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Anatomy of the lateral ligaments of the rectum: A controversial point of view

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World Journal of Gastroenterology 2010年第43期16卷 5411-5415页

作者： Guo-Jun Wang, Chun-Fang Gao, Dong Wei, Cun Wang, Wen-Jian Meng, Institute of Digestive Surgery and Department of General Surgery, 150 Hospital of PLA, Gaoxin District, Luoyang 471031, Henan Province, China Institute of Digestive Surgery and Department of General Surgery 150 Hospital of PLA Gaoxin District Luoyang 471031 Henan Province China.

The existence and composition of the lateral ligaments of the rectum (LLR) are still the subjects of anatomical confusion and surgical misconception up to now. Since Miles proposed abdominoperineal excision as radical surgery for rectal cancer, the identification by "hooking them on the finger" has been accepted by many surgeons with no doubt; clamping, dividing and ligating are considered to be essential procedures in mobilization of the rectum in many surgical textbooks. But in cadaveric studies, many anatomists could not find LLR described by the textbooks, and more and more surgeons also failed to find LLR during the proctectomy according to the principle of total mesorectal excision. The anatomy of LLR has diverse descriptions in literatures. According to our clinical observations, the traditional anatomical structures of LLR do exist; LLR are constant dense connective bundles which are located in either lateral side of the lower part of the rectum, run between rectal visceral fascia and pelvic parietal fascia above the levator ani, and covered by superior fascia of pelvic diaphragm. They are pathways of blood vessels and nerve fibers toward the rectum and lymphatic vessels from the lower rectum toward the iliac lymph nodes.

关键词： The lateral ligaments of the rectum Anatomy Total mesorectal excision Abdominoperineal excision Fascia

Mechanical properties of 65Mn chiral structure with three ligaments

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Acta Mechanica Sinica 2019年第1期35卷 88-98,I0003页

作者： X.W.Su D.M.Zhu C.Zheng M.M.Tomovic School of Technology Beijing Forestry UniversityBeijing 100083China School of Mechanical Engineering University of Science and Technology BeijingBeijing 100083 China Batten College of Engineering and Technology Old Dominion University Norfolk VA 23529 USA

Chiral honeycomb structures have been developed in recent years, showing excellent mechanical properties, including in-plane deformation and out-of-plane bearing and vibration isolation. In this study, the 65Mn chiral structure with three ligaments was modeled and analyzed using the finite element (FE) method. The effects of the dimensionless ligament length and dimensionless ligament thickness on the in-plane equivalent elastic modulus, equivalent Poisson's ratio, and out-of-plane shear modulus were studied. The numerical results indicate that increase of the dimensionless ligament length leads to decrease of the equivalent elastic modulus and increase of the equivalePoisson's ratio, whereas the out-of-plane equivalent shear modulus decreases. The results also indicate that increase of the dimensionless ligament thickness leads to in crease of the equivalent elastic modulus, whereas the equivalent Poisson's ratio remains nearly unchanged and the out-of-plane equivalent shear modulus shows a linear in crease. The numerical results are verified by comparis on with published experime ntal data. These results will provide a reference for the application of chiral structures with three ligaments in the aerospace field.

关键词： Chiral structure with three ligaments Mechanical properties Finite elemern method

A non-linear finite element model of human L4-L5 lumbar spinal segment with three-dimensional solid element ligaments

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Theoretical & Applied Mechanics Letters 2011年第6期1卷 75-80页

作者： Zhitao Xiao,1 Liya Wang,1 He Gong,1, ) Dong Zhu,2, ) and Xizheng Zhang3 1)Department of Engineering Mechanics, Jilin University, Changchun 130012, China 2)Department of Orthopaedic Trauma No.1, Hospital of Jilin University, Changchun 130012, China 3)Institute of Medical Equipment, Academy of Military Medical Sciences, Tianjin 300161, China Jilin Univ Dept Engn Mech Changchun 130012 Jilin Peoples R China Hosp Jilin Univ Dept Orthopaed Trauma 1 Changchun 130012 Jilin Peoples R China Acad Mil Med Sci Inst Med Equipment Tianjin 300161 Peoples R China

This paper establishes a non-linear finite element model (NFEM) of L4-L5 lumbar spinal segment with accurate three-dimensional solid ligaments and intervertebral disc. For the purpose, the intervertebral disc and surrounding ligaments are modeled with four-nodal three-dimensional tetrahedral elements with hyper-elastic material properties. Pure moment of 10 N·m without preload is applied to the upper vertebral body under the loading conditions of lateral bending, backward extension, torsion, and forward flexion, respectively. The simulate relationship curves between generalized forces and generalized displacement of the NFEM are compared with the in vitro experimental result curves to verify NFEM. The verified results show that: (1) The range of simulated motion is a good agreement with the in vitro experimental data; (2) The NFEM can more effectively reffect the actual mechanical properties than the FE model using cable and spring elements ligaments; (3) The NFEM can be used as the basis for further research on lumbar degenerative diseases.

