The supernumerary muscles of the leg: a report of two cases

Summary Two cases of supernumerary muscles of the leg reported, which were both inserted on the sides of the calcaneus. The accessory soleus m., adductor of the fore-foot, is a variation of the triceps surae which through hypertrophy on the medial side of the leg can become particularly problematic in athletes. The fourth peroneal m. abductor of the fore-foot, is considered to increase the stability of the ankle and is asymptomatic.

---

Les muscles surnuméraires de la jambe : à propos de deux cas

Résumé Les auteurs rapportent 2 cas de muscles surnuméraires de la jambe qui s'insèrent sur les faces du calcanéum. Le m. soléaire accessoire, adducteur de l'arrièrepied, est une variation du triceps sural qui, par son hypertrophie au bord médial de la jambe, peut devenir gênante spécialement chez le sportif. Le m. 4^e péronier, abducteur de l'arrière-pied, est considéré comme un élément progressif améliorant la stabilité de la cheville et restant asymptomatique.

     

腘动脉及小腿动脉的观察

在102例教学用过的下肢标本上,对腘动脉及小腿动脉进行了观察: 1.成人腘动脉的平均长度为17.36±1.17cm。膝上内动脉和膝上外动脉分别起白有腘动脉中段上1/3和中段中1/3各有40.59％和46.53％。膝下内动脉和膝下外动脉起自下段上1/3各有32.35％和36.37％。膝中动脉起自膝上外动脉38.78％。 2.腘动脉均在腘肌下缘分为胫前动脉和胫后动脉。胫后动脉在其始部的下方2.4±8.1cm处分出腓动脉,后者有3.92±1.92％特别发育,并代替胫后动脉分布。 3.测量小腿动脉的管径及与主干所呈角度。     

Compressive Neuropathies Complicating Normal Childbirth: Case Report and Literature Review

ABSTRACT: Background: Peroneal neuropathy has been well described in the literature, but few cases have been reported of bilateral peroneal neuropathy as a complication of normal childbirth. Most reported cases are due to prolonged squatting during childbirth, which is prevalent in certain countries. Case report: A 30‐year‐old woman developed bilateral footdrop shortly after normal vaginal delivery under epidural analgesics. Neurological examination and electrodiagnostic studies confirmed bilateral common peroneal mononeuropathy most likely secondary to prolonged and excessive pressure around the knees by attendants who were assisting at the delivery. The woman showed significant improvement of her symptoms after physical therapy and assisted devices. Conclusions: Excessive and prolonged pressure knee holding during normal childbirth may result in compressive peripheral neuropathy. Patient education and awareness among the labor and delivery team will prevent this avoidable complication. (BIRTH 34:2 June 2007)     

Large mycotic aneurysm of the peroneal artery

We describe the case of a 37-year-old patient with mycotic aneurysm of the right peroneal artery associated with episodes of endocarditis. There are only 7 cases of mycotic aneurysms of the crural arteries reported in the literature. To the best of our knowledge, this is the first reported case of a mycotic aneurysm of the peroneal artery in an adult.     

腘动脉外侧皮支单蒂皮瓣或联合腓动脉穿支双蒂皮瓣游离移植修复手足创面

目的 探讨腘动脉外侧皮支单蒂皮瓣或联合腓动脉穿支双蒂皮瓣游离移植修复手足皮肤软组织缺损的临床效果。方法 回顾性研究。纳入2013年3月—2020年6月东莞市长安新安医院手足显微外科收治的手足皮肤缺损伴肌腱、骨骼外露患者21例,其中男19例、女2例,年龄16~65岁（平均37.8岁）。手部创面8例,足部创面13例;软组织缺损面积3.5 cm×5.5 cm~10.0 cm×14.0 cm。观察患者术后皮瓣成活情况,采用英国医学研究会颁布的感觉功能恢复分级评价标准评估患者皮瓣感觉功能恢复情况,采用笔者参考皮瓣功能7项检查制定的皮瓣外观功能10项检查表进行皮瓣外观功能综合评价。结果 21例患者术后皮瓣全部成活。采用腘动脉外侧皮支单蒂皮瓣游离移植修复13例、腘动脉外侧皮支联合腓动脉穿支双蒂皮瓣游离移植修复8例,皮瓣切取面积4.0 cm×6.5 cm~10.0 cm×16.0 cm,供区创面直接缝合或植皮覆盖。术后随访6~36个月,皮瓣质地良好,厚薄适中,两点间辨别觉13~25 mm;皮瓣外观功能综合评价：优7例、良11例、可3例,优良率为85.7％。小腿供区无功能性影响。结论 腘动脉外侧皮支单蒂皮瓣或联合腓动脉穿支双蒂皮瓣游离移植修复手足创面,皮瓣血供有保障,成活率高,是修复手足软组织创面的有效术式之一。     

