The extensor apparatus of the knee joint and its peripheral vasti: anatomic investigation and clinical relevance

L'appareil extenseur du genou et les muscles vastes: investigations anatomiques et conséquences cliniques

Summary

Anatomic dissections of the vastus medialis m. in 115 fixed thigh specimens always demonstrated a clear separation between a long head of the muscle (VML) inserted at the base of the patella and a short head (VMO) inserted at its medial margin. The plane of separation was identified by a branch of the femoral n. in every case. In 17 instances, the localization of the nerve was superficial; in 57, it was in the areolar fascial Plane; and in 41 instances in lay deeply between the muscles. The ramification of the branch of the femoral n. traversing the plane of separation showed 4 types of variation. Dissections of the vastus lateralis m. in 42 specimens always demonstrated a separation into 2 heads: a long head inserted at the base of the patella (VLL) and a short head inserted at its lateral margin (VLO). The directions of the individual heads of the quadriceps femoris m. were angulated in relation to the long axis of the femur. The deviations were between 10° and 17±8 laterally for the vastus lateralis longus m. (VLL), between 26° and 41° laterally for the vastus lateralis obliquus m. (VLO), between 15° and 18° medially for the vastus medialis longus m. (VML), and between 46° and 52° medially for the vastus medialis obliquus m. (VMO). The results demonstrate great Variation in the distal parts of the medial and lateral anterior thigh m.

Résumé

Cent quinze dissections cadavériques du m. vaste médial ont montré de façon constante une séparation nette entre une portion longue du muscle qui s'insère à la partie supérieure (VML) de la rotule et une portion courte (VMO) qui s'insère au niveau de son bord interne. Dans chaque cas le plan de séparation a pu être identifié par une branche du n. fémoral. Dans 17 cas, le nerf était superficiel, dans 57 autres cas il se trouvait dans le plan du fascia et dans 41 cas, il était situé dans la profondeur entre les faisceaux musculaires. Les ramifications de cette branche du n. fémoral présentent 4 types de variations. 42 autres dissections du muscle vaste latéral ont montré une séparation en 2 portions: une portion longue s'insérant à la partie supérieure de la rotule (VLL) et une portion courte s'insérant au niveau de son bord externe (VLO). Les directions prises par les différents faisceaux du m. quadriceps forment un angle variable par rapport à l'axe du fémur, cet angle est de 10 à 17° en dehors pour la longue portion du m. vaste latéral (VLL), de 26 à 41° en dehors pour la portion oblique du m. vaste latéral (VLO), de 15 à 18° en dedans pour la longue portion du m. vaste médial (VML) et de 46 à 52° pour la portion oblique du vaste médial (VMO). Ces résultats montrent de grandes variations entre les parties distales des m. vastes médial et latéral.

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Abbreviations

RF :

rectus femoris m

VI :

vastus intermedius m

VML :

vastus medialis longus m

VMO :

vastus medialis obliquus m

VLL :

vastus lateralis longus m

VLO :

vastus lateralis obliquus m.

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Weinstabl, R., Scharf, W. & Firbas, W. The extensor apparatus of the knee joint and its peripheral vasti: anatomic investigation and clinical relevance. Surg Radiol Anat 11, 17–22 (1989). https://doi.org/10.1007/BF02102239

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Key words

  • Extensor apparatus
  • Knee joint
  • Vastus medialis obliquus m
  • Vastus lateralis obliquus m
  • Anatomic investigation