David Kachlík

• MD PhD
• Head of Department at Charles University in Prague

OBJECTIVE Retrograde ejaculation (RE) is a known complication of anterior lumbar interbody fusion (ALIF) and results from injury to the superior hypogastric plexus (SHP) during intervertebral disc exposure. Yet, there has been no recommendation for SHP mobilization. Thus, the aim of this study was to describe the anatomy of the SHP and vessels at t...

The sural nerve is commonly used as an autologous nerve graft. Its harvest results in a sensory deficit in the corresponding distribution area. End-to-side neurorrhaphy of the distal sural nerve stump to the superficial fibular nerve could address the problem of sensory loss in the dorsolateral foot without altering the donor nerve. The purpose of...

The sartorius muscle is typically innervated by two branches of the femoral nerve arising from the lumbar plexus. We present an unreported variant where the sartorius muscle was innervated by an accessory branch arising from the ilioinguinal nerve in addition to the proper two branches from the femoral nerve. The iliohypogastric nerve was fused wit...

BACKGROUND AND OBJECTIVES En bloc sacrectomy is associated with sacral root transection causing loss of urinary bladder, rectum, and sexual function. The aim of the study was to determine the position of the pudendal branches (sensorimotor) and pelvic splanchnic nerves (parasympathetic) on the sacral roots relative to the sacrum, and the minimal an...

Purpose This study provides an insight on the extent of muscular variability at the suprascapular notch and elaborates on its anatomical interference in suprascapular nerve arthroscopic decompression procedures. Methods The suprascapular notch was dissected and its muscular topography was observed in 115 cadaveric specimens. High resolution imagin...

Detection of ligamentum lunotriquetrum interosseum damage, unless it is a part of complex wrist injury, is difficult during routine examination, therefore chronic instabilities are often diagnosed arthroscopically. There is no surgical procedure of choice for the treatment of chronic conditions. The authors present fifteen-year results involving 17...

As the spleen is a morphologically highly variable organ, radiologists and surgeons frequently encounter normal variants which might be misinterpreted. Accessory spleen is quite a common anatomical variation and generally does not causes any symptoms. However, the finding of an accessory spleen located outside its usual position—the splenic hilum o...

Introduction En-bloc spondylectomy in the lumbar spine is a challenging procedure mainly due to a complex prevertebral anatomy. The aim of our study is to describe the anatomy of the diaphragmatic crura and surrounding vascular and neural structures which may be iatrogenically injured during the surgical resection. Materials and methods Ten embalm...

Introduction: En-bloc spondylectomy in the lumbar spine is a challenging procedure mainly due to a complex prevertebral anatomy. The aim of our study is to describe the anatomy of the diaphragmatic crura and surrounding vascular and neural structures which may be iatrogenically injured during the surgical resection. Materials and methods Ten embalm...

Background Large femoral defects after trauma, femoral non-unions, fractures complicated by osteomyelitis or defects after bone tumour resection present high burden and increased morbidity for patient and are challenging for reconstructive surgeons. Defects larger than 6 cm and smaller defects after failed spongioplasty are suitable for reconstruct...

Introduction: Isolated musculocutaneous nerve injuries occur rarely due to their anatomical location. We present our patient with a musculocutaneous nerve injury in a motorcyclist. Case: The patient was initially treated for a motorcycle accident. Further examination of the patient revealed impaired elbow flexion and numbness of the lateral fore...

Introduction: Isolated musculocutaneous nerve injuries occur rarely due to their anatomical location. We present our patient with a musculocutaneous nerve injury in a motorcyclist. Case: The patient was initially treated for a motorcycle accident. Further examination of the patient revealed impaired elbow flexion and numbness of the lateral forearm...

Background Together with an increased interest in minimally invasive lateral transpsoas approach to the lumbar spine goes a demand for detailed anatomical descriptions of the lumbar plexus. Although definitions of safe zones and essential descriptions of topographical anatomy have been presented in several studies, the existing literature expects s...

Purpose The accessory bones around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient’s history. They are of different natur...

Awareness of unique path of the superficial branch of the radial nerve and its unusual sensory distribution can help avoid potential diagnostic confusion. We present a unique case encountered during a routine dissection of a Central European male cadaver. An unusual course of the superficial branch of the radial nerve was found in the right forearm...