Endovascular treatment of diabetic foot ischemic ulcer – Technical review

This article is a technical review of the common techniques used in the treatment of lower-limb occlusive arterial disease associated with diabetes. The techniques described here reflect the author’s own practice and are methods that the author finds helpful in avoiding complications and in making the technical aspects of the procedures easier.     

Posterior Fibular Groove Deepening Procedure With Low-Profile Screw Fixation of Fibrocartilaginous Flap for Chronic Peroneal Tendon Dislocation

Chronic peroneal tendon dislocation is an uncommon disorder that frequently presents with concomitant pathology. Posterior fibular groove deepening and retinaculum repair have been increasing in popularity for treatment of peroneal tendon dislocations. The purpose of the present study was to introduce a posterior fibular groove deepening procedure using low-profile snap-off screws to securely and simply fix the fibrocartilaginous flap to facilitate faster rehabilitation and to assess the clinical outcomes of patients with chronic peroneal tendon dislocation and associated pathologic features. In the present retrospective case series, 34 ankles in 34 patients underwent the fibular groove deepening procedure using low-profile screws with superior peroneal retinaculum repair. The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale and patient subjective satisfaction rate. The time of return to recreational and sports activities was also assessed. Weightbearing ankle radiographs were evaluated to assess the stability of the flap by checking the screws. The mean follow-up period was 47.96 (range 12 to 142) months. The mean AOFAS scale score for all patients improved from 69.96?±?13.14 to 87.72?±?10.13 at the last follow-up examination (p?<?.001). Overall, 85.3% of patients subjectively rated their operative outcomes as excellent or good. The 18 (52.9%) patients with an isolated peroneal tendon dislocation had a faster return to recreational or sports activities than the 16 (47.1%) patients with concomitant pathologic features (2.95?±?0.19 versus 4.14?±?1.34 months; p?=?.002). No patient experienced residual dislocation, screw loosening, or irritation from the screws. The fibular groove deepening procedure using low-profile screws is be a simple procedure that offers rigid fixation. This leads to relatively fast rehabilitation and resumption of recreational or sports activities.     

Bilateral Common Peroneal Nerve Entrapment After Excessive Weight Loss: Case Report and Review of the Literature

We report a case of excessive weight loss causing bilateral common peroneal nerve entrapment in a 60-year-old patient. The bilateral peroneal involvement suggested a systemic cause. Excessive weight loss during a relatively short period can cause changes in the tissues surrounding the common peroneal nerve and lead to its entrapment in the peroneal tunnel. Our patient underwent successful surgical decompression with significant improvement.     

壳寡糖对兔腓总神经损伤的影响

目的:研究壳寡糖(COSs)对兔周围神经损伤的修复作用。方法:对32只健康成年兔行腓总神经夹伤术。再分为4组:COSs高、低剂量组(剂量3mg/kg及1.5mg/kg),弥可保组(阳性对照,剂量30μg/kg),空白对照组(给予等体积双蒸水),均耳缘静脉给药6周,行Meyer's改良神经三色染色和透射电镜观察。结果:COSs高、低剂量组再生髓鞘数目显著优于空白对照组(P<0.01)。超微结构观察显示COSs高、低剂量组再生神经的髓鞘形态明显优于空白对照组,变性纤维数少于空白对照组。结论:COSs能促进兔腓总神经夹伤后的再生。