CROSSED LEG PALSY with Report of a Recurrent Case

A form of peroneal palsy may be caused by crossing the legs. Two physical factors—pressure and tension — are the basic causes, although other factors may be contributory. Direct pressure is applied by the bones of the two legs, compressing the peroneal nerve between them at its superficial part near the head and neck of the fibula.The palsy may be overlooked as an integral part of a widespread disorder so that careful evaluation and observation of the patient''s habits are required. Detection becomes especially difficult when the palsy is bilateral, for then the lesion by virtue of its symmetry blends more readily with associated polyneuritis. A case of recurrent peroneal palsy due to crossing the legs in a prolonged postoperative convalescence is reported in detail.     

Ankle-arm index versus angiography for the preassessment of the fibula free flap

Peripheral arterial occlusive disease or congenital anomalies of the major crural arteries may limit the use of the fibula free flap and should be detected preoperatively. Conventional selective angiography is the definitive standard imaging method for making this diagnosis, but it has drawbacks. A safer, cheaper, more accurate, and noninvasive alternative is desirable. The authors sought to test the hypothesis that the ankle-arm index of each of the three crural arteries, combined with pencil Doppler examination of the peroneal skin perforators, would provide adequate information to restrict the use of angiography to cases in which the outcomes of either or both of these options are insufficient. The ankle-arm index data of each of the three crural arteries, as well as pencil Doppler examination of the peroneal skin perforators of both legs of nine prospectively included patients and the nonoperated legs of 13 retrospectively included patients, were compared statistically in four different ways with the preoperative angiographic findings. A combined ankle-arm index and pencil Doppler examination is not accurate enough to detect legs or arteries with subclinical peripheral arterial occlusive disease or vascular variation and, hence, is not a sufficient basis on which to develop the surgical plan for a fibula free flap.     

A new surgical technique for the treatment of high common peroneal nerve palsy

In this article, the authors introduce a new procedure for the treatment of high common peroneal nerve palsy. The principle of this technique consists of the neurotization of the anterior tibial nerve (deep peroneal nerve) with the bundle composed of the nerves to the soleus and lateral head of gastrocnemius muscles. The authors used this procedure for eight children who had permanent common peroneal nerve palsy caused by the injection of diclofenac in the gluteal region and for a 25-year-old male patient whose common peroneal nerve was transected near the gluteal region by a stab wound. For the cases in which paralysis was less than 8 months in duration, the results are satisfactory.     

The toe-spreading reflex of the rabbit revisited--functional evaluation of complete peroneal nerve lesions.

Although a variety of electrophysiological and morphological tests are available for studying nerve regeneration in animals, these endpoints do not necessarily correlate with the return of muscle function. Recent efforts have focused on the assessment of function as the endpoint of nerve regeneration. One of the best known of these tests is the sciatic function index in rats. For rabbits, the toe-spreading reflex has been suggested as a valuable index of peroneal function. We examined the reliability and sensitivity of the toe-spreading reflex in a study of nerve regeneration of the peroneal nerve in 10 New Zealand White rabbits. Eleven weeks after the transection and immediate suturing of the peroneal nerve in both hind legs (at two slightly different sites), a toe-spreading reflex could always be elicited on that side where the level of the severed nerve was closer to the dependent muscles. Also on this hind leg the muscle weight of the peroneal target muscles was significantly higher (P = 0.031) than on the contralateral side, which corresponds well to the results of the toe-spreading reflex. The toe-spreading reflex is an excellent and sensitive indicator of the onset of motor recovery in the peroneal nerve-dependent muscles of rabbits. Even small differences in the localization of lesions in both hind legs can be differentiated with this test.     

Skin island flaps supplied by the vascular axis of the sensitive superficial nerves: anatomic study and clinical experience in the leg.

