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    Connection between medial dorsal cutaneous nerve and saphenous nerve: case report
    (Springer France, 2023) Cicek, Fatih; Koc, Turan; Olgunus, Zeliha Kurtoglu
    PurposeThere are no data on the connection of the saphenous nerve (SN), located on the medial side of the foot, with the terminal branches of the superficial fibular nerve. The aim of this study is to reveal the variation that surgeons should pay attention to for anesthesia applied in foot surgeries.MethodsIn this study, the left foot of a 70-year-old female cadaver fixed with formalin was dissected. The distance to the medial malleolus and the incision line was recorded using digital caliper to determine the reference points in the resulting variation.ResultsIt was observed that a branch from the SN, which arose from the SN and proceeded anteriorly to the upper part of the medial malleolus and continued towards the dorsum of the foot, hooked with a branch from the medial dorsal cutaneous nerve (MDCN). The branches arising from this hook were distributed on the medial edge of the foot up to the proximal metatarsophalangeal joint I. The distance of this nerve connection to the medial malleolus is 91.14 mm, and the distance to the incision line is 15.76 mm.ConclusionsIt is suggested that the case presented as an unusual SN variation, which may affect the success of local anesthesia in invasive procedures to the medial part of the foot and could be considered in the evaluation of sensory loss after anteromedial surgical approach to the ankle, should be included in the classification of the cutaneous innervation pattern of the foot.
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    Investigation of Morphometric Characteristics of the Mesencephalon in a Healthy Turkish Population: An MRI-Based Morphometric Study
    (Springernature, 2023) Demir, Mehmet; Cinaroglu, Selim; Ceranoglu, Faruk G.; Cicek, Fatih; Koc, Turan
    Introduction: Due to the important functions of the mesencephalon, knowledge of its morphometric characteristics in a healthy population is important for any pathological diagnosis. The aim of this study was to determine the specific morphometric values of the mesencephalon in a healthy Turkish population.Methods: Magnetic resonance (MR) images of 184 subjects (98 females, 86 males) with a mean age of 47.33 years (range 18 to 85 years) were included in the study. Then, parameter measurements were performed on 1.5 T MR images, and MicroDicom Digital Imaging and Communications in Medicine (DICOM) viewer 2022.1 (MicroDicom Ltd., Sofia, Bulgaria) software program was used for the measurements.Results: The mean sagittal diameter of the right cerebral peduncle was 17.17 +/- 2.03 mm, the mean crosssectional area of the right cerebral peduncle was 171.75 +/- 32.81 mm(2), the mean transverse diameter of the left cerebral peduncle was 16.60 +/- 2.32 mm, sagittal diameter of tectum and tegmentum 17.01 +/- 1.57 mm, the cross-sectional area of tectum and tegmentum 223.40 +/- 27.37 mm(2) and pontomesencephalic angle 52.03(degrees)+/- 10.61(degrees), while in males these values were 18.26 +/- 2.38 mm, 182.61 +/- 38.57 mm(2), 17.39 +/- 2.57 mm, 17.76 +/- 1.90 mm, 237.20 +/- 35.94 mm(2) and 56.77(degrees)+/- 9.78(degrees), respectively. Except for the mamillopontine distance, there was a statistically significant difference between genders in the other parameters (p<0.05).Conclusion: In conclusion, the findings related to the mesencephalon obtained in this study are presented for the first time in a healthy Turkish population. Especially, the cerebral peduncle cross-sectional area, tectum and tegmentum cross-sectional area, and cerebral peduncle transverse diameter can be evaluated clinically. We believe that knowledge of these values will guide specialists and radiologists in the diagnosis of any pathologic condition. Furthermore, the pontomesencephalic angle and mamillopontine distance have been identified as potentially useful landmarks in the diagnosis of intracranial hypotension and hydrocephalus. In particular, these angles can be measured in patient groups and may be a potential landmark in making an alternative diagnosis.
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    Positional and dimensional relation of tendons around the first metatarsal bone with hallux valgus
    (Springer France, 2023) Olgunus, Zeliha Kurtoglu; Cicek, Fatih; Koc, Turan
    1. Coughlin MJ, Jones JP (2007) Hallux valgus: demographics, etiology, and radiographic assessment. Foot Ankle Int 28:759-777. https://doi.org/10.3113/FAI.2007.0759 2. Perera A, Mason L, Stephens M (2011) The pathogenesis of hallux valgus. J Bone Joint Surg Am 93:1650-1661. https://doi.org/10. 2106/JBJS.H. 01630 3. Cavalheiro CS, Arcuri MH, Guil VR, Gali JC (2020) Hallux valgus anatomical alterations and its correlation with the radiographic findings. Acta Ortop Bras 28:12-15. https://doi.org/10. 1590/1413-785220202801226897 4. Chhaya SA, Brawner M, Hobbs P, Chhaya N, Garcia G, Loredo R (2008) Understanding hallux valgus deformity: what the surgeon wants to know from the conventional radiograph. Curr Probl Diagn Radiol 37:127-137. https://doi.org/10.1067/j.cpradiol. 2007.11.004 5. Coughlin MJ, Shurnas PS (2003) Hallux valgus in men part II: first ray mobility after bunionectomy and factors associated with hallux valgus deformity. Foot Ankle Int 24:73-78. https://doi.org/ 10.1177/107110070302400112 6. Mickle KJ, Nester CJ (2018) Morphology of the toe flexor muscles in older people with toe deformities. Arthritis Care Res (Hoboken) 70:902-907. https://doi.org/10.1002/acr.23348
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    The effect of hallux valgus on the anatomy of the nerves around the first metatarsal bone
    (Springer France, 2024) Cicek, Fatih; Olgunus, Zeliha Kurtoglu; Koc, Turan
    Objective To identify the variations in the location of the nerves that may be at risk in hallux valgus (HV) surgery, and to reveal whether these nerves are affected by the anatomical changes associated with HV. Method In the formalin fixed, 46 lower extremities (19 female, 27 male) (9 normal, 14 mild HV, 21 moderate/severe HV), extensor hallucis longus tendon (EHL), deep plantar artery, medial dorsal cutaneous (MDCN), deep fibular (DFN), common plantar digital (CPDN) and proper plantar digital (PPDN) nerves were examined. The branches of MDCN extending to the medial side of foot were recorded in three segments. The positional topography of nerves according to EHL were analyzed on 360(degrees) circle and clock models. Results Sex-related differences observed in some parameters in direct measurements were not found in the clock model comparisons. In advanced HV angles (> 20(degrees)), DFN was closer to EHL in the distal part of the metatarsal bone, while there was no difference in the proximal. The intersection of the medial branch of the MDCN with the EHL was more proximal in HV cases than in normal feet. The location of the nerves in the clock pattern did not change in HV. Of the nerve branches reaching the medial side of the foot, 65.2% were in Part I, 71.7% in Part II, and 4.3% in Part III. Conclusion Sex differences in the distance of the nerves to the EHL disappeared when the size effect of the cross-section of the first metatarsal bone region was eliminated with the clock model. Only in advanced HVA (>20(degrees)) (not in mild HV), the DFN being closer to the EHL distally and the intersection of the medial branch of the MDCN with the EHL in HV being more proximal than in normal can be interpreted as specific reflections of HV progress. The variations we revealed in the number of branches reaching the inside of the foot may explain the diversity of neuromas or nerve injuries associated with HV surgery.