Department of Morphological Sciences (Human Anatomy and Embriology Unit), Faculty of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Department of Radiology, Hospital of Barcelona, Barcelona, Spain.
Surg Radiol Anat. 2024 Sep;46(9):1421-1428. doi: 10.1007/s00276-024-03411-z. Epub 2024 Jun 18.
The rectus femoris forms the anterior portion of the quadriceps muscle. It has a proximal tendinous complex, which is constituted by a direct tendon, an indirect tendon, and a variable third tendon. Direct and indirect tendons converge into a common tendon. The purposes of this study are to add anatomical knowledge about the proximal tendinous complex and describe anatomical variants of the indirect tendon and, on these basis, categorize different anatomical patterns.
In this study, 48 hemipelvis from bodies donated to the Universitat Autònoma de Barcelona have been dissected to examine the proximal tendinous complex of the rectus femoris.
The following anatomical variants of the indirect tendon were described: inferior aponeurotic expansion in 23/48 cases (47.9%); superior aponeurotic expansion in 21/48 cases (43.7%); and an unusual origin of the myotendinous junction of the rectus femoris in the free portion of the indirect tendon in 19/48 cases (39.6%). On the basis of the aponeurotic expansions, the following anatomical patterns of the indirect tendon were defined: standard (19/48 cases, 39.6%), superior and inferior complex (15/48 cases, 31.2%), inferior complex (8/48 cases, 16.7%), and superior complex (6/48 cases, 12.5%).
We can categorize four different anatomical patterns of the indirect tendon, three of which are complex. We suggest that complex patterns can cause an increased stiffness of the indirect tendon and so be considered non-modifiable risk factors for rectus femoris injuries. Finally, it would be useful to identify complex patterns and perform injury prevention actions through specific physical preparation programs.
股直肌形成四头肌的前部分。它有一个近端腱性复合体，由直接肌腱、间接肌腱和可变的第三肌腱组成。直接肌腱和间接肌腱汇聚成一个共同的肌腱。本研究的目的是增加关于近端腱性复合体的解剖学知识，并描述间接肌腱的解剖学变异，并在此基础上对不同的解剖学模式进行分类。
在这项研究中，对捐赠给巴塞罗那自治大学的 48 具半骨盆进行了解剖，以检查股直肌的近端腱性复合体。
描述了间接肌腱的以下解剖学变异：23/48 例（47.9%）存在下腱膜扩张；21/48 例（43.7%）存在上腱膜扩张；19/48 例（39.6%）股直肌的肌-腱结合部在间接肌腱的游离部分有不寻常的起源。基于腱膜扩张，将间接肌腱的以下解剖学模式定义为：标准（19/48 例，39.6%）、上-下复合（15/48 例，31.2%）、下复合（8/48 例，16.7%）和上复合（6/48 例，12.5%）。
我们可以将间接肌腱分为四种不同的解剖学模式，其中三种是复合的。我们认为，复合模式可能会增加间接肌腱的僵硬程度，因此可以被视为股直肌损伤的不可改变的风险因素。最后，识别复杂模式并通过特定的身体准备计划进行损伤预防是很有用的。
