Abstract
PurposeThe flexor digitorum longus and posterior tibial tendon as well as the perforating veins are located along the distal posteromedial tibial border. Adipose tissue may surround these structures and possibly play a role in reducing mechanical stress. This study aimed to examine the adipose tissue along the posteromedial tibial border via magnetic resonance imaging (MRI), ultrasound, and gross anatomical examination.MethodsThe lower legs of 11 healthy individuals were examined every 3 cm from the medial malleolus using MRI and ultrasound. The fat fraction was calculated using fat fraction images. In addition, the gross anatomy of the flexor digitorum longus origin and adipose tissue along the posteromedial tibial border was examined in seven fresh cadavers. The fat fraction was compared at different heights along the posteromedial tibial border and in Kager’s fat pads; we also compared the height of the flexor digitorum longus origin and adipose tissue.ResultsIn vivo, the adipose tissue was identified along the entire posteromedial tibial border using MRI and ultrasound. There was no significant difference in fat fraction between Kager’s fat pads and the adipose tissue along the posteromedial tibial border, except at the 6 cm mark. All seven cadavers presented adipose tissue along the posteromedial tibial border, significantly more distal than the flexor digitorum longus origin.ConclusionThe adipose tissue was identified along the posteromedial tibial border via MRI, ultrasound, and gross anatomical examination; thus, this tissue may play a role in reducing friction and compressive stress in tendons.
Highlights
The adipose tissue exists around vessels and tendon attachments and plays a role in reducing friction and compressive stress [1, 3, 13]
In vivo study magnetic resonance imaging (MRI) In vivo, tissue that appeared to be the adipose tissue was identified along the posteromedial tibial border and soft tissue that enclosed the adipose tissue in all participants
The flexor digitorum longus (FDL) muscle belly enclosed the posterior side of the adipose tissue from the 6 to 21 cm marks (Fig. 4b)
Summary
The adipose tissue exists around vessels and tendon attachments and plays a role in reducing friction and compressive stress [1, 3, 13]. Excessive friction and compressive stress lead to adipose tissue inflammation in the ankle and knee joints [4, 21]. These findings indicate that the adipose tissue causes pain. It is important to determine the adipose tissue distribution for treatment in the field of orthopaedics. Along the distal posteromedial tibial border, the flexor digitorum longus (FDL) and posterior tibial (PT) tendon. Two- and six-point Dixon gradient-echo magnetic resonance imaging (MRI) have been shown to provide stable water–fat signal separation for dual-echo imaging using phase information to resolve water–fat
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