Surgical And Radiologic Anatomy[JOURNAL]
Sun
200 papers
Influence of retrocalcaneal bursal effusion on the mechanical behavior of the Achilles tendon insertion during ankle dorsiflexion: a cadaveric study.
Sakamoto K, Edama M, Sato R … +6 more , Kato Y, Nawir DA, Ishigaki T, Komiya M, Takabayashi T, Sato N
Surg Radiol Anat · 2026 Jul · PMID 42399589 · Publisher ↗
BACKGROUND: Retrocalcaneal bursitis is often accompanied by insertional Achilles tendinopathy. However, the mechanical effects of bursal effusion remain unclear. This study aimed to elucidate the mechanical impact of ret...
BACKGROUND: Retrocalcaneal bursitis is often accompanied by insertional Achilles tendinopathy. However, the mechanical effects of bursal effusion remain unclear. This study aimed to elucidate the mechanical impact of retrocalcaneal bursal effusion using Thiel-embalmed cadavers, which are known to exhibit mechanical properties comparable to those in vivo. METHODS: Ten lower limbs from seven Thiel-embalmed cadavers were examined. Ultrasound-guided injection of the preservation fluid was performed to simulate retrocalcaneal bursal effusion. Ultrasonographic evaluation was conducted under three conditions based on bursal thickness: Baseline, Mild (2 ± 0.5 mm), and Severe (4 ± 0.5 mm). The dynamics of the Achilles tendon insertion during passive ankle dorsiflexion were recorded using ultrasonography. Average curvature and thickness of the Achilles tendon insertion were measured and compared between the conditions and ankle angles. RESULTS: In Baseline and Mild conditions, the average curvature increased from plantarflexion to dorsiflexion but remained unchanged in the severe condition. The Severe condition demonstrated a significantly greater average curvature at plantar flexion than the other conditions. The thickness significantly decreased with dorsiflexion only in the severe condition, resulting in a significantly thinner insertion at maximum dorsiflexion compared with the other conditions. CONCLUSION: Our findings suggested that Mild effusion of the retrocalcaneal bursa may not exacerbate the mechanical load of Achilles tendon insertion. In contrast, in the presence of severe effusion, the retrocalcaneal bursa may compress the Achilles tendon insertion even in the plantarflexion position, and during dorsiflexion the tendon showed deformation compatible with increased compression.
Anatomic variations in basilar artery termination: a systematic review and meta-analysis with presentation of an illustrative case.
Mathangasinghe Y, Jayapala D, Narayan A … +4 more , Wijayawardhana S, Villar-Puchades R, Mariajoseph F, Gonsalvez DG
Surg Radiol Anat · 2026 Jul · PMID 42390637 · Full text
PURPOSE: Despite extensive literature on anatomical variations of the basilar artery, evidence on its termination patterns is limited. We sought out to systematically pool the prevalence of basilar artery termination var...
PURPOSE: Despite extensive literature on anatomical variations of the basilar artery, evidence on its termination patterns is limited. We sought out to systematically pool the prevalence of basilar artery termination variations and describe their neurointerventional implications with an illustrative case. METHODS: We conducted a systematic review and meta-analysis of human basilar artery termination patterns in accordance with PRISMA guidelines. PubMed, Ovid MEDLINE, Web of Science, and Scopus were systematically searched. A risk of bias assessment was performed using the JBI critical appraisal tool. A meta-analysis of proportions was performed in R using random-effects models. Heterogeneity was assessed, and pre-specified subgroup analyses were conducted based on study type (deceased donor vs. imaging). We also present a case of basilar artery non-furcation identified during a dissection. RESULTS: From 8469 initial records, 31 articles were eligible for quantitative analysis. The classic bifurcation pattern was most common, with a pooled prevalence of 85.94% [95% CI 56.65-96.62%]. The estimated pooled prevalences for variations were: non-furcation 8.95% [95% CI 6.20-12.74%], trifurcation 7.05% [95% CI 3.56-13.50%], quadrifurcation 5.30% [95% CI 2.16-12.45%], and pentafurcation 2.92% [95% CI 1.08-7.67%]. Hexafurcation was reported in a single study (0.87%). Imaging studies generally reported higher prevalence for variations compared to deceased donor cohorts. CONCLUSION: A significant proportion (14% of the population) possess variations, with non-furcation and trifurcation being most common. An understanding of these anatomical variations, as highlighted by our review and case presentation, is critical for clinical practice in neuroradiology and neurosurgery.