An anatomic study performed on 64 fresh injected legs has shown the role of the vascular axis that follows the superficial sensitive nerves in supplying the skin. Three nerves were studied: the saphenous nerve, the superficial peroneal nerve, and the sural nerve. Conclusions are the same for the three nerves: The vascular axis, which can be either a true artery or an interlacing network, ensures the vascularization of the nerves, gives off several cutaneous branches in the suprafascial course of the nerve, and anastomoses with the septocutaneous arteries issuing from a deep main vessel. The superficial nerves that course the leg can therefore be considered as vascular relays owing to their neurocutaneous arteries. The concept of a neuroskin island flap has been developed and applied to six clinical cases for coverage of some specific areas of the knee and of the lower part of the limb.     

White Ibis integument color during the breeding season

ABSTRACT.   Many birds undergo bare part color changes during the breeding season. Most investigators have focused on color as a signal of individual quality. An alternative, but not exclusive, function of bare part color may be signaling readiness to breed, especially in colonial, asynchronous breeders. White Ibises ( Eudocimus albus ) are colonial waterbirds that show vivid bare part colors on their bills and legs during reproduction. We quantified bill and leg colors to describe color changes and their possible relationship to reproductive status during the breeding season of White Ibises in the Florida Everglades from 1998 to 2001. We also examined the correlation between bare part colors and circulating concentrations of sex steroids to understand the factors that regulate bare part colors. During the display stage, male and female ibises developed dark pink bills and scarlet legs. As the breeding season progressed, bills and legs faded and developed a muted pink hue. The bare part colors of female ibises were correlated with testosterone concentrations, but those of male ibises were not correlated with any hormones. A discriminant function analysis based on principal component scores (representing variation in saturation and hue) and the amount of black on the bill successfully classified ibis reproductive stage 94% of the time. The use of bare part colors to determine reproductive status may be useful for studying reproduction in colonially nesting birds, where access to breeding sites can be difficult and potential for researcher disturbance is high.     

Comparative functional morphology of the primate peroneal process

The first metatarsal of living Primates is characterized by a well-developed peroneal process, which appears proportionally larger in prosimians than in anthropoids. A large peroneal process has been hypothesized to: 1) reflect powerful hallucal grasping, 2) act as a buttress to reduce strain from loads acting on the entocuneiform-first metatarsal joint during landing and grasping after a leap, and/or 3) correlate with differences in physiological abduction of the hallux. In this study, we address the latter two hypotheses by comparing the morphology of the peroneal process in 143 specimens representing 37 species of extant prosimians, platyrrhine anthropoids, and tupaiids (tree shrews) that engage in different locomotor behaviors. In particular, we compare taxa that vary in leaping frequency and hallucal abduction. Linear and angular measurements on the first metatarsal were obtained to evaluate differences in relative peroneal process thickness and length, first metatarsal abduction angle, and overall first metatarsal shape. Leaping frequency was significantly correlated only with relative peroneal process thickness within extant lorisoids. Relative process length was positively correlated with the angle of hallucal abduction within prosimians; this angle is significantly greater in prosimians than anthropoids. Multivariate analyses of metatarsal shape effectively separate species along phylogenetic lines, but not by locomotor behaviors. The hypothesis that the peroneal process on the first metatarsal reduces the loads on the entocuneiform-first metatarsal joint during landing after a leap is in part supported by data from extant lorisoids (i.e., slow quadrupedal lorises vs. leaping galagos). A peroneal process of greater length within prosimians may serve to increase the lever arm for the peroneus longus muscle in order to prevent hyper-abduction, followed by inversion in locomotor situations where the animal's weight is born on a highly divergent/abducted hallux.     

Cutting edge: expansion of the KIR locus by unequal crossing over

The killer Ig-like receptor (KIR) genes have high sequence similarity and are organized in a head-to-tail fashion. These properties may enhance misalignment of homologous chromosomes during synapsis preceding meiotic recombination, resulting in unequal crossing over. We have identified an extended KIR haplotype that contains a novel hybrid gene and two copies of each of two previously described KIR genes. A parsimonious mechanism for the derivation of this haplotype invokes unequal crossing over between two known ancestral KIR haplotypes. These data raise the possibility that unequal crossing over may be responsible in part for the expansion/contraction of KIR haplotypes as well as other homologous gene families that map in tandem.     

