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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 164 - 164
1 Feb 2004
Lappas D Liaskovitis B Gisakis I Bostanitis A Chrisanthou C Tzortzopoulou A Davvetas E Fragiadakis E
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During the medical student’s training in the Anatomy we have studied the arterial constitutions of the superior limb in 100 bodies from the Laboratory of the Descriptive Anatomy of the Medical School, University of Athens.

We have examined the brachial artery and the superficial brachial artery. Superficial brachial artery is called the major artery that is found superficially of the middle nerve. Such an artery can either substitute or complete the brachial artery. For reasons of classification we took into account the arteries only and neglected the smaller branches. The superficial brachial artery often origins from the proximal part of the forearm and the clinical interest of this remark consists on the fact that this artery leads to the forearm, in front of the biceps brachial muscle’s aponeurosis. By this way it can easily be mistaken as a vein and an “intravenous” injection can be disastrous.

Our results were:

A. Only one brachial artery: 76%

The classic case of the books of Anatomy: the brachial artery is found opposite of the middle nerve, crossing under it at the upper arm: 74%

The middle nerve’s constitution is not the typical one at the armpit, but the artery crosses under it: 2%

B. Presence of one brachial artery only: 10% One brachial artery in front of the two radixes of the middle nerve: 2%

The major artery is found opposite of the radixes of the middle nerve, but crosses in front of it at the arm:4%

The dorsal artery is found behind the middle nerve from the dorsal part but comes over the nerve between the musculocutaneous and the middle nerve: 2%

There is not the typical constitution of the middle nerve from two radixes and the artery is found in front of the middle nerve:2%

C. Two major arterial branches: 14%

The axillary artery is divided in two branches one in frond of and the other behind of the radixes of the middle nerve: 5%

The brachial artery is divided in two branches one of which is found in frond of the middle nerve: 9%


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 164 - 164
1 Feb 2004
Lappas D Liaskovitis B Gisakis I Bostanitis A Chrisanthou C Tzortzopoulou A Nikolaou B Fragiadakis E
Full Access

During the medical student’s training in the Anatomy we have studied the arterial constitutions of the forearm in 100 bodies from the Laboratory of the Descriptive Anatomy of the Medical School, University of Athens.

On our efforts to classify the complexity of the forearm concerning its blood supply we accepted that we might have some basic groups that can be explained by the embryology. Our results were:

A. “Regular” hematosis of the forearm (with the presence of the radial, the ulnar and the interosseous artery): 81%

All the forearm’s arteries ramify from the brachial artery: 68%

All the forearm’s arteries ramify from the superficial brachial artery: 7%

The radial artery origins from the superficial brachial artery, the ulnar and the interosseous arteries from the brachial artery: 4%

As in 3 with a wide osculation between the brachial and the radial artery in the elbow: 2%

B. Forearm’s superficial arteries: 10%

The superficialulnar artery substitutes the ulnar artery: 4%

Superficial middle artery: 2%

Superficial radial artery in addition to the normal radical artery: 2%

The forearm’s superficial artery is short and ends at the forearm’s proximal part: 2%

C. Presence of the middle artery (embryo remnant): 9%

The middle artery origins from the ulnar artery with the interosseous artery: 3%

The middle artery origins from the ulnar artery far from the common interosseous artery: 2%

The middle artery origins from the common interosseous artery: 2%

The middle artery origins from the radical artery: 2%


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 165 - 165
1 Feb 2004
Lappas DA Liaskovitis V Tzortzopoulou A Bostanitis A Chrisanthou C Gisakis I Nikolaou B Fragiadakis E
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Aim: The orthopedic surgeons, especially those who are specialized in arthroplasty, should be conversant with all the anatomic variations of the popliteal bothrium. After a wide research we present our conclusions about the variations of the popliteal bothrium.

Material-method: The study was carried out in the Anatomic Laboratory of Athens Medical University during the last 16 years and for our purpose we dissected 110 cadavers (220 legs).

Results: The length of the popliteal artery, from the major adductor foramen to the division into anterior and posterior tibial artery, is 4–9 cm. We have classified the observed variations into two groups, according to whether the division is below or above the level of the popliteal muscle:

1. below the level of the popliteal muscle (194/220)

A. The division occurs after the origin of the peroneal artery (172/220)

B. The peroneal artery arises at the level of the division (16/220)

C. The popliteal artery divides into posterior tibial and peroneal artery, while the anterior tibial artery arises from the peroneal (6/220)

2. above the level of the popliteal muscle (26/220)

A. The peroneal artery arises from the posterior tibial artery (10/220)

B. The peroneal artery arises from the posterior tibial artery, while the anterior tibial artery runs in front of the popliteal muscle (8/220)

C. The peroneal artery arises from the anterior tibial artery (8/220)


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 164 - 165
1 Feb 2004
Lappas D Liaskovitis V Pandelidis E Gisakis I Chrisanthou C Bostanitis A Fragiadakis E
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During a wide study of the arterial variations in the Greek population, we examined the arterial trunks, arising from the subclavian and axillary arteries.150 cadavers were examined by the Forensic Service of Athens University.