Letter to the Editor "Aberrant right posterior hepatic artery originating from the gastroduodenal artery with a concomitant replaced left hepatic artery: a rare clinical variant".
Mateo R, Diaz-Robinson J, Weeks SR … +1 more , Granite G
Surg Radiol Anat · 2026 Jul · PMID 42390625 · Publisher ↗
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MRI-based normative orbital anthropometric measurements in pediatric populations: age-related variations and clinical implications.
Gulsever CI, Ates A, Karlı EH … +6 more , Karapinar E, Bayramoglu Z, Cakir MS, Durak G, Sencer S, Barburoglu M
Surg Radiol Anat · 2026 Jul · PMID 42390538 · Publisher ↗
PURPOSE: Accurate anthropometric data of the pediatric orbit is critical for diagnosing and managing various pediatric orbital pathologies and for planning surgical and reconstructive interventions. The purpose of this s...
PURPOSE: Accurate anthropometric data of the pediatric orbit is critical for diagnosing and managing various pediatric orbital pathologies and for planning surgical and reconstructive interventions. The purpose of this study was to establish MRI-based normative anthropometric data for pediatric orbital structures, analyze age-related variations, and evaluate interobserver reliability among expert neuroradiologists. METHODS: This retrospective study included 64 healthy pediatric patients (32 males, 32 females; age range, 1-17 years) who underwent MRI scans for indications unrelated to orbital pathology. Patients were categorized into three age groups: pre-school (3-6 years), school-age (7-12 years), and adolescent (13-17 years). MRI scans acquired at 1.5 Tesla and 3 Tesla were independently evaluated by three neuroradiologists to measure orbital anthropometric parameters, including extraocular muscle dimensions, orbital breadth, orbital height, interzygomatic line length, intercanthal distance, optic nerve sheath width, and optic nerve angle. Statistical analyses included Spearman's correlation, Kruskal-Wallis tests, Mann-Whitney U tests, and intraclass correlation coefficients (ICC) to assess interobserver reliability. RESULTS: Significant positive correlations were identified between patient age and orbital parameters, particularly the interzygomatic line length (Spearman's r = 0.772, p < 0.001). Orbital breadth (right: r = 0.674; left: r = 0.703) and orbital height (right: r = 0.608; left: r = 0.644) also significantly increased with advancing age (all p < 0.001). Interobserver reliability demonstrated excellent reproducibility, with ICC values notably high for orbital breadth (ICC = 0.92, 95% CI: 0.89-0.95) and orbital height (ICC = 0.90, 95% CI: 0.87-0.93). CONCLUSION: MRI-based normative anthropometric measurements provide precise and reliable reference values for pediatric orbital anatomy. These measurements reveal significant age-related developmental trends, enhancing diagnostic accuracy, clinical management, and surgical planning in pediatric orbital conditions.
Intraoperative relationship between the retromandibular vein and the marginal mandibular branch of the facial nerve: a prospective surgical study and literature review.
Mehel DM, Demirel E, Koç R … +6 more , Yılmaz E, Çeçen A, Arslan H, Akgül G, Ünal A, Özdemir D
Surg Radiol Anat · 2026 Jun · PMID 42377568 · Publisher ↗
PURPOSE: To prospectively evaluate the intraoperative relationship between the retromandibular vein (RMV) and the marginal mandibular branch (MMB) or inferior facial nerve division during parotidectomy, and to synthesize...
PURPOSE: To prospectively evaluate the intraoperative relationship between the retromandibular vein (RMV) and the marginal mandibular branch (MMB) or inferior facial nerve division during parotidectomy, and to synthesize the relevant anatomical and surgical literature. METHODS: Consecutive parotidectomy procedures performed over a one-year period were prospectively evaluated. The RMV-MMB/inferior facial nerve relationship was recorded intraoperatively, and variants were photographed and documented. A structured narrative literature review was performed to identify cadaveric, fetal, radiological, surgical series, and case reports describing RMV-facial nerve relationships. During this period, 44 parotidectomies were performed; the final anatomical analysis included the 35 cases in which the RMV-MMB/inferior facial nerve relationship could be clearly defined. RESULTS: Thirty-five parotidectomy procedures were evaluated. The classical configuration, defined as the RMV deep/medial to the MMB or inferior facial nerve division, was observed in 27 cases (77.1%). Eight variants (22.9%) were documented: four cases (11.4%) showed MMB interposition between the superficial temporal vein and maxillary vein, and four cases (11.4%) showed a cervicofacial branch coursing deep/medial to the RMV. Across the literature review and the present cohort, 1454 sides/cases were summarized, including 1346 classical configurations (92.6%) and 108 variants (7.4%). Among these 35 cases, facial nerve dissection was performed anterogradely in 33 cases and retrogradely in 2 cases; both retrograde cases showed the classical relationship. CONCLUSION: The RMV is a useful landmark during parotidectomy, especially in retrograde dissection, but its relationship with the MMB and inferior facial nerve division is not constant. Awareness of interposition and deep/medial nerve variants may help reduce the risk of venous bleeding, surgical-plane misidentification, and facial nerve injury.