Gladioferens Henry (Copepoda: Calanoida) discovered in Antarctica: G. antarcticus sp. nov. described from a lake in the Bunger Hills

A new species of Gladioferens is described from a freshwater lake in the Bunger Hills, Greater Antarctica. A key to the six species of Gladioferens is provided for both sexes. Most species of the subgenus containing G. antarcticus sp. nov. are remarkable in possessing asymmetries in the second legs (male) and fourth legs (female). This suggests that the mating behaviour of these species may be radically different from that in most heterarthrandrian calanoids and calls for further study. However, G. antarcticus is more primitive than its consubgeners in having, in the male, symmetrical second legs and 3-segmented endopods in the fifth legs. The genus shows a highly disjunct distribution (Australia, New Zealand and Bunger Hills) and its biogeography is now of outstanding interest.     

An Analysis of Heterosis VS. Inbreeding Effects with an Autotetraploid Cross-Fertilized Plant: MEDICAGO SATIVA L

Self-fertilization and crossing were combined to produce a large number of levels of inbreeding and of degrees of kinship. The inbreeding effect increases with the complexity of the character and with its supposed relationship with fitness. A certain amount of heterozygosity appears to be necessary for the expression of variability. With crossing of unrelated noninbred plants, genetic variance is mainly additive, but with inbreeding its major part is nonadditive. High additivity in crossing, therefore, coexists with strong inbreeding depression. However, even in inbreeding the genetic coefficient of covariation among relatives appears to be strongly and linearly related to the classical coefficient of kinship. This means that deviations from the additive model with inbreeding could be partly due to an effect of inbreeding on variances through an effect on means. An attempt to analyze genetic effects from a theoretical model, based upon the identity by descent relationship at the level of means and of covariances between relatives, tends to show that allelic interactions are more important and nonallelic interactions are less important for a character closely related to fitness. For a complex character, these results lead to the conception of a genome organized in polygenic complementary blocks integrating epistasis and dominance. Some consequences for plant breeding are also discussed.     

Stick insects walking on a wheel: Perturbations induced by obstruction of leg protraction

Summary Stick insects (Carausius morosus) walking on a wheel were perturbed by restricting the forward protraction of individual legs. A barrier placed before a single middle or rear leg prevented that leg from reaching its normal protraction endpoint but allowed it unimpeded retraction. Upon striking the barrier, the protracting leg attempted to get past it and thereby prolonged protraction. This prolongation increased with the extent to which the obstruction infringed upon the leg's normal step range. Barriers placed near the midpoint of this range elicited large perturbations: the blocked leg often continued its protraction throughout many step cycles of the other legs (Fig. 1 E, F). For the most part walking was irregular and smooth forward progression was disrupted. Nevertheless, the infrequent steps by the affected leg usually were coordinated with those of the adjacent ipsilateral legs.More rostral barrier positions elicited smaller perturbations: the blocked leg usually made one step in each step cycle of the other legs (Fig. 1 B, C, D, G). Measurements for these regular step sequences showed quantitatively that protraction duration increased in proportion to the severity of the infringement on normal leg movement (Figs. 3, 4). The fraction of the step period occupied by protraction increased from ca. 10% for normal walking to ca. 50% for caudal barrier positions. This proportionality is interpreted to show the importance of spatial components of the walking program.When one leg was obstructed, its extended protraction influenced the stepping of the three adjacent legs as follows. First, the ipsilateral rostral leg showed the largest change: its protraction onset was regularly delayed for the duration of the extended protraction (Figs. 4, 7, 8), demonstrating a strong, centrally mediated inhibition. The presence of a further delay of up to 100 to 140 ms suggests that peripheral input from the protracting leg may be important for releasing this inhibition. Second, steps by an adjacent caudal leg were not measurably affected. However, the method may not have sufficed to reveal such effects because during regular walking middle leg protractions rarely lasted long enough to conflict with subsequent steps by the ipsilateral rear leg. Third, contralateral effects differed between middle and rear leg obstructions. If the obstructed leg was a middle leg, its extended protraction had little effect upon stepping by the contralateral middle leg: the latter leg frequently protracted while the blocked leg continued its protraction and there was no consistent change in the phase relation of these two legs (Table 1). In contrast, if the obstructed leg was a rear leg, protractions by the contralateral rear leg tended to be delayed (Table 1).     

