title: Anatomic guide and sonography for surgical repair of leg muscle lacerations.
abstract: BACKGROUND
  There were over 110,000 leg laceration cases reported in the United States in 2011. Currently, muscle laceration is repaired by suturing epimysium to epimysium. Tendon-to-tendon repair is stronger, restores the muscle's resting length, and leads to a better functional recovery. Tendons retract into the muscle belly following laceration and surgeons have a difficult time finding them. Many surgeons are unfamiliar with leg muscle anatomy and the fact that the leg muscles have long intramuscular tendons that are not visible in situ. A surgical anatomic guide exists to help surgeons locate forearm tendons; no such guide exists for tendons in the leg.
  
  
  METHODS
  The leg tendon ends of 11 cadavers were dissected, measured, and recorded as percentages of leg length. High-frequency ultrasound was used to locate tendon ends in three additional cadavers. These locations were compared with the actual tendon ends located via dissection.
  
  
  RESULTS
  There was little variation in tendon end position within the cadaver group, between men and women or right and left legs. The data are presented as an anatomic guide to inform surgeons of the tendon ends' likely locations in the leg.
  
  
  CONCLUSIONS
  The location of leg intramuscular tendon ends is predictable and the anatomic guide will help surgeons locate tendon ends and perform tendon-to-tendon repairs. Ultrasound is a potentially effective tool for detection of accurate location of repairable tendon ends in leg muscle lacerations.
authors.affiliation: Louisiana State University Health, Shreveport, Louisiana 71103, USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Ballard
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Campbell
authors.forename: Krystle B
authors.initials: KB
authors.lastname: Hedgepeth
authors.forename: Anne M
authors.initials: AM
authors.lastname: Hollister
authors.forename: Alberto A
authors.initials: AA
authors.lastname: Simoncini
authors.forename: M Elaine
authors.initials: ME
authors.lastname: Pahilan
authors.forename: Asser M
authors.initials: AM
authors.lastname: Youssef
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D004210:Dissection; D005260:Female; D006801:Humans; D022125:Lacerations / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D007866:Leg; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D019651:Plastic Surgery Procedures; D013536:Suture Techniques; D013710:Tendons / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography
keywords: Leg laceration; Leg muscle anatomy; Muscle laceration; Tendon repair; Ultrasound tendons