Effectiveness of three-dimensional printed lumbar spine-model-based training for epidural anesthesia in novice anesthesiology residents.
Sertoz N, Sahutoglu C, Ozgul KK … +2 more , Ozer MA, Govsa F
Surg Radiol Anat · 2026 Jun · PMID 42377555 · Publisher ↗
BACKGROUND: Epidural procedures have a steep learning curve and may raise patient-safety concerns during early anesthesiology training. We evaluated whether a low-cost, three-dimensional (3D) simulation model improves ea...
BACKGROUND: Epidural procedures have a steep learning curve and may raise patient-safety concerns during early anesthesiology training. We evaluated whether a low-cost, three-dimensional (3D) simulation model improves early procedural success and efficiency in novice trainees. METHODS: In this prospective randomized controlled study, 36 anesthesia residents were randomized into two groups. Group A received hands-on training on a 3D simulation model plus audiovisual teaching, whereas Group B received audiovisual teaching only. Performance was assessed at baseline (0 h), 3 h, and 6 h using procedural success, a checklist score, and a global rating scale; procedure time was recorded. RESULTS: Baseline success was comparable between groups. At 3 h and 6 h, Group A demonstrated a marked improvement, reaching a success rate of 94.4% at 6 h compared with 50.0% in Group B. Checklist scores did not differ at baseline (p = 0.888) but were significantly higher in Group A at 3 h and 6 h (both p < 0.001). Procedure time decreased significantly in Group A (from 149 ± 24 s to 107 ± 26 s, p < 0.001) versus a limited reduction in Group B (from 148 ± 26 s to 142 ± 22 s, p = 0.001). The model was inexpensive and feasible to produce (~ 6 h printing time; total cost ~$11.50/model). CONCLUSION: Low-cost 3D model-assisted training improved short-term simulator-based epidural performance, checklist scores, GRS scores, and procedural efficiency among novice anesthesiology residents. These findings support the use of 3D printed models as an accessible hands-on adjunct to conventional audiovisual epidural anesthesia training. Further studies are needed to determine whether these improvements translate into long-term retention, clinical performance and patient outcomes.
Anatomical variations of the fibularis tertius accessory tendon with insertion into the fifth digit: case reports and clinical implications.
Park ES, Park KR
Surg Radiol Anat · 2026 Jun · PMID 42360456 · Publisher ↗
PURPOSE: The fibularis tertius (FT) and extensor digitorum longus (EDL) muscles exhibit considerable anatomical variability, which may influence surgical approaches and clinical outcomes. This study aims to report a rare...
PURPOSE: The fibularis tertius (FT) and extensor digitorum longus (EDL) muscles exhibit considerable anatomical variability, which may influence surgical approaches and clinical outcomes. This study aims to report a rare anatomical variation of the fibularis tertius accessory tendon (FTAT) and to explore its clinical and developmental significance. METHODS: Two cadaveric cases were examined. Morphological features of the FTAT, including its origin, course, insertion, and dimensions (length, thickness, and width), were documented. RESULT: In Case 1, the FTAT was observed in the right leg of a 94-year-old female cadaver. The FTAT originated from the fibularis tertius muscle, branched from the main tendon 33.4 mm distal to the musculotendinous junction, and inserted into the fifth digit. It measured 92.5 mm in length, 1.1 mm in thickness, and 6.4 mm in width. In Case 2, the FTAT was identified in the left leg of a 79-year-old female cadaver. It originated independently from the fibularis tertius muscle and coursed separately to the fifth digit. A thin connecting slip measuring 61.0 mm in length was present between the FTAT and the EDL tendon. The FTAT measured 179.0 mm in length, 1.0 mm in thickness, and 3.9 mm in width. CONCLUSION: This variation of the FTAT, characterized by a distinct accessory tendon with a rare insertion into the fifth digit, may have clinical relevance in foot surgery. Awareness of such morphology is important for accurate diagnosis and safe surgical planning.
