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3 Folia Morphologica

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Bilateral double testicular arteries: a case report and review of the literature. Potential embryological and surgical considerations

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Paraskevas G. K. , Natsis K. , Nitsa Z. , Papaziogas B. , Kitsoulis P.

nr 3

The aberrancies concerning the number, origin and course of the testicular arteries are found in an incidence of approximately 4.7–20% in the literature and are documented less frequently than the respective variations of the homonymous veins. In the current study, a very rare complex of testicular arteries’ variations is described, in which the occurrence of bilateral double testicular arteries is recorded. Particularly, apart from the normal testicular arteries on each side, we observed an additional right testicular artery originated from the ipsilateral renal artery and an additional left testicular artery taking its origin from the abdominal aorta just above the renal artery’s origin site; the latter additional testicular artery arched above the left renal vein. Both, the bilateral double testicular arteries accompanied the testicular vein on each side as their satellite arteries. We discuss the potential embryological development of that complex of arterial variants, their likely clinical and surgical applications, as well as we proceed on a brief review of the relevant literature. (Folia Morphol 2014; 73, 3: 383–388)

Morphological study of the calcaneofibular ligament in cadavers

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Kitsoulis P. , Marini A. , Pseftinakou A. , Iliou K. , Galani V. , Paraskevas G.

nr 3

The aim of the present study was to investigate the anatomical and morphological characteristics and the maximum elongation of the calcaneofibular ligament (CFL) in cadavers. In a sample of 72 cadaveric lower limbs the mean values of length, width, thickness, and angle with the sagittal plane were recorded for the CFL. The mean ligament’s length was 31.8 mm, and the mean width and thickness were 4.4 mm and 1.5 mm respectively. The mean angle with the sagittal plane was 51.11°. In 72.2% of the lower limbs studied, the ligament presented one band, while 22.2% and 5.6% of them were two-banded and three-banded respectively. A common origin with the anterior talofibular ligament (TFL) was found in 24 of the feet (33%). There were also 4 cases in which the anterior TFL was absent. Finally, we measured the maximal elongation of the ligament during extreme inversion and simultaneous dorsal flexion and found it to be 2.88 mm on average. We noticed and statistically verified that women presented a greater elongation compared to men. A precise knowledge of the origin, insertion, direction, and morphology of CFL is critical for ligament injuries in ankle sprains and during ankle reconstruction. Ligament elasticity plays an important role in the range of ankle motion and ligament shearing. Male and female ankle joints differ in several anthropometric characteristics and thus the genre differences in ligament elongation are of great interest. (Folia Morphol 2011; 70, 3: 180–184)

An accessory middle scalene muscle causing thoracic outlet syndrome

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Paraskevas G. , Loannidis O. , Papaziogas B. , Natsis K. , Spanidou S. , Kitsoulis P.

tom 66

nr 3

The aim of our study is to present a very rare accessory middle scalene muscle, leading to thoracic outlet syndrome. In particular, a muscular bundle was discovered on a male cadaver connecting the middle portion of the middle scalene muscle with the anterior scalene muscle insertion to Lisfranc’s tubercle. This triangular accessory muscle and, especially, its sharp medial border compressed the middle and lower trunk of the brachial plexus and the subclavian artery. This anomaly is of great importance because it emphasises the fact that it is not primarily the anterior scalene muscle that produces symptoms of thoracic outlet syndrome but the anterior displacement of the middle scalene muscle or its accessory muscular bands. We also present the relative international literature and the clinical significance of our finding.