SUBCLAVIAN ARTERY

The focal point of our research was the origin of the inferior thyroid, the suprascapular and the transversal cervical artery. In 6.6% of our cases all three of the mentioned arteries had a common origin. As far as the rest 93.4% is concerned, we came to the following conclusions:

A. There was only one trunk without the participation of the pleurocervical trunk (81.3%)

1. The thyrocervical trunk is formed by the inferior thyroid, the suprascapular and the transversal cervical branches (classical anatomic knowledge) (33.3%)

2. The internal mammary artery arises from the thyrocervical trunk (9.3%)

3. The trunk is formed by the inferior thyroid and the suprascapular artery (26.6%)

4. The trunk is formed by the inferior thyroid, the supra-scapular and the internal mammary artery (6.6%)

5. There are two trunks: the first one is formed by the inferior thyroid and the suprascapular and the second one by the transversal cervical and the internalmammary artery (2.6%)

6. There are two trunks: the first one is formed by the inferior thyroid and the transversal cervical artery and the second one by the suprascapular and the internal mammary artery (4%)

B. Participation of the pleurocervical trunk (12%)

1. The transversal cervical artery with the pleurocervical trunk (6%)

2. The pleurocervical trunk arises from the internal mammary artery (2%)

3. The pleurocervical trunk with the suprascapular artery (1.3%)

4. The inferior thyroid artery with the pleurocervical trunk (1.3%)

5. The pleurocervical trunk with the inferior thyroid and the suprascapular artery (1.3%)

AXILLARY ARTERY

As far as the axillary is concerned, the 12% of the cadavers follow the basic model. As far as the rest of the cases are concerned, we concluded that:

A. Some branches form common trunks (48%)

1. The lateral thoracic and the dorsothoracic artery form a common trunk (11.3%)

2. The lateral thoracic together with the subscapular artery form a common trunk (9.3%)

3. The subscapular and the posterior circumflex brachial artery (9.3%)

4. Both the circumflex brachial arteries form a common trunk (18%) B. The arteries of the arm arise from the axillary artery (21.3%)

1. The profunda brachial artery arises from the axillary artery (11.3%)

2. The superficial brachial artery arises from the axillary artery (5.3%)

3. The profunda brachial artery arises from the posterior circumflex brachial artery (4.6%) C. Special cases (18.6%)

1. There are supplementary branches in the parries (5.3%)

2. Separate origin of the circumflex scapular artery and the dorsothoracic artery (5.3%)

3. The dorsothoracic artery is short compared to the lateral thoracic artery (2.6%)

4. The posterior circumflex artery arises from the brachial artery (5.3%)


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 165 - 165
1 Feb 2004
Lappas DA Liaskovitis V Pandelidis E Bostanitis A Chrisanthou C Gisakis I Davvetas P Fragiadakis E
Full Access

During our research we studied the vessels of the leg and especially the anatomic variations of the tibial, peroneal and pedis arteries. The orthopedic surgeons, especially those who are specialized in operant radiology and angiography, should be conversant with all the anatomic variations of the vessels, running below the popliteal level. Our research was carried out in the Anatomic Laboratory of Athens University and we dissected 100 cadavers. We had great difficulties in describing the arteries, which run below the level of the popliteal bothrium. We have agreed in regarding the peroneal artery as the basic one, because it substitutes for the tibial artery when the last one is missing. When the anterior tibial is missing, the dorsalis pedis arises from the peroneal artery. In a same way, when the posterior tibial is missing, the pedis arteries arise from the peroneal artery. Very interesting is the variability of the branch, which supplies the tibial bone. In 50% of the cases this branch arises from the posterior tibial-peroneal trunk or from the posterior and anterior tibial artery or rarely from the peroneal and popliteal artery. The origin of the branch, which supplies the tibial bone, can affect the morphology of the bone (the correspondent foramen of the tibial bone).

The variations can be classified in the following way:

The typical anatomic knowledge: The peroneal artery gives an anastomosis branch to the posterior tibial artery and a perforating branch to the anterior tibial artery (85%)

The dorsalis pedis is formed by two equal branches, arising from the peroneal and the anterior tibial artery (2%)

The perforating branch of the peroneal artery forms the dorsalis pedis artery, while the anterior tibial is missing (7%)

The posterior tibial artery is missing and the pedis arteries arise from the peroneal (6%)