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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
In contrast, the details of the “trick” performed within the lower limb to provide blood supply to the posterior leg structures are very different from those seen in the “trick” displayed within the upper limb to provide blood supply to the posterior forearm muscles. In the upper limb, an anterior artery—the ulnar artery that branches from the brachial artery—gives rise to the common interosseous artery, which then divides into the anterior interosseous artery and the posterior interosseous artery, the latter of which provides blood supply to the posterior forearm. In the lower limb, the femoral artery runs through the adductor canal to reach and pass through the adductor hiatus—an opening in the tendon of the adductor magnus muscle just above the knee (Plate 5.6a)—to appear in the posterior side of the knee region. It changes name to popliteal artery as it enters the popliteal fossa (Plate 5.6c). As an aside, note that the saphenous nerve and the nerve to the vastus medialis accompany the femoral artery and femoral vein in the adductor canal, but as noted in Section 5.2.1, the saphenous nerve does not go all the way to the posterior side of the knee region as the popliteal artery and popliteal vein do. Instead, the saphenous nerve remains mainly an anterior nerve also in the leg region, to provide cutaneous innervation to the medial side of the leg (Plate 5.1).
The Triple Heater (TH)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Posterior interosseous artery: Both the anterior and posterior interosseous arteries arise from the common interosseous artery, which branches off of the ulnar artery. Both interosseous arteries course along the interosseous membrane. The posterior interosseous artery gives rise to the recurrent interosseous artery, which participates in the anastomoses around the elbow joint.
The Antebrachium
Published in Gene L. Colborn, David B. Lause, Musculoskeletal Anatomy, 2009
Gene L. Colborn, David B. Lause
Deep Structures of the Extensor Compartment. The posterior interosseous artery passes between the radius and ulna to reach its present position within the posterior compartment of the forearm. The deep branch of the radial nerve curves from in front of the lateral epicondyle to its passage through the supinator - after which it joins the emerging posterior interosseous vessels. The supinator muscle arises from the lateral epicondyle and ulna and inserts obliquely upon the radius.
Immediate tendon transfer for functional reconstruction of a dorsal forearm defect after sarcoma resection
Published in Journal of Plastic Surgery and Hand Surgery, 2023
Ryo Karakawa, Hidehiko Yoshimatsu, Yuma Fuse, Kenta Tanakura, Tomohiro Imai, Masayuki Sawaizumi, Tomoyuki Yano
A 74-year-old male suffered from soft tissue sarcoma on the dorsal aspect of the left forearm (Figure 3(a)). Additional surgical wide resection followed by immediate tendon transfer was planned. Surgical wide resection, including the extensor compartment muscles (EDC, EDM, ECRL, ECRB, EPL) and posterior interosseous nerve, was performed (Figure 3(b)). A preoperatively planned tendon transfer was performed. Transfers of the FCR to the EDC and the EDM, and the PL tendon to the EPL were performed (Figure 3(c–e)). The size of the defect after tumor ablation was 11.5 × 12.5 cm. The skin defect was covered using an 11 × 18 cm superficial circumflex iliac artery perforator (SCIP) free flap (Figure 3(f)). The posterior interosseous artery and vein were used as recipient vessels. The resected mass was confirmed to be a UPS. The same rehabilitation as with case 1 was performed. Within 21 months, the patient returned to normal activity with full fist motion, pinch of the thumb and little finger, DIP joint extension of 0°, PIP joint extension of 5°, MP joint extension of 5° and thumb IP joint extension of 0°. The MSTS score was 27 (Figure 4).
Reconstruction of postburn contractures due to tandir oven
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Hakan Cinal, Ensar Zafer Barin, Murat Kara, Kerem Yilmaz, Harun Karaduman, İhtişam Zafer Cengiz, Oguz Boyraz, Osman Enver Aydin, Onder Tan
More severe contractures may need larger flaps. In our series, we have used posterior interosseous artery flap (PIO) and as the first choice in small- to moderate-sized defects of the hand region (Figure 7). Pedicle forearm flaps could be another alternative for the reconstruction of hand contractures [16]. However, sacrifice of a major artery of the hand has been a major drawback. On the other hand, Ulkür et al. [17] have successfully used dorsal ulnar flap for palmar reconstruction with less donor morbidity. We used reverse sural flap on the ankle (Figure 8) and trapezius musculocutaneous pedicle flap on the neck in order to benefit from the advantages of pedicled flaps (Figure 9).
Malignant transformation of a phalangeal enchondroma into a recurrent grade II chondrosarcoma requiring successive transcarpal amputations: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Ceyran Hamoudi, Benjamin Bouillet, Antoine Martins
It is particularly challenging to manage soft tissue defects of the hand following wide-margin resection because numerous underlying structures such as bones, tendons, vascular pedicles, and nerves are exposed. Various types of hand reconstruction techniques and skin flaps have been described, to preserve limb function as well as the integrity of underlying structures; however, the posterior interosseous artery (PIA) flap is the option that was selected by us. These flaps are known to be reliable for wrist and hand reconstruction in the background of traumatic soft tissue defects [14] and following resection of soft tissue [15].