Accessory head of the sartorius arising from the femoral sheath: an anatomical variant with its clinical implications.
Datta S, Majumder R, Gobind AP
Surg Radiol Anat · 2026 Jun · PMID 42360333 · Publisher ↗
PURPOSE: The sartorius muscle is a strap muscle in the front of the thigh that contributes to movements of the hip and knee joints. Variation in the origin and insertion of this muscle is rare but clinically relevant. Al...
PURPOSE: The sartorius muscle is a strap muscle in the front of the thigh that contributes to movements of the hip and knee joints. Variation in the origin and insertion of this muscle is rare but clinically relevant. Although registered in historical catalogue and reference books, no case report presenting sartorius originating from femoral sheath with photographic documentation and analysis of clinical implications has been found in the indexed literature to the best of our knowledge. METHODS: A 74-year-old male cadaver was dissected for routine educational purposes, during which an accessory head of the sartorius muscle was identified. Morphometric measurements were recorded using a flexible tape following standard fixation. RESULTS: The accessory head arose from the anterior layer of the femoral sheath, 5 cm inferolateral to the pubic tubercle, measured 21 cm in length and 1.2 cm in width, descended along the medial border of the main sartorius muscle, and fused with it at the junction of the upper two-thirds and lower one-third of the thigh. It was innervated by a branch of the anterior division of the femoral nerve and received its arterial supply from a branch of the femoral artery. The contralateral limb showed no such variation. CONCLUSION: This accessory head may potentially cause neurovascular compression involving structures like femoral artery and/or saphenous nerve which may lead to diagnostic confusion. It may also cause difficulty or untoward complications during flap harvesting procedure. Recognition and proper documentation of sartorius muscle variants of this kind is important to avoid diagnostic and surgical challenges involving the femoral region.
Auriculotemporal nerve morphology revisited: a novel classification based on root pattern and arterial topography.
Kayan G, Uzmansel D, Koç T … +2 more , Öztürk NC, Çiftçi AT
Surg Radiol Anat · 2026 Jun · PMID 42334634 · Publisher ↗
The auriculotemporal nerve (ATN), carrying both sensory and parasympathetic fibers, is a branch of the mandibular nerve (MN) and courses through the anatomically complex infratemporal fossa (ITF). Along its path, it main...
The auriculotemporal nerve (ATN), carrying both sensory and parasympathetic fibers, is a branch of the mandibular nerve (MN) and courses through the anatomically complex infratemporal fossa (ITF). Along its path, it maintains close proximity to the maxillary artery (MA) and middle meningeal artery (MMA). This study aimed to investigate the morphometry, formation patterns, and vascular relationships of the ATN in both adult cadavers and fetuses. Bilateral ITF dissections were performed on 15 adult cadavers (mean age: 76.07 ± 14.1 years) and 15 fetuses (mean gestational age: 23.87 ± 3.40 weeks). The number of roots forming the ATN, their morphometry, configurations, and vascular relationships were documented. A classification system was developed based on root number, fusion patterns, and spatial relation to the MA and MMA. Both adult and fetal specimens demonstrated various root and connection patterns. Up to five roots were observed in adults and up to four in fetuses. In both groups, the two-root configuration was the most common (60%). The first root passed lateral to the MMA in 87% of adults and 90% of fetuses, while the second root was medial in 81% and 79%, respectively. Understanding the anatomical variability of the ATN is essential for safe surgical navigation within the ITF. Dissection-based studies that illuminate such variations provide valuable guidance for clinical procedures involving this region.
Insertional patterns of the Achilles tendon at the calcaneus: a cadaveric study in the Korean population.
Choe Y, Kim D, Park S … +5 more , Park KR, Kwon HW, Choi YJ, Park J, Cho J
Surg Radiol Anat · 2026 Jun · PMID 42332079 · Publisher ↗
PURPOSE: This study aimed to investigate the insertional patterns of the Achilles tendon at the calcaneus in Korean cadaveric lower limbs and to evaluate whether morphometric characteristics differ according to insertion...