Electromyography of crural and pedal muscles in tufted capuchin monkeys (Sapajus apella): Implications for hallucal grasping behavior and first metatarsal morphology in euprimates

A hypertrophied peroneal process of the hallucal metatarsal, as seen in prosimians, has been linked to a powerful hallucal grasp via the contraction of the peroneus longus (PL) muscle causing adduction of the big toe. Electromyography (EMG) studies of lemurs and lorises, however, have concluded that PL is not substantially recruited during small branch locomotion when powerful hallucal grasping is needed most, and have suggested that there is no link between PL activity and peroneal process size. If this is correct, then we should also observe no change in PL activity when strong hallucal grasping is required in anthropoids because they have a relatively smaller peroneal process for PL to act on. This study addresses this hypothesis by evaluating EMG of crural and pedal muscles in capuchins (Sapajus apella) walking on substrates of different diameters. During locomotion on the narrow substrate (3.1 cm) that should elicit a strong hallucal grasp, we observed an intense increased recruitment of adductor hallucis, but only sustained, rather than markedly increased, PL activity. This indicates that PL is not involved in powerful hallucal grasping in capuchins, and confirms similar findings previously documented in prosimians. We continue to reject the hypothesis that a large peroneal process is an adaptation for powerful grasping and further argue that its morphology may not be related to PL's ability to adduct the hallux at all. In addition, the morphology of the peroneal process should not be used to assess hallucal grasping performance in fossils. Am J Phys Anthropol 156:553–564, 2015. © 2015 Wiley Periodicals, Inc.     

Studies on the tibiotarsal chaetotaxy of Collembola

Abstract. A system of identifying and homologizing the tibiotarsal setae of Collembola by means of letters and numerals is described. These setae are arranged in a series of whorls, each whorl consisting of up to seven setae. The whorls are identified by letters (A, B, etc.), whorl A being the most distal. The setae are numbered from the medio-dorsal surface and over the anterior face, that is, clockwise for left legs but anticlockwise for right legs. The setal pattern appears to be constatn within some genera, and may be of phylogenetic significance.     

The anatomy of the extended peroneal venous system

The fibula has deservedly become a workhorse flap for vascularized bone grafts. As with most flaps, much is known regarding idiosyncrasies of its arterial supply, and the corresponding venous system has generally been assumed to be comparable. Because this donor site has become increasingly versatile, a detailed anatomic study that would verify this latter assertion should be important. Therefore, venous mapping specifically of the peroneal venae comitantes was completed in 29 fresh lower limbs. In every specimen, paired venae comitantes of large caliber indeed paralleled the course of the peroneal artery. All were of quality satisfactory for microanastomoses, which should provide reassurance that preoperative evaluation of the peroneal venous system is not routinely indicated. However, anatomic variations proved to be the norm. The two venae comitantes did not necessarily coalesce into a single common peroneal vein [6 of 29 (21 percent)]. Usually, the lateral peroneal vein was the larger and continued proximally either alone (17 percent) or as the common peroneal vein (66 percent) to form the lateral tibioperoneal vena comitans. Thus, the venous pedicle of a fibula flap could be lengthened up to its confluence with the popliteal vein, a maneuver that potentially could obviate the need for a vein graft at least on the venous side. Although anomalies of the peroneal artery could preclude use of the fibula altogether, there appeared to be no such contraindications from a venous standpoint, despite the fact that the venous anatomy was unique in every individual. Some important similarities in patterns, though, do exist. For example, a common peroneal vein was formed by the juncture of the lateral peroneal vein and some combination of branches joining the lateral posterior tibial vein and medial peroneal vein in 63 percent of all limbs. Because exceptions are the rule, the choice of donor vein and venous pedicle length best remains an intraoperative decision dependent on the presenting anatomy.     