Background There are many surgical strategies aimed to treat the symptomatic neuroma of the superficial branch of the radial nerve (SBRN). It is still difficult to treat, despite many attempts to reveal a reason for surgical treatment failure. The lateral antebrachial cutaneous nerve (LACN) is known to overlap and communicate with SBRN. The aim of...

Unfortunately, the long-awaited revision of the official anatomical nomenclature, the Terminologia Anatomica 2 (TA2), which was issued in 2019 and after a referendum among the Member Societies officially approved by the General Assembly of the International Federation of Associations of Anatomists in 2020, is built on a new version of the Regular A...

Background The sural nerve is a somatosensory nerve that provides sensation to the posterolateral aspect of the lower leg and the lateral part of the ankle and foot. Due to its location and anatomical properties, it is often used as an autologous nerve graft. However, the nerve harvest can be complicated by the presence of side branches. The object...

Purpose The accessory ossicles around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient’s history. They are of different na...

Introduction: The lateral antebrachial cutaneous nerve (LACN) is a somatosensory nerve coursing in the lateral portion of the forearm. The nerve is located in a close proximity to the cephalic vein (CV) all along its course with a danger of being injured during venipuncture. The LACN also overlaps and communicates with the superficial branch of the...

Purpose Arterial variations of the upper limb may bear high importance for many clinical procedures, including the use of flaps in plastic surgery. We present a feasible way for visualization and confirmation of presence of these variations. Methods All variations were detected by ultrasonography and confirmed by Color Doppler Imaging. Proper docu...

Purpose Discrepancy between the morphology of the acetabular margin and the design of hemispheric acetabular cups used in total hip arthroplasty may produce postoperative hip pain due to an iliopsoas impingement at the iliopsoas notch. This study aimed to determine the anatomical features of the iliopsoas notch in the Central European sample, and t...

Background: The accessory ossicles around the elbow are very rare variant structures, present in approximately 0.7% of cases. They can cause diagnostic problems and can be mistaken for pathological structures, especially when pain and limitation of elbow movements are present and a trauma can be traced in the patient’s history. They are of differen...

Background Angular projection measurements have long been an established approach in anatomical morphometry. However, many described projection angles are in reference to inherently curved structures, often oversimplifying their topologies. Aims The objective of this study is to develop a quick, quantitative method for determining structural cur...

Angular projection measurements have long been an established approach in anatomical morphometry. However, many described projection angles are in reference to inherently curved structures, often oversimplifying their topologies. Measuring the curvature of a structure allows for a more accurate description of the structure’s course and behavior in...

Background: In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many more European countries. Methods: For this second update, we have asked a...

The palmaris profundus muscle is a rare anatomical variation of the forearm muscles. It has been described in both cadaveric and clinical studies as a possible cause of carpal tunnel syndrome. We observed three cases of this variant in recent years and decided to perform a scoping review of this uncommon anatomical entity. Major databases were sear...

The middle colic artery usually arises from the superior mesenteric artery, but in rare cases it may arise from the coeliac trunk or its branches. The aim of this study was to investigate variant origins of the middle colic artery on computed tomography and anatomical dissection. Variant middle colic arteries were identified on computed tomography...

Objectives: The vascular supply to the neck and body of the pancreas is highly variable. The dorsal pancreatic artery is the dominant artery feeding this area. The aim of this study was to describe the vascular supply of postresection pancreatic remnants after pancreaticoduodenectomy. Patients with hazardous anatomical arrangement may be at a high...

Backgrounds: Oncological outcomes of the robotic low anterior rectal resection with total mesorectal excision (TME) are still under discussion. Few studies have proven that robotic TME (rTME) is a safe and equivalent method for treatment of rectal carcinoma. But there is almost no comparison between the rTME and conventional TME in terms of the nu...

Purpose Cubital tunnel syndrome is a well-described entity with many reported etiologies and anatomical compression sites. Accessory ossicles of either traumatic or congenital origin might occur around the elbow joint. Only one case reporting such ossicles compressing the ulnar nerve exists in previous literature. We aim to present this entity with...

Although the term articularis cubiti muscle is incorporated in the official anatomical nomenclature, only sparse data about its appearance are available. It is usually described as few fibres originating from the medial head of the triceps brachii muscle and inserting to the capsule of the elbow joint. However, the most recent observations regardin...

