• Anatomy and Cell Biology
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• v.56 no.1
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• pp.150-154
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• 2023

During the deep dissection of the front of the forearm, an anomalous accessory muscle in relation to the flexor digitorum profundus (FDP) muscle was observed in the right forearm. The accessory muscle consisted of a spindle-shaped muscle belly with a long tendon underneath the flexor pollicis longus muscle. When followed distally, the accessory muscle tendon was found lateral to the FDP tendon for the index finger and entered the palm deep to the flexor retinaculum. In the palm, we encountered the first lumbrical muscle as a bipennate muscle taking origin from the adjacent sides of the middle of the tendons of FDP and accessory muscle tendon. After giving origin to first lumbrical muscle, the accessory muscle got merged with the tendon of FDP for index finger. Understanding this kind of variation is required for radiologists and hand surgeons for diagnostic purposes and while performing corrective surgical procedures.

• Journal of Korean Foot and Ankle Society
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• v.5 no.1
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• pp.62-68
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• 2001

Purpose: to investigate the etiology and the results of surgical treatment of the symptomatic accessory navicular in adults. Materials and Methods: Between 1996 and 2000, 17 cases in 16 adult patients who were older than 20 years were diagnosed as painful accessory na vicular. 11 patients could recall a twisting injury of the ankle, and 8 of them were inversion sprain. 4 patients had tibialis posterior tendon lesions. 13 feet of 12 patients were treated by resection of accessory navicular, the synchondrosis, the medial portion of the navicular and reattachment of tibialis posterior tendon without transposition. 9 feet in 8 patients were followed for more than one year after surgery. In 4 patients with tibialis posterior tendon lesions, additional procedures were performed according to the state of the lesion. Results: All were type II accessory navicular bone which had synchondroses. There was gross motion of the synchondrosis in 'the operating field in all feet. Of the 9 feet which were followed for more than one year after surgery, results were excellent in five and good in four. Conclusion: The painful accessory navicular in adult might be closely associated with inversion ankle sprain, and also with the tibialis posterior tendon lesions. Satisfactory result could be obtained without transposition of the tibialis posterior tendon to the undersurface of the navicular and immediate postoperative weight bearing does not have harmful effect on the result.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.33-37
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• 2007

Purpose: The harvest of hamstring tendon is technically demanding because of the inadequate identification of hamstring tendon separation and accessory tendon of semitendinosus tendon. We conducted therefore conducted an anatomic study, aiming at the anatomic knowledge for graft harvest. Materials and Methods: 20 human cadaveric knees (10 cadavers) were used for the study. The location of tendon separation in conjoined tendon and accessory tendon of semitendinosus tendon were described and recorded. Results: The location of tendon separation of conjoined tendon was average $39.68{\pm}9.97mm$ vertically and $18.57{\pm}2.91mm$ horizontally from the tibial spine. We found that the accessory structure of the semitendinosus tendon was mostly fascia-like structure(17 knees), the tendinous structure, 3 cases which was straightly located 15cm from the tibial crest. Conclusion: We propose that the expected incision for hamstring tendon harvest is centered on the inferior 40mm, medial 20mm from the tibial spine. The accessory structure of the semitendinosus tendon was mostly found of fascia-like structure.

• Journal of Korean Foot and Ankle Society
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• v.14 no.1
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• pp.36-40
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• 2010

Purpose: To investigate the results of surgical treatment of the symptomatic accessory navicular in adolescent. Materials and Methods: 11 patients who were 11-16 years old with symptomatic accessory navicular were identified between 2001 and 2009. Six cases were diagnosed after trauma and 8 cases were diagnosed by accident with painful bony protrusion on medial aspect of foot. In cases after at least 3 months of ineffective conservative treatment, patients were treated by resection of accessory navicular and reattachment of tibialis posterior tendon to the apex of the medial longitudinal arch using periosteum and ligamentous soft tissue without transposition of its course. And then short leg cast was applied for correction of the flat foot (if it is combined) which was molded into the longitudinal arch with the talonavicular joint released and foot inverted during about 6 weeks. Results: All were type II accessory navicular without tibialis posterior tendon lesions. In most cases pain was improved, results were excellent in seven and good in four. Calcaneal pitch angle and talus-first metatarsal angle was improved about $4.64^{\circ}$ and $5.79^{\circ}$ in average. Conclusion: Symptomatic accessory navicular in adolescent might not be associated with the tibialis posterior tendon lesions. The surgical treatment composed of excision of the accessory navicular with simple replication of the tibialis posterior tendon without altering its course led to good results in most cases. The procedure has a low rate of complications. And it is easy to be performed with a good satisfaction.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.726-730
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• 2023

The accessory tendon of the extensor hallucis longus is a common type of extensor hallucis longus variation. This is a case of a 38-year-old female patient who initially considered conservative treatment for a suspected partial rupture, but finally underwent surgery after being diagnosed with a complete rupture of the main tendon and accessory tendon medial to the main tendon on MRI scan.