The contralateral coordination of walking legs in the crayfish Astacus leptodactylus

The coupling mechanisms which coordinate the movement of ipsilateral walking legs in the crayfish have been described in earlier investigations. Concerning the coupling between contralateral legs it was only known that these influences are weaker than those acting between ipsilateral legs. The nature of these coupling mechanisms between contralateral legs of the crayfish are investigated here by running left and right legs on separate walking belts at different speeds. The results show that coordination is performed by a phase-dependent shift of the anterior extreme position of the influenced leg. This backward shift leads to a shortening of both the return stroke and the following power stroke. As the coupling influence is only weak, several steps might be necessary to retain normal coordination after a disturbance. This corresponds to v. Holst's relative coordination. The influences act in both directions, from left to right and vice versa. However, one side may be more or less dominant. A gradient was found in the way that anterior leg pairs show less strong coordination than posterior legs. In some cases the coupling between diagonally neighbouring legs was found to be stronger than between contralateral legs of the same segment. The interpretation of this result is still open.     

Postthrombophlebitic syndrome; rehabilitation of patients

A common cause of disability in industrial workers is the postthrombophlebitic syndrome. Swelling of one or both lower extremities may require frequent rest periods during the day for relief. The disabling symptoms are aching, burning, heaviness, and bursting or throbbing pains in the legs. The nights are often disturbed by restlessness of the legs in which it is difficult to find a comfortable position to sleep. It follows from a few days to even years an inflammation of the veins of the legs. Treatment is directed at reducing the swelling of the legs. This often necessitates a change in the patient's routine of daily living. Frequent rest periods are often required with the legs in the horizontal position. Elastic bandages or stockings must be worn, and drugs must be taken to improve blood flow. The adjustment is necessary not only at work, but also at home. If the patient cannot continue at his previous job, efforts should be made to place him in a new job where the necessary adjustments can be made. This is possible primarily in industries manufacturing small items such as instruments, toys and appliances.     

POSTTHROMBOPHLEBITIC SYNDROME—Rehabilitation of Patients

A common cause of disability in industrial workers is the postthrombophlebitic syndrome. Swelling of one or both lower extremities may require frequent rest periods during the day for relief. The disabling symptoms are aching, burning, heaviness, and bursting or throbbing pains in the legs. The nights are often disturbed by restlessness of the legs in which it is difficult to find a comfortable position to sleep. It follows from a few days to even years an inflammation of the veins of the legs.Treatment is directed at reducing the swelling of the legs. This often necessitates a change in the patient''s routine of daily living. Frequent rest periods are often required with the legs in the horizontal position. Elastic bandages or stockings must be worn, and drugs must be taken to improve blood flow. The adjustment is necessary not only at work, but also at home.If the patient cannot continue at his previous job, efforts should be made to place him in a new job where the necessary adjustments can be made. This is possible primarily in industries manufacturing small items such as instruments, toys and appliances.     