Purpose The aim of present study is to extend the sections of Terminologia Anatomica (TA) concerning anterolateral knee structures and reveal the clinical, educational and sceintific importance of using that newly proposed anatomical terms. Methods Anatomical terms were gathered both from anatomical textbooks and journals. Samples were compared wi...

Purpose Differentiating the anatomical variations of the anterosuperior portion of the glenoid labrum from pathologies is important to avoid unnecessary iatrogenic complications resulting from inaccurate diagnosis. Additionally, the presence of several variations was reported to be conductive to lesions involving the glenoid labrum. Thus, the aim o...

Objective: To investigate the relationship between osseous variations of the glenoid fossa and thinning of the overlaying articular cartilage. Materials and methods: In total, 360 dry scapulae, comprising adult, children and fetal specimens, were observed for potential presence of osseous variants inside the glenoid fossa. Subsequently, the appe...

Introduction: The superficial branch of the radial nerve (SBRN) and the lateral antebrachial cutaneous nerve (LACN) are sensory nerves coursing within the forearm in a close relationship. This high degree of overlap and eventual communication between the nerves is of great surgical importance. The aim of our study is to identify the communication...

Dual nerve transfer of the spinal accessory nerve to the suprascapular nerve (SAN-SSN) and the radial nerve to the axillary nerve is considered to be the most feasible method of restoration of shoulder abduction in brachial plexus injuries. Supraspinatus muscle plays an important role in the initiation of abduction and its functional restoration is...

The aim of this study was to review the literature on the posterior gastric artery, estimate its prevalence and summarize its reported origins. The databases Pubmed, Scopus, Web of Science and Google Scholar were searched to find all studies describing the prevalence and origin of the posterior gastric artery. Pooled prevalences were estimated usin...

The interpubic cavity (cleft) is a narrow, slit‐like, oval‐shaped cavity which has frequently been described within the fibrocartilaginous interpubic disc. The aim of this article is to thoroughly analyze what is known about the interpubic cavity. The following three scientific databases (PubMed, Web of Science and Google Scholar) were systematical...

Saphenopopliteal junction classification has been developing, but still the precise knowledge of junction type is crucial for proper surgical treatment. We examined the saphenopopliteal junction by duplex venous scanning in 244 extremities in healthy volunteers (median age: 23.0 years, 83 females, 39 male) and performed a meta-analysis of 13 studie...

Introduction Anatomical variants observed during the posterior approach to the elbow joint require special attention due to their clinical relevance. We aim to present a compendious review of described variants potentially encountered during the posterior approach towards the elbow joint to the experts in the elbow surgery. Methods A narrative rev...

PURPOSE OF THE STUDY Carpometacarpal (CMC) instabilities of the thumb joint occur after injuries or due to joint overload in patients with congenital joint hypermobility. They are often undiagnosed and, if left untreated, are the basis for the development of rhizarthrosis in young individuals. The authors present the results of the Eaton-Littler te...

Purpose: Lumbrical muscles of the upper limb belong to the middle group of intrinsic hand muscles. Their anatomical variability has been extensively studied with heterogeneous findings. Therefore, the aim of this study is to provide a systematic review and a meta-analysis of the lumbrical muscles variations in the human hand. Methods: For this p...

Purpose Knowledge of the unusual arrangement of the flexor pollicis longus (FPL) muscle is important as the variable tendon may be a rare cause of carpal tunnel syndrome. Methods During a routine dissection at the Department of Anatomy, an unusual formation of the FPL muscle was observed in a formalin embalmed Central European cadaver. Results Th...

Background: The subclavius muscle runs underneath the clavicle. However, there have been a few reports of a duplicated subclavius muscle which is commonly referred to as subclavius posticus muscle due to its orientation being posterior to the proper subclavius muscle. Its occurrence seems to potentially create a narrowing interval at the superior...

Arterial blood to the human uterus is provided by a pair of uterine arteries (UA) and supported by terminal branches of ovarian (OA) and vaginal arteries (VA). Literature reports the existence of ipsilateral and contralateral anastomoses between these arteries and the UA, but data on the prevalence of such anastomoses are discrepant. The aim of thi...

Anatomical variations and congenital anomalies of the uterine tubes (UTAVsCAs) are rare conditions, which are often undiagnosed, or accidentally diagnosed upon imaging, laparotomy, laparoscopy for unrelated condition, or during the Cesarean section. UTAVsCAs are often asymptomatic, but their clinical relevance lies in their possibly adverse impact...