PURPOSE: This study aimed to investigate the insertional patterns of the Achilles tendon at the calcaneus in Korean cadaveric lower limbs and to evaluate whether morphometric characteristics differ according to insertional pattern. METHODS: Fifty-five Korean cadavers (110 lower limbs) were dissected. Nine lower limbs with severe deformities were excluded, and 101 lower limbs were included in the final analysis. After separation of the tendon components of the triceps surae, insertional patterns were classified according to the criteria proposed by Edama et al. Tendon length, width, and thickness were measured at predefined reference points. RESULTS: Three insertional patterns were identified. Type 2 was the most common pattern (55.4%), followed by Type 1 (22.8%) and Type 3 (21.8%). Tendon width and thickness differed significantly according to measurement level (p < 0.001), with the greatest values observed at the calcaneal insertion. However, no significant differences in tendon length, width, or thickness were identified according to insertional pattern. CONCLUSION: Type 2 was the predominant insertional pattern of the Achilles tendon in Korean cadaveric lower limbs. Although morphometric characteristics varied along the course of the tendon, they were not significantly associated with insertional patterns. These findings provide baseline anatomical data regarding insertional variation and morphometric characteristics of the Achilles tendon.
Targeting the radial nerve in upper limb spasticity: a surgical anatomy guide.
De Lepeleere B, Frank P, Bram C … +1 more , Caroline L
Surg Radiol Anat · 2026 Jun · PMID 42298235 · Publisher ↗
PURPOSE: The radial nerve is of particular importance in the spastic upper limb, as it innervates muscles that frequently exhibit spasticity as well as muscles that are often paretic. This study describes its anatomy at...
PURPOSE: The radial nerve is of particular importance in the spastic upper limb, as it innervates muscles that frequently exhibit spasticity as well as muscles that are often paretic. This study describes its anatomy at the elbow, to provide a surgical reference for selective neurectomy or nerve transfers in spasticity treatment. METHODS: The radial nerve of sixteen fresh cadaveric upper limbs was dissected from the distal end of the radial groove to the point where the posterior interosseous nerve (PIN) runs within the supinator muscle. All branches were identified and documented. RESULTS: The branching order, based on the mean distance from the lateral epicondyle to the first branch innervating each muscle, was: brachialis, brachioradialis, extensor carpi radialis longus (ECRL), superficial branch, supinator muscle, extensor carpi radialis brevis (ECRB). A branch to the brachialis muscle originating from the radial nerve was present in 9 out of 16 specimens (56%). The brachioradialis muscle typically received two branches from the radial nerve, always arising proximal to the bifurcation into the superficial and deep branch and proximal to the ECRB branch. The ECRL was usually innervated by one or two branches, sharing a common origin with the brachioradialis or ECRB in over half of the specimens. The ECRB was innervated by a single branch, originating from the superficial branch in 7/16 cases (44%). CONCLUSION: Although the radial nerve at the elbow exhibits considerable variability, this study can provide an anatomical framework for surgical planning in selective neurectomy and nerve transfer procedures targeting the radial nerve.
Concurrent thyroid ima artery, high-riding brachiocephalic trunk, and supreme intercostal artery in thoracic vertebral artery configuration: a computed tomography angiography case report.
Rusu MC
Surg Radiol Anat · 2026 Jun · PMID 42297964 · Full text
PURPOSE: To report a cluster of five concurrent cervical vascular variants identified on computed tomography angiography (CTA), including a thyroid ima artery (TIA) from a high-riding brachiocephalic trunk (BCT), a supre...
PURPOSE: To report a cluster of five concurrent cervical vascular variants identified on computed tomography angiography (CTA), including a thyroid ima artery (TIA) from a high-riding brachiocephalic trunk (BCT), a supreme intercostal artery (SIA) in thoracic vertebral artery (TVA) configuration, and associated variants, and to discuss their embryological basis and combined surgical implications. METHODS: Retrospective review of an archived CTA study of a 74-year-old female patient, using the Horos DICOM workstation with multiplanar reformatting and three-dimensional volume-rendered reconstruction. All measurements were performed by a single observer, repeated on a separate session, and the mean reported. RESULTS: Five concurrent vascular variants and one skeletal variant were identified. (1) A common origin of the brachiocephalic trunk and left common carotid artery (the so-called bovine aortic arch). (2) A high pretracheal BCT course (calibre 1.29 cm, length 2.9 cm) with its upper margin 1.74 cm above the manubrial notch, crossing the anterior trachea from left to right. (3) A TIA arising from the BCT immediately proximal to its bifurcation and supplying both thyroid lobes. (4) An inferior mediastinal loop of the right subclavian artery (1.72 cm) with an intrathoracic origin of the right vertebral artery at 0.99 cm below the neck of the first rib. (5) A right SIA (calibre 1.1 mm) arising from the right vertebral artery at the level of the C7 transverse process in the TVA configuration, passing through the C7 transverse foramen and descending posterior to the necks of ribs 1-3. In addition, bilateral poor sternoclavicular joint articulation converted the suprasternal notch into an interclavicular space simultaneously containing the BCT, TIA, and thyroid isthmus. CONCLUSION: This combination of variants places multiple vessels in a shared pretracheal/interclavicular operative plane and appears to be undocumented as a combined pattern in the anatomical literature reviewed for this report. The embryological basis, clinical implications, and role of preoperative CTA in detection are discussed.
