 35. Szaro P, Witkowski G, Ciszek B. The twisted structure of the fetal calcaneal tendon is already visible in the second trimester. SRA 2020:1-8.
  • 36. Harvey FJ, Chu G, Harvey PM. Surgical availability of the plantaris tendon. J Hand Surg Am 1983;8(3):243-7.
  • 37. Moss A. Is there an association between an absence of palmaris longus tendon and an absence of plantaris tendon? Eur J Plast Surg 1988;11(1):32-4.
  • 38. Simpson SL, Hertzog MS, Barja RH. The plantaris tendon graft: an ultrasound study. J Hand Surg Am 1991;16(4):708-11.
  • 39. Wehbé MA. Tendon graft donor sites. J Hand Surg Am 1992;17(6):1130-2.
  • 40. Alagoz MS, Uysal AC, Tuccar E, Tekdemir I. Morphologic assessment of the tendon graft donor sites: palmaris longus, plantaris, tensor fascia lata. J Craniofac Surg 2008;19(1):246-50.
  • 41. Köse Ö, Ege T, Demiralp B, Sanal T, Bek D, Başbozkurt M. Prediction of the presence of plantaris tendon through examination of palmaris longus tendon. Is there a link? Int J Morphol 2014;32(2):589-592.
Toplam 41 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Original Article
Yazarlar

Anil Didem Aydın Kabakçı 0000-0003-1594-0188

Ahmet Safa Gökşan 0000-0001-9352-875X

Duygu Akın Saygın 0000-0003-4260-9263

Mustafa Büyükmumcu 0000-0002-8475-6061

Aynur Çiçekcibaşı 0000-0002-1373-3065

Yayımlanma Tarihi 1 Ağustos 2022
Gönderilme Tarihi 7 Aralık 2021
Yayımlandığı Sayı Yıl 2022 Cilt: 32 Sayı: 3

Kaynak Göster

Vancouver Aydın Kabakçı AD, Gökşan AS, Akın Saygın D, Büyükmumcu M, Çiçekcibaşı A. A Morphometric and Morphological Analysis of Plantaris in Fetal Cadavers. Genel Tıp Derg. 2022;32(3):245-51.