Extramuscular myofascial force transmission also occurs between synergistic muscles and antagonistic muscles

The purpose of the present study was to test the hypothesis that myofascial force transmission may not be limited by compartmental boundaries of a muscle group to synergists. Muscles of the anterior tibial compartment in rat hindlimb as well as of the neighbouring peroneal compartment (antagonistic muscles) were excited maximally. Length–force data, based on proximal lengthening, of EDL, as well as distal lengthening of the tibial muscles (TA + EHL) and the peroneal muscle group (PER) were collected independently, while keeping the other two muscle groups at a constant muscle–tendon complex length. Simultaneously measured, distal and proximal EDL active forces were found to differ significantly throughout the experiment. The magnitude of this difference and its sign was affected after proximal lengthening of EDL itself, but also of the tibial muscle complex and of the peroneal muscle complex. Proximal lengthening of EDL predominantly affected its synergistic muscles within the anterior crural compartment (force decrease <4%). Lengthening of either TA or PER caused a decrease in distal EDL isometric force (by 5–6% of initial force). It is concluded also that mechanisms for mechanical intermuscular interaction extend beyond the limits of muscle compartments in the rat hindlimb. Even antagonistic muscles should not be considered fully independent units of muscular function.

Particular, strong mechanical interaction was found between antagonistic tibial anterior muscle and peroneal muscle complexes: Lengthening of the peroneal complex caused tibial complex force to decrease by approximately 25%, whereas for the reverse a 30% force decrease was found.     

Comparative Density of Hair Sensilla on the Legs of Cavernicolous and Epigean Harvestmen (Arachnida: Opiliones)

To allow an animal to behave appropriately, the location of sensorial structures is expected to be related to their function. As the different leg pairs of arachnids may have different functions (probing x supporting the body), one could expect them to have a different density of sensilla. Moreover, different regions of the same leg (dorsal, lateral, and ventral) would also be expected to have different densities of sensilla, according to the use of each region (e.g., the ventral part is often in contact with the substrate while the dorsal part is not). As cavernicolous animals are expected to be more sensitive than their epigean relatives, one could also expect a different density of sensilla when comparing cavernicolous and epigean animals. Using three epigean and three cavernicolous species of harvestmen (Arachnida, Opiliones), this study aimed at describing the morphology of hair sensilla on the legs and answering three questions: (1) Are there differences in the density of hair sensilla between the dorsal, lateral and ventral regions of each leg pair of the same individual? (2) Are there differences in the density of hair sensilla between the leg pairs of the same individual? (3) Are there differences in the density of hair sensilla when comparing the leg pairs of individuals of cavernicolous and non-cavernicolous species? The tarsi and metatarsi of all right legs of the six studied species were analyzed under a scanning electron microscope. The results (P < 0.05) showed that, in general: the ventral region of the tarsus was denser in sensilla trichodea than the lateral and dorsal regions, particularly on legs I and II; the density of sensilla chaetica did not differ on legs III and IV, but was greater on the dorsal region of legs I and II; the ventral part of legs I had the higher density of sensilla trichodea of the four pairs, whereas the second pair had the lower density; Holcobunus citrinus (Eupnoi) was the species with higher density of sensilla trichodea, on all legs; the cavernicolous species had a lower density of sensilla than the epigean species. The results are tentatively related to harvestmen behavior.     

Decompression of the common peroneal nerve: experience with 20 consecutive cases

A retrospective review of 20 patients with common peroneal nerve palsy treated with decompression between 1986 and 1997 was undertaken. Subjects were evaluated preoperatively and postoperatively by electromyography, nerve conduction, and clinical measures. The mean interval between the onset of symptoms to surgery (operative delay) was 15.9 months. The mean postoperative follow-up was 32.2 months with a minimum follow-up of 1 year. Decompression was performed at the level of the fibular neck and slightly distally at the tendinous origin of the peroneus longus using a standard approach to release tight fascial structures or scar tissue. External neurolysis was performed using the operating microscope in two cases for which scarring of the nerve was identified intraoperatively. Postoperatively, 19 of 20 patients showed improvement in ankle dorsiflexion as assessed by the Medical Research Council scale. Electromyographic examination was useful in the preoperative evaluation and selection of patients for decompression surgery. In conclusion, decompression even after a 1-year delay may offer benefit and suggest early intervention in patients with a severe lesion.