Nomenclatural symmetry of accessory middle cerebral artery and accessory posterior cerebral artery in a single patient.
Mugikura S, Mori N
Surg Radiol Anat · 2026 Jun · PMID 42295401 · Publisher ↗
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Atypical variants of the cerebral arterial circle beyond the Lazorthes classification: a retrospective morphologic and neuroradiologic study.
Bulbuc I, Lupascu M, Bordei P … +2 more , Ionescu C, Caraban BM
Surg Radiol Anat · 2026 Jun · PMID 42295393 · Full text
PURPOSE: To characterize atypical variants of the cerebral arterial circle that fall outside the Lazorthes classification and to interpret them in a contemporary neuroradiologic framework. METHODS: This retrospective mor...
PURPOSE: To characterize atypical variants of the cerebral arterial circle that fall outside the Lazorthes classification and to interpret them in a contemporary neuroradiologic framework. METHODS: This retrospective morphologic-neuroradiologic study analyzed 650 cases collected between 1 September 2023 and 1 March 2026: 40 dissections, including 10 injected with plastic material, 10 digital subtraction angiograms, 300 computed tomography angiograms, and 300 magnetic resonance angiograms. Typical configurations were separated from non-classifiable variants using the 22-variant Lazorthes system as the reference framework. RESULTS: Of the 650 cases, 523 (80.5%) were assignable to the Lazorthes classification, whereas 127 (19.5%) showed atypical configurations. These included six-sided anterior variants, anatomical absence or imaging non-visualization of one or two arterial segments, and incomplete posterior anastomotic patterns caused by segmental hypoplasia. The most frequent atypical pattern was unilateral anatomical absence or imaging non-visualization of a posterior communicating artery (43 cases; 6.6%), followed by unilateral anatomical absence or imaging non-visualization of a P1 segment (17 cases; 2.6%) and bilateral anatomical absence or imaging non-visualization of the posterior communicating arteries (11 cases; 1.6%). CONCLUSION: A substantial proportion of cerebral arterial circles cannot be adequately described within the classical Lazorthes typology. These atypical variants are best interpreted as patterns of altered collateral design with potential relevance for CTA and MRA interpretation, cross-flow potential, vascular territory dependence, and cerebrovascular risk assessment.
Anatomical characteristics and coordinate-based mapping of neurovascular structures within the ankle flexor retinaculum in Vietnamese cadavers.
Tuan HNA, Trinh NP, Van NT … +1 more , Tuyen LQ
Surg Radiol Anat · 2026 Jun · PMID 42295338 · Publisher ↗
PURPOSE: This study aimed to characterize the anatomical features of the ankle flexor retinaculum and to provide a coordinate-based anatomical data on tibial nerve and posterior tibial artery branching points in Vietname...
PURPOSE: This study aimed to characterize the anatomical features of the ankle flexor retinaculum and to provide a coordinate-based anatomical data on tibial nerve and posterior tibial artery branching points in Vietnamese cadaveric specimens. METHODS: A descriptive cadaveric study was conducted on 60 lower leg and foot specimens from Vietnamese adult cadavers preserved in formalin. Anatomical measurements were obtained using calibrated electronic calipers. The branching points of the tibial nerve and posterior tibial artery were mapped using an O-xy Cartesian coordinate system, with the medial malleolus serving as the reference landmark. RESULTS: The mean length of the medial malleolus-calcaneus axis was 66.3 ± 6.8 mm. Branching within the flexor retinaculum was observed in 76.7% of specimens for the tibial nerve and 100% for the posterior tibial artery. The mean coordinates of tibial nerve branching points were (26.8 ± 8.5; 16.4 ± 11.9), while those of the posterior tibial artery were (36.8 ± 6.1; -2.6 ± 8.6). Significant sex differences were identified in most anatomical measurements (p < 0.05). A branching-dense region was observed approximately 25-40 mm distal to the medial malleolus. CONCLUSION: This study provides coordinate-based anatomical data on neurovascular branching within the ankle flexor retinaculum in Vietnamese cadaveric specimens. The findings offer supplementary anatomical references for procedures around the medial ankle and should be interpreted together with individual anatomical variation and image-guided assessment when available.