Introduction Interpretation of traumatological radiographs of the region of the elbow joint may come with many challenges. Aside from traumatological avulsions and fractures, we can also identify other entities such as persistent epiphysis, aseptic necrosis, osteochondritis dissecans, calcific bursitis, synovial chondromatosis, and other degenerati...

It is well known that the blood supply of the greater omentum and female internal genital organs are not physiologically connected. There is also no mention of such anatomical variation in anatomical, radiological, or surgical textbooks. Here we present a very rare case report of atypical double arterial anastomosis (the first and second variant ar...

Although it is not an easy task to classify cells into different types, or in turn cell types into tissue types, a clear, understandable, didactically and clinically relevant tissue classification is indispensable for undergraduate medical education, expert discussions in biomedical research as well as for clinical practice. From the earliest disco...

Zusammenfassung Die ulnare Translation des Karpus (UT) ist eine seltene und oft übersehene Verletzung. Wir berichten über unsere Erfahrung punkto Diagnostik und Therapie aus der Behandlung von 8 Patienten mit einer drohenden (5), manifesten (1) respektive chronischen UT (2).

Purpose To report atypical anatomical variation of an osseous suprascapular canal, and to elaborate on its clinical significance as a potential anatomical factor that could obscure a direct posterior surgical approach and suprascapular nerve block. Methods Osteological observational study of the scapula with emphasis on the suprascapular space. Th...

Purpose Dorsal closing wedge calcaneal osteotomy (DCWCO) is indicated in patients with insertional tendinopathy of the calcaneal (Achilles) tendon. The Chauveaus-Liet’s (CL) angle is represented by the difference between the angle of verticalization (α) and morphological angle (β) of the calcaneus (CL angle = α − β). The purpose of the study was to...

There are many osseous variants that occur around the elbow joint such as supracondylar process, supratrochlear foramen, accessory ossicles, and others. Scientific databases were searched for variants around the elbow joint. Elbow radiographs from our center demonstrating some of these findings were included in the study. The aim of the present rev...

Purpose Dorsal closing wedge calcaneal osteotomy (DCWCO) is indicated in patients with insertional tendinopathy of the calcaneal (Achilles) tendon. The Chauveaus-Liet's (CL) angle is represented by the difference between the angle of verticalization (α) and morphological angle (β) of the calcaneus (CL angle = α − β). The purpose of the study was to...

BACKGROUND: The superficial branch of the radial nerve (SBRN) is a sensory nerve innervating the dorsoradial part of the hand. It originates in the cubital fossa, runs under the belly of the brachioradialis muscle (BM), emerges from underneath in the distal third of the forearm and continues in the subcutaneous tissue towards the hand. There exist...

Introduction: The anatomy of the brachial plexus has been a subject of interest to many researchers over time resulting in an inconsistent amount of data. Previously, our team had published two evidence-based studies on the anatomical variations involving the brachial plexus, therefore the aim of this study was to analyze the findings regarding th...

Since time immemorial, bodies of deceased have been an integral part of teaching anatomy, and therefore the study of medicine. Without them, the teaching of anatomy, clinical anatomy and many research projects could not be realized. Nowadays, the European countries allow to use exclusively bodies of the deceased donors. Recently, we have registered...

Introduction: The goal of this study was to investigate prevalence and morphometric parameters of pubic ligaments and the interpubic disk and its cavity using imaging methods for use in clinical medicine. Methods: Pubic symphysis morphology was investigated in 652 patients (348 women and 304 men), from which 449 CT scans and 203 MR scans were av...

The anatomy of the biceps brachii muscle has been a subject of interest to many researchers. In particular, the presence of one or more accessory heads has been reported to be the most common variation of the biceps brachii muscle. In fact, contemporary knowledge is quite inconsistent and lacks a definitive summary. Taking this into account, the pr...

Background /Objectives: The dorsal pancreatic artery is the main artery of the body and tail of the pancreas. Its origin and branching is highly variable. The aim of this study was to perform a meta-analysis to generate pooled prevalence data on the presence and origin of the dorsal pancreatic artery. Clinically important aspects of the dorsal panc...

