Łukasz Olewnik1, Richard Shane Tubbs2,3,4, Kacper Ruzik5, Michał Podgórski6, Paloma Aragonés7, Anna Waśniewska5, Piotr Karauda1, Bartłomiej Szewczyk1, Jose Ramón Sanudo8, Michał Polguj5. 1. Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland. 2. Department of Neurosurgery, Tulane University School of Medicine, New Orleans, Louisiana, USA. 3. Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, Louisiana, USA. 4. Department of Anatomical Sciences, St. George's University, True Blue, Grenada. 5. Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Lodz, Lodz, Poland. 6. Department of Imaging Diagnostic, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland. 7. Department of Orthopedics Surgery, Hospital Santa Cristina, Madrid, Spain. 8. Department of Human Anatomy and Embryology, Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
Abstract
PURPOSE: The quadriceps femoris (QF) consists of four muscles: the rectus femoris; vastus medialis; vastus lateralis, and vastus intermediate. The tendons of all of these parts join together into a single tendon that attaches to the patella. The QF is a powerful extensor of the knee joint that is needed for walking. A growing number of publications have examined the fifth head of the QF muscle. There is no information about the possibility of other heads, and there is no correct classification of their proximal attachments. Further, the frequency of occurrence of additional heads/components of the QF remains unclear. METHODS: One hundred and six lower limbs (34 male and 18 female) fixed in 10% formalin solution were examined. RESULTS: Additional heads of the QF were present in 64.1% of the limbs. Three main types were identified and included subtypes. The most common was Type I (44.1%), which had an independent fifth head. This type was divided into two subtypes (A-B) depending on its location relative to the vastus intermediate. The second most common type was Type II (30.8%), which originated from other muscles: IIA from the vastus lateralis; IIB from the vastus intermediate, and IIC from the gluteus minimus. In addition, Type III (25%) was characterized by multiple heads: IIIA-two heads with a single common tendon; IIIB-two heads with two separate tendons; IIIC-three heads (lateral, intermediate, medial), and IIID-four heads (bifurcated lateral and bifurcated medial). CONCLUSION: The introduction of a new classification based on a proximal attachment is necessary. The presence of the fifth, sixth, seventh, or eighth head varies.
PURPOSE: The quadriceps femoris (QF) consists of four muscles: the rectus femoris; vastus medialis; vastus lateralis, and vastus intermediate. The tendons of all of these parts join together into a single tendon that attaches to the patella. The QF is a powerful extensor of the knee joint that is needed for walking. A growing number of publications have examined the fifth head of the QF muscle. There is no information about the possibility of other heads, and there is no correct classification of their proximal attachments. Further, the frequency of occurrence of additional heads/components of the QF remains unclear. METHODS: One hundred and six lower limbs (34 male and 18 female) fixed in 10% formalin solution were examined. RESULTS: Additional heads of the QF were present in 64.1% of the limbs. Three main types were identified and included subtypes. The most common was Type I (44.1%), which had an independent fifth head. This type was divided into two subtypes (A-B) depending on its location relative to the vastus intermediate. The second most common type was Type II (30.8%), which originated from other muscles: IIA from the vastus lateralis; IIB from the vastus intermediate, and IIC from the gluteus minimus. In addition, Type III (25%) was characterized by multiple heads: IIIA-two heads with a single common tendon; IIIB-two heads with two separate tendons; IIIC-three heads (lateral, intermediate, medial), and IIID-four heads (bifurcated lateral and bifurcated medial). CONCLUSION: The introduction of a new classification based on a proximal attachment is necessary. The presence of the fifth, sixth, seventh, or eighth head varies.
Authors: Łukasz Olewnik; Kacper Ruzik; Bartłomiej Szewczyk; Michał Podgórski; Paloma Aragonés; Piotr Karauda; R Shane Tubbs; Jose Ramon Sanudo; Maria Bettencourt Pires; Michał Polguj Journal: Biomed Res Int Date: 2022-02-16 Impact factor: 3.411