Anatomic guide and sonography for surgical repair of leg muscle lacerations.
BACKGROUND
There were over 110,000 leg laceration cases reported in the United States in 2011. Currently, muscle laceration is repaired by suturing epimysium to epimysium. Tendon-to-tendon repair is stronger, restores the muscle's resting length, and leads to a better functional recovery. Tendons retract into the muscle belly following laceration and surgeons have a difficult time finding them. Many surgeons are unfamiliar with leg muscle anatomy and the fact that the leg muscles have long intramuscular tendons that are not visible in situ. A surgical anatomic guide exists to help surgeons locate forearm tendons; no such guide exists for tendons in the leg.


MATERIALS AND METHODS
The leg tendon ends of 11 cadavers were dissected, measured, and recorded as percentages of leg length. High-frequency ultrasound was used to locate tendon ends in three additional cadavers. These locations were compared with the actual tendon ends located via dissection.


RESULTS
There was little variation in tendon end position within the cadaver group, between men and women or right and left legs. The data are presented as an anatomic guide to inform surgeons of the tendon ends' likely locations in the leg.


CONCLUSION
The location of leg intramuscular tendon ends is predictable and the anatomic guide will help surgeons locate tendon ends and perform tendon-to-tendon repairs. Ultrasound is a potentially effective tool for detection of accurate location of repairable tendon ends in leg muscle lacerations.
['Ballard|David H|DH|', 'Campbell|Kevin J|KJ|', 'Hedgepeth|Krystle B|KB|', 'Hollister|Anne M|AM|', 'Simoncini|Alberto A|AA|', 'Pahilan|M Elaine|ME|', 'Youssef|Asser M|AM|']
D000368:Aged D000369:Aged, 80 and over D002102:Cadaver D004210:Dissection D005260:Female D006801:Humans D022125:Lacerations D007866:Leg D008297:Male D008875:Middle Aged D018482:Muscle, Skeletal D019651:Reconstructive Surgical Procedures D013536:Suture Techniques D013710:Tendons D014463:Ultrasonography
Muscle laceration Leg laceration Leg muscle anatomy Tendon repair Ultrasound tendons