Thyrolinguofacial trunk arising laterally from the common carotid artery with superior laryngeal artery and high carotid bifurcation.
Tadokoro O, Wang Y, Jian G … +2 more , Okumura M, Nishida D
Surg Radiol Anat · 2026 Jun · PMID 42274772 · Publisher ↗
During routine dissection of a 59-year-old male cadaver, we identified a rare anatomical variation consisting of a thyrolinguofacial trunk (TLFT) arising from the lateral aspect of the right common carotid artery (CCA),...
During routine dissection of a 59-year-old male cadaver, we identified a rare anatomical variation consisting of a thyrolinguofacial trunk (TLFT) arising from the lateral aspect of the right common carotid artery (CCA), which also gave rise to the superior laryngeal artery (SLA). The trunk measured 3 mm in diameter and branched successively into the superior thyroid artery, SLA, lingual artery, and facial artery. This variation coexisted with a very high carotid bifurcation at the C2 vertebral level (angle of the mandible). To the best of our knowledge, this specific combination, lateral CCA origin, SLA contribution from the TLFT, and C2-level bifurcation, has not been previously reported. Recent meta-analyses confirm the rarity of such common trunks. Embryologically, the anomalies likely share a mechanism involving disrupted remodeling of the third aortic arch derivatives. Clinically, this variation increases the risk of extensive ischemia and complicates head and neck surgeries, including carotid endarterectomy and thyroidectomy. Preoperative imaging is essential for surgical planning.
The role of metacognitive skills in anatomy education: a narrative review.
Asghar A, Patra A, Narayan RK … +1 more , Babu CSR
Surg Radiol Anat · 2026 Jun · PMID 42262617 · Publisher ↗
BACKGROUND: Metacognition, defined as "thinking about thinking," is an essential skill that enables medical students to navigate the cognitive complexity of anatomy curricula. By fostering learners' abilities to monitor...
BACKGROUND: Metacognition, defined as "thinking about thinking," is an essential skill that enables medical students to navigate the cognitive complexity of anatomy curricula. By fostering learners' abilities to monitor comprehension, recognise knowledge gaps, and strategically regulate their learning approaches, metacognition supports both academic achievement and lifelong learning. This narrative review provides a comprehensive overview of the role of metacognitive skills in anatomy education. It examines existing literature and educational interventions to provide insights into developing and applying these skills for students and educators. METHODS: A targeted literature search was conducted across major electronic databases, including PubMed, Scopus, and ERIC. The search used a Boolean string combining terms related to metacognition with those for anatomy and health professions education. The review included a broad range of article types to synthesise diverse applications and theoretical underpinnings. RESULTS: Multiple studies show that explicit, integrated metacognitive interventions-such as structured training, reflective writing, and flipped classroom methodologies-are associated with improvements in metacognitive awareness. These approaches appear most effective when incorporated as ongoing, course-specific activities rather than as isolated sessions. Notably, while metacognitive knowledge improves readily, the development of self-regulatory learning behaviours requires sustained scaffolding and practice. CONCLUSION: The literature suggests metacognition as a crucial skill for academic success in anatomy and for a successful career as a health professional. An integrated pedagogical approach that combines strategies such as retrieval practice, peer teaching, and reflective writing appears essential. This approach fosters deep, lasting learning and empowers students to become self-directed, resilient learners who can continually adapt to new challenges throughout their careers.
Fibularis brevis tendon variants: a classification-based surgical and radiological approach.
Olewnik Ł, Landfald IC, Ruzik K
Surg Radiol Anat · 2026 Jun · PMID 42262541 · Full text
PURPOSE: Fibularis brevis tendon (FBT) variants are under-recognised and may alter both imaging interpretation and operative strategy. The purpose of this review was to synthesise the available anatomical, radiological,...