关键词： lumbar spine non-linear ligaments finite element analysis

Magnetic resonance imaging of the ligaments of the craniocervical region at 3Tesla magnetic resonance unit: Quantitative and qualitative assessment

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Journal of Biomedical Science and Engineering 2012年第12期5卷 901-909页

作者： Katerina Vassiou Kapsalaki Eftichia Konstantinos Marinos Filio Kotrogianni Michail Fanariotis Ioannis Fezoulidis Dimitrios Arvanitis Department of Anatomy Medical School University of Thessalia Larissa Greece Department of Radiology Medical School University of Thessalia Larissa Greece epartment of Anatomy Medical School University of Thessalia Larissa Greece Medical School University of Thessalia Larissa Greece

Purpose: The assessment of the morphology and dimensions of the craniocervical ligaments using a 3 Tesla (T) Magnetic Resonance (MR) scanner, the correlatation of our results with those from cadaveric and other MR studies and the detection of the most appropriate sequence for the best imaging of the craniovertebral junction ligaments. Methods: 58 healthy volunteers (mean age 45 years) underwent a Magnetic Resonance Imaging (MRI) of the cervical spine at 3T MR unit. The MRI protocol included axial, coronal and sagittal Proton-Density (PD) sequences and sagittal T1 Fluid Attenuated Inversion Recovery (FLAIR) and T2 sequences. The images were evaluated by two radiologists and the posterior atlantoocipital ligament, the anterior atlantoocipital ligament, the transverse ligament and the apical ligament were anatomically detected, described and measured. Results: The transverse ligament was identified at 93.1%, the apical ligament was identified at 60.34%, the posterior at- lantooccipital membrane was identified at 94.8% and the anterior atlantooccipital membrane was identified at 96.5% of the cases. All ligaments appeared with low signal intensity, except the anterior atlantooc-cipital ligament which appeared with intermediate signal intensity. Their length, width and thickness were measured and, in general, correlated well with other anatomic and MR studies. Conclusion: Reliable assessment of the morphology and signal intensity of the craniocervical ligaments can be achieved with PD sequence at 3T MR imaging. The sagittal plane provides better delineation of the craniocervical (CC) ligaments but the axial and coronal planes are of paramount importance in the assessment of the transverse and apical ligaments.

关键词： raniocervical Region ligaments MRI Apical Ligament Transverse Ligament Atlantooccipital Membrane

Three-dimensional finite element analysis of ligaments of lumbar spine

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Journal of Medical Colleges of PLA(China) 1992年第2期7卷 132-135,140页

作者：戴力扬屠开元张文明成培来 Department of Orthopaedics Changzheng HospitalSecond Military Medical UniversityShanghai 200433 Tianjin Institute of Technology Tianjin 300191

The lumbar ligaments play an important role in spinal biomechanics.The results ofthree-dimensional finite dement analysis showed that one of the functions of lumbar ligaments istransmission of the tensile load between the lumbar vertebrae.The anterior longitudinal ligament isloaded in extension of lumbar spine and the resistance to the tensile load in flexion is providedby other ligaments.These ligaments are subject to much more tension with degeneration of theintervertebral disc so that a series of pathological changes occur.Relevant significance in clinical as-pect is also discussed.

关键词： biomechanics lumbar vertebrae ligaments articular human

Clinical,imaging,arthroscopic,and histologic features of bilateral anteromedial meniscofemoral ligament:A case report

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World Journal of Methodology 2023年第4期13卷 359-365页

作者： Juan Bautista Luco Damian Di Memmo Valentina Gomez Sicre Tomas Ignacio Nicolino Matias Costa-Paz Juan Astoul Ignacio Garcia-Mansilla Division of Knee Department of OrthopaedicsHospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Radiology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Pathology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina

BACKGROUND The anteromedial meniscofemoral ligament(AMMFL)is a very rare entity,commonly unrecognized and underreported.Although it was not proved to be a cause of anterior knee pain,concerns have been raised on the relationship between the presence of this structure and medial meniscus injury secondary to its abnormal motion.Regarding histologic examination,some studies have shown meniscus-like fibrocartilage,while others have identified it as ligament-like collagenous fibrous connective tissue.CASE SUMMARY We report the case of a 34-year-old ballerina with an AMMFL associated with a torn medial meniscus of both knees.Surgery was performed to treat the meniscal injury and two biopsies of each AMMFL were taken in different locations to define the histopathological composition.Histologic examination revealed fibrocartilaginous tissue compatible with meniscus.Follow-up evaluation one year after surgery evidenced full remission of symptoms and the patient had resumed her athletic activities.CONCLUSION Clinical,magnetic resonance imaging,arthroscopic,and histological features have been carefully described to better characterize the AMMFL.