Every surgeon starts the training with suturing, which can be very confusing as most of the senior surgeons have their own style, approach, tricks and different rules to follow. It is hard for residents and medical students to know what is an evidence-based rule that should be followed and what is a personal trick of their teacher that can be modif...

Restoring shoulder abduction is one of the main priorities in the surgical treatment of brachial plexus injuries. Double nerve transfer to the axillary nerve and suprascapular nerve is widely used and considered the best option. The most common donor nerve for the suprascapular nerve is the spinal accessory nerve. However, donor nerves for axillary...

Johannes Jessenius or Ján Jesenský (1566–1621) can be considered as a contradictory and inconsistent personality of the early modern history. Being not only a physician, but also scientist, teacher, philosopher and even historian and politician, he definitively ranks among the outstanding polymaths of his time in the region of Central Europe. His s...

Breast is a complex organ with rich blood and nerve supply and various pathways of lymphatic drainage. The knowledge of its anatomy and possible variants is essential for targeting breast cancer management from diagnosis, through surgery, radiation and medical treatments, to follow up. In this chapter, the anatomy of the breast, thoracic wall and a...

BACKGROUND This report depicts a rare case of acutely developed urinary retention as well as sensory and motor disturbances caused by formation of a large hematoma within the piriformis muscle, which caused compression of nerves within the suprapiriform and infrapiriform foramina, thus imitating cauda equina syndrome. Although cases of acute lumbos...

Introduction: Thrombolysis has been suggested as a feasible method to treat arterial renal transplant thrombosis under conditions of short duration of ischemia. Data on maximal duration of ischemia that are still feasible to treat are scarce. Methods: We retrospectively analysed our experience involving three attempts to utilize thrombolysis to tr...

Ameloblastoma is a benign odontogenic tumor characterized by slow growth causing painless facial swelling. The tumor can behave locally aggressively, and may have direct destructive effects on the surrounding soft and hard tissues. This paper reports the unique case of a female patient with giant ameloblastoma of the mandible. Computed tomography (...

The morphology of the vascular supply of peripheral branches of cardiac nerves has not been systematically described until now. The aim of this study was to describe the architectonics of the vasa nervorum of epicardial nerves in porcine hearts by using two injection techniques. Twenty‐three hearts from young healthy pigs were used. In 10 hearts In...

Background and Objectives: Angular projection measurements have long been an established approach in anatomical morphometry. However, many described projection angles are in reference to inherently curved structures, often oversimplifying their topologies. Measuring the curvature of a structure allows for a more accurate description of the structur...

New modern technologies are emerging as teaching tools in anatomy. There are variety of tools and modalities aiming to deliver visual interactive experience. Anatomage Table was among the tools we had adopted and experienced for 3 years by now. We had used it as a supplementary tool for teaching. Hereby we share our personal positive experience wit...

Background The scapula structures that have not yet been assigned by anatomical terms generate a challenge in clinical diagnostics and surgical application as well as in scientific observation. The aim of this study was to solve the lack in terminology concerning the scapula and the scapular region. Methods Observation and description of 29 struct...

Background: Translational research refers to scientific findings that have been extensively studied in models and find their way to clinical studies. In a certain sense in translational anatomy a similar application of conventional anatomical knowledge finds its way to clinics in the surgical theatre. With the propagation of endoscopic middle ear s...

Introduction: The anatomy of the supraclavicular part of the brachial plexus is highly variable, therefore the aim of this study was to perform a systematic review and meta-analysis of the various origins of the long thoracic, dorsal scapular, suprascapular and subclavian nerves. Materials and methods: Major electronic databases were searched to...

Purpose The structure of the proximal margin of the superficial layer of the supinator muscle is of high interest to many researches. Its tendinous appearance, called the arcade of Frohse, may be clinically important because of its close relationship to the deep branch of the radial nerve passing beneath it and is considered to be the cause of seve...

PurposeVariations of the peripheral nervous system in the upper limb, especially of the musculocutaneous and median nerves, are common, but closer attention to the knowledge of the variant anatomy should be paid to avoid iatrogenic injury or to understand the unusual clinical signs.Methods During a routine dissection course, bilateral variations we...

Introduction: Great variability in shape and size of the bony pelvis can be observed in the current population, but there is not enough data on how long the historical period must elapse to gain changes in pelvic shape and size. The aim of the study was to identify morphological changes in bony pelvis in males and females after a developmentally s...