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Lower Limb Muscles
Published in Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Handbook of Muscle Variations and Anomalies in Humans, 2022
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo, Malynda Williams
Bersu et al. (1976) describe a male infant with Hanhart syndrome. The femora of this infant were normally developed but distal secondary ossification centers were absent. The left leg stump had a patella and a small rudiment of the proximal tibia but no fibular rudiment. The right leg stump was less developed and had a patella, smaller tibial rudiment, and no fibular rudiment. On both sides of the body, tensor fasciae latae originated from the fascia at the anterior border of gluteus medius and had normal insertions.
The anterior approach to the hip for a minimally invasive prosthesis
Published in K. Mohan Iyer, Hip Preservation Techniques, 2019
Alessandro Geraci, Alberto Ricciardi
The location of the lateral femoral cutaneous nerve must be taken into consideration in this approach in order to preserve lateral thigh sensation. It is located about 1 cm medial and below the anterior superior iliac, and passes over the sartorius. The incision is extended straight to the superficial aponeurosis of the tensor fascia lata (Figure 28.12b and c).
Lower Limb
Published in Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno, Understanding Human Anatomy and Pathology, 2018
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno
The muscles of the gluteal region (Table 5.1) comprise two main developmental units: the medial rotator glutealgroup and the lateral rotatorglutealgroup (Plate 5.7). The medial rotator group includes the tensor fasciae latae, gluteus minimus, and gluteus medius, all innervated by the superior gluteal nerve. Their common function is to medially rotate the thigh because they attach mainly on the anterior side of the greater trochanter of the femur. The gluteus medius and gluteus minimus are more oblique (fibers running distally and laterally to attach onto the anterior, superior aspect of the greater trochanter of the proximal femur), so they also abduct the thigh because their fibers pass superior to the hip joint (Figure 5.3). The tensor fasciae latae is more vertical (fibers running mainly distally to attach through the iliotibial tract to the lateral, proximal tibia), that is more parallel to the femur, so it cannot abduct but has a proper configuration to flex the thigh. This muscle can also tense the fascia lata (namely, the iliotibial tract, as its name suggests, and thus can stabilize the knee joint).
Separated center-of-pressure measurements reveal new characteristics of reduced anticipatory postural adjustments during gait initiation in patients with Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2022
Ryo Onuma, Tadashi Masuda, Fumihiko Hoshi, Tadamitsu Matsuda, Tomoko Sakai, Atsushi Okawa, Tetsuya Jinno
Anticipatory postural adjustments (APAs) are defined as changes in posture prior to voluntary movement and contribute to the smooth initiation of gait (Belen’kii, Gurfinkel, and Paltsev, 1967). APAs at gait initiation include activation of the tibialis anterior and suppression of the soleus prior to the start of movement (Breniere, Cuong, and Bouisset, 1987; Elble, Moody, Leffler, and Sinha, 1994). APAs also cause the center of pressure (COP) to move posteriorly (Crenna and Frigo, 1991; Winter, 1995). The trajectory of the COP is thought to be due to the APAs through a combination of the shift in pressure of the left and right legs (combined COP) (Fawver, Roper, Sarmento, and Hass, 2018; Sun, Guerra, and Shea, 2015). The COP must shift from the center of both soles to posterior to the stepping leg and then posterior to the stance leg. Trunk acceleration and posterior COP displacement are typical measures of APAs at gait initiation in patients with PD. Trunk acceleration and posterior displacement are known to be lower in patients with PD (Halliday et al., 1998; Mancini et al., 2009; Rocchi et al., 2006; Rogers et al., 2011). Decreased trunk acceleration in the lateral direction and co-contraction of the tensor fasciae latae are indicative of decreased medio-lateral APAs in patients with PD (Mancini et al., 2009; Schlenstedt et al., 2018).
Characterising gait in paediatric neuromuscular disorders: an observational study of spatio-temporal gait in a clinical cohort
Published in Disability and Rehabilitation, 2022
Rachel A. Kennedy, Katy de Valle, Justine Adams, Monique M. Ryan, Alisha K. Fitzgerald, Kate Carroll
The assumption that lower limb weakness is a likely contributor to slower gait in children with NMD is supported by the results of this study. In children with CMT, distal foot and ankle weakness is associated with slower gait [1,14,16]. The children with CMT in this study, walked 10 cm/s slower than their TD peers which is consistent with our previous systematic review and study, where gait was nearly 14 cm/s slower in a larger sample [13,16]. Proximal lower limb weakness in children with SMA type III, likely influences reduced step length and cadence and hence slower gait; with the association between step length and speed greater than the association between cadence and speed, similar to other reports in children with SMA [25]. Children with DMD and BMD walked with a wider base of support compared to their TD peers. Gait was wider again in older children with DMD (≥10 years) reflecting the association between disease progression and gait dysfunction (Figure 3). In DMD, early proximal weakness affects hip extensors and abductors [15]. Extensor moments are reduced, affecting step length; and tightness in the hip abductors/tensor fascia lata complex is greater, contributing to a wider base of support and gait pattern. Slower walking with shorter, wider steps occurs in parallel with disease progression in DMD and is supported in other studies [9,26].
External iliac artery injury following total hip arthroplasty via the direct anterior approach—a case report
Published in Acta Orthopaedica, 2020
Ellen Burlage, Jasper G Gerbers, Bob R H Geelkerken, Wiebe C Verra
After a period of nonoperative treatment the patient was scheduled for uncemented THA via direct anterior approach (DAA) using spinal anesthesia (Siguier et al. 2004). After incision, the fascia of the tensor fascia lata was incised. The tensor fascia lata and gluteus medius muscles were retracted laterally with a Hohmann retractor (Figure 1), and the sartorius and rectus muscles were retracted medially with a blunt Hohmann retractor in order to expose the anterior hip capsule. The third, pointed, Hohmann retractor was placed under the rectus tendon just at the bony border of the acetabular rim (Figure 2). The retractor aimed in the direction of the contralateral kidney and was fixed using a device that statically holds both the second and third retractor. After opening the anterior capsule, the osteotomy of the femoral neck was performed. There was minimal blood loss, by suction, 50 mL. The labrum was excised and the acetabulum reamed. In the meantime, the patient had become hemodynamically unstable with hypotension, tachycardia and no response to vasopressors and intravenous fluids. In view of the poor circulatory situation, the patient was intubated and cardiopulmonary resuscitation was started.