PURPOSE: Fibularis brevis tendon (FBT) variants are under-recognised and may alter both imaging interpretation and operative strategy. The purpose of this review was to synthesise the available anatomical, radiological, and surgical literature on distal FBT variants and to frame this evidence through a classification-based approach. METHODS: This study was designed as a narrative review. Anatomical/cadaveric, imaging, and surgical publications relevant to distal FBT morphology and clinical interpretation were synthesised using the Olewnik classification as the organising framework. No formal systematic-review protocol or meta-analysis was undertaken. RESULTS: The available literature describes two main distal attachment types of the FBT: Type I and Type II, the latter further subdivided into subtypes IIa-IIc. The most consistent findings concern recognition of accessory slips and fused components, differentiation of variants from longitudinal split tears or pseudomass-like findings, and appreciation of how atypical insertions may influence distal operative exposure. The strongest evidence remains anatomical and imaging-based, whereas direct validation of classification-guided treatment is still limited. CONCLUSION: The Olewnik classification provides a useful anatomical framework for radiological reporting and preoperative planning, but it should presently be regarded as clinically promising rather than fully validated. A structured, variant-aware interpretation can improve communication and operative preparation in patients with lateral ankle pain, tendon pathology, or instability.
An anatomical reclassification of the temporal fascia from superficial to deep layers using true color sectioned images and 3D models.
Park JS, Noel G
Surg Radiol Anat · 2026 Jun · PMID 42262518 · Publisher ↗
PURPOSE: This study aimed to redefine the precise morphology and relationships of the temporal fasciae using high resolution sectioned images and three dimensional (3D) models. In the temporal region, fascial layers are...
PURPOSE: This study aimed to redefine the precise morphology and relationships of the temporal fasciae using high resolution sectioned images and three dimensional (3D) models. In the temporal region, fascial layers are difficult to distinguish by cadaveric dissection, which has contributed to inconsistent anatomical terminology. Therefore, we undertook this study to investigate and clarify these fasciae. METHODS: Using the sectioned images with true color and high resolution, fascial, muscular, and vascular structures in the temporal region were traced, segmented, and reconstructed into surface models using MATLAB and Slicer. Maya scripts integrated these models with the sectioned images for 3D visualization. RESULTS: Three fascial layers (the temporoparietal fascia, the superficial layer of the deep temporal fascia, and the deep layer of the deep temporal fascia) were clearly distinguished. The deep temporal fascia presented as a single layer posteriorly but divided into two layers anteriorly. Distinct fat pads were consistently identified between each fascial layer and between the deep fascia and temporal muscle. The courses of the superficial temporal artery and middle temporal vein were precisely visualized. CONSCLUSION: This study provides a clarified, 3D anatomical framework of the temporal fascia, resolving discrepancies in traditional descriptions. High fidelity, artifact free image data offer a reliable basis for safer surgical approaches, flap elevation, filler injections, and regional anesthesia in the temporal region.
Normative Evans index values in the Turkish adult population: an age- and sex-stratified MRI study.
Selcuk M, Inci M, Kasar H … +1 more , Demircioglu T
Surg Radiol Anat · 2026 Jun · PMID 42262516 · Publisher ↗
PURPOSE: The Evans Index (EI) is a widely used radiological parameter for the assessment of ventriculomegaly and normal pressure hydrocephalus, but its values may vary according to demographic characteristics. The aim of...
PURPOSE: The Evans Index (EI) is a widely used radiological parameter for the assessment of ventriculomegaly and normal pressure hydrocephalus, but its values may vary according to demographic characteristics. The aim of this study was to determine EI normative reference values in the Turkish adult population and to evaluate the relationship of these values with age and sex. METHODS: The study included 600 individuals with normal cranial magnetic resonance imaging (MRI) findings. The individuals were divided into three age groups (18-39, 40-59, 60-77 years) with 100 women and 100 men in each group. EI was calculated by measuring frontal horn width (FHW) and maximum internal skull diameter (MISD) on T2-weighted axial sections (EI = FHW/MISD). RESULTS: The mean EI value for the entire sample was found to be 0.243 ± 0.02. FHW, MISD and EI values were significantly higher in males than in females (p < 0.05). In the age group analysis, FHW values remained stable, but due to the significant decrease in MISD with age (r= - 0.271), EI values were found to be higher in older age groups and plateaued from the age of 40 onwards. The main difference was determined to be between the 18-39 age group and the other groups (p = 0.002). CONCLUSION: The normative EI values determined for the Turkish population are below the 0.30 threshold found in the literature. It has been determined that the age-related increase in the index may be associated with cranial changes rather than ventricular dilatation and stabilises after the age of 40. These findings emphasise the importance of population-specific and age-sensitive reference ranges in clinical assessments.
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