• Anatomy and Cell Biology
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• v.56 no.1
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• pp.137-140
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• 2023

Tibialis anterior (TA) muscle originates from the lateral surface of tibia and its tendon attaches to the medial cuneiform and base of the first metatarsal. The TA muscle is responsible for both dorsiflexion and inversion of the foot. We present a case of bilateral TA muscle variations that diverge slightly from the current classification systems of this muscle. Recognizing variations such as these may be important for anatomists, surgeons, podiatrists, and physicians. Following routine dissection, an accessory tendon of the TA muscle was found on both sides. Accessory tendons of the extensor hallucis longus and extensor hallucis brevis joined to form a common tendon on both sides. We believe that this unique case will help further the classification systems for the tendons of the TA and also be informative for clinical anatomists as well as physicians treating patients with pathology in this region.

• Journal of Korean Foot and Ankle Society
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• v.8 no.2
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• pp.161-165
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• 2004

Purpose: To analyze clinical symptom and clinical course of accessory navicular bone and to evaluation of surgery of accessory navicular bone in sports players Materials and Methods: Twenty-two patients with accessory navicular bone were identified between January 1 2001 and June 30. 2003 Results: Subjective satisfaction of 23 patients rated very satisfaction (16), satisfaction (6), common (1). Symptomatic pain were thoroughly disappeared at average 2.5 months ($1{\sim}6$ months) after operation. On one year follow-up, most of patients could maintain daily life and could go back to their sports carreer at 3 months. Conclusion: In athlete, excision of accessory navicular and reattachment of posteior tibial tendon to navicular like non-athletes is the best solution to management of symptomatic accessory navicular failed to manage conservatively.

• Journal of the Korean Arthroscopy Society
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• v.1 no.1
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• pp.81-85
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• 1997

This article describes a modified arthroscopic technique of anterior cruciate ligament (ACL) reconstruction using quadrupled hamstring tendon graft. The autogenous semitendinosus and gracilis grafts are harvested without detachment of the tibial insertion. To obtain longer graft, the accessory tibial insertions of the hamstring tendons are dissected. The EndoButton(Acupex Microsurgical, Andover, MA) is used for femoral fixation and two spiked staples are used for tibial fixation in a belt buckle fashion. Then the residual anterior laxity is restored by additional absorbable interference screw fixations. In this technique. more viable graft is obtained and firmer distal fixation is achieved by preservation of the tibial insertion of hamstring tendons.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.441-447
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• 2023

One of the suprahyoid muscles is the digastric muscle which comprises anterior and posterior bellies joined by an intermediate tendon. Because of its close relationship with the submandibular gland, lymph nodes, and chief vessels of the neck, detailed knowledge about the morphometry of the digastric muscle is essential. The objective of the current cross-sectional evaluative study is to record morphometry along with the digastric muscle's origin, insertion, and variability. Forty human cadavers (25 males and 15 females) were dissected, and the head and neck regions were studied in detail. The attachment of the digastric muscle anterior belly to the digastric fossa of the mandible was noted, and the distal attachment of the posterior belly to the mastoid notch was traced. The length of the anterior belly from the digastric fossa to its intermediate tendon and the length of the posterior belly from the intermediate tendon to its mastoid attachment were measured. There is a fair correlation between the length of the neck and the length of the anterior and posterior belly. The study also identified two cases of bilateral accessory bellies of the anterior belly of the digastric. Normal morphometric data is provided by this study on details of the digastric muscle. It is significant from a clinical and surgical point of view as the muscle lies in proximity to the important structures of the neck.

• Journal of the Korean Arthroscopy Society
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• v.12 no.2
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• pp.112-117
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• 2008

Purpose: Double-bundle reconstruction of anterior cruciate ligament(ACL) has the advantage of restoring the isometry and original function of ACL. The purpose of this study is to evaluate the clinical results following double-bundle reconstruction of ACL using autogenous hamstring grafts through an accessory anteromedial portal. Materials and Methods: From January 2005 to July 2006, sixty patients(52 males, 8 females) underwent double-bundle ACL reconstruction using autogenous hamstring tendons..The mean age was 31.7 years($20{\sim}51$ years). The mean follow up period was 13.4 months($12{\sim}16$ months). We made a horizontal-oblique skin incision just medial to tibial tuberosity and harvested semitendinosus and gracilis tendon. Tibial tunnel for posterolateral bundle was made near its anatomical position. By modifying an anatomic reconstruction of ACL by Yasuda et al., we made a femoral tunnel for posterolateral bundle through accessory anteromedial portal. Tunnels for anteromedial bundle were made with conventional method. We reconstructed anteromedial bundle with semitendinosus tendon and posterolateral bundle with gracilis tendon. Clinical results at last follow up were evaluated by range of motion, extent of anterior displacement(KT-1000 arthrometer), pivot-shift test. Functional evaluation of clinical outcomes were evaluated by Lysholm score and modified Feagin Scoring System. Results: There was no limitation of motion of knee joint at last follow up. Mean side to side difference of anterior displacement of tibia by KT-1000 arthrometer was improved from 8.4 mm preoperatively to 1.7 mm postoperatively(p<0.05). Average Lysholm score was improved from 64.1 preoperatively to 92.2 postoperatively(p<0.05). In modified Feagin Scoring System, 90% of cases were rated as good or excellent. Conclusion: Double-bundle reconstruction of ACL using autogenous hamstring grafts through accessory anteromedial portal results in good clinical outcomes.