关键词： Meniscofemoral ligaments Knee arthroscopy Histology Case report

Spreading of a Multicomponent Drop in Water: Solutions and Suspensions

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Fluid Dynamics & Materials Processing 2020年第4期16卷 723-735页

作者： Andrey Y.Ilinykh Ishlinsky Institute for Problems in Mechanics of the Russian Academy of Sciences Moscow119526Russia

The distribution of material resulting from the impact of a freely falling drop with a target liquid has been studied by photo and video registration methods.Different cases have been investigated by considering drops made of aqueous solutions(ink,salt,acid)and including fine solid particles(i.e.,suspensions).New features have been observed in terms of flow dynamics and thin components produced as a result of the impact(such as banded elements,ligaments,and vortices at the surface of the liquid).In particular,the characteristics of emerging netlike structures have been found to depend on the size of the suspension clusters.For the case of acetic acid,a different patterning behavior has been obtained:sequences of concentric arcs are produced in that case.However,linear scaling laws and the discrete nature of the distribution of the droplet material seem to be features common to all the cases considered.

关键词： Drop impact splashes ligaments material distribution

Three-dimensional finite element analysis of the effects of ligaments on human sacroiliac joint and pelvis in two different positions

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Three-dimensional finite element analysis of the effects of ...

New insights in the treatment of acromioclavicular separation

中国力学大会（CCTAM2019）

作者： YANG Jia-jing ZHAO Gai-ping XU Hai-fei WANG Fei School of Medical Instrument and Food Engineering University of Shanghai for Science and Technology Changhai Hospital of Shanghai

Objective: To present the effects of ligaments on the sacroiliac joint stability and human pelvis biomechanical characteristics in two different positions by using three-dimensional finite element models of the human pelvis. Methods: Based on the CT image data of human pelvis, three-dimensional finite element models of human pelvis in the sitting and standing positions was established, which include the bone(sacrum, ilium and coccyx) and the main six ligaments(sacroiliac, sacrospinous, sacrotuberous, inguinal, superior pubic and arcuate pubic ligaments). A force of 600 N was applied at the upper surface of the sacrum along the longitudinal axis of pelvis to analyze the stress and displacement distribution of the pelvic bone and sacroiliac joint(SIJ). Results: The simulation results demonstrate that the maximum stresses of sacrum and ilium on the SIJ contact surface are 5.63 MPa and 7.40 MPa in the standing position and 7.44 MPa and 7.95 MPa in the sitting position, respectively. The stresses of the ligament dysfunction group was higher than that of the health group, which increase by 22.6% and 35.7% in standing position and 25.2% and 43.6% in sitting position in sacrum and ilium. The maximum displacement locates on the upper surface of the sacrum, which was 0.13 mm and 1.04 mm in the standing and sitting positions. ligaments dysfunction group increased 30.7% and 9.6% than health group in the standing and sitting positions. The integral displacement of pelvis bone in the sitting position was greater than that in the standing position. Conclusions: The location of stress concentration and displacement distribution of pelvic bone are closely resembled the previous research results in two different positions. The simulation results may provide beneficial information and theoretical models for clinical research of the pelvic fracture, joint movement and ligament functional injuries and so on.

关键词： pelvis ligaments sacroiliac joint different positions finite element model

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World Journal of Orthopedics 2017年第12期8卷 861-873页

作者： Christiaan J A van Bergen Annelies F van Bemmel Tjarco D W Alta Arthur van Noort Department of Orthopaedic Surgery Amphia Hospital Department of Orthopaedic Surgery Spaarne GasthuisHoofddorp 2134 TM

A direct force on the superior aspect of the shoulder may cause acromioclavicular(AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types Ⅰ?and Ⅱ are treated nonoperatively, while types Ⅳ, Ⅴ and Ⅵ are generally treated operatively. Controversy exists regarding the optimal treatment of type Ⅲ dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.

关键词： Acromioclavicular dislocation Rockwood classification Coracoclavicular ligament reconstruction Hookplate Arthroscopically assisted acromioclavicular reconstruction Weaver and Dunn procedure Conoid and trapezoid ligaments