MORPHOLOGICAL STUDY OF THE

MUSCLE- BONE INTERFACE IN MAN

THESIS
Submitted for the partial Fulfillment of the Master degree
"M.Sc." in Anatomy
Presented by
HESHAM NOAMAN ABDEL RAHEEM MUSTAFA
M.B., B.Ch.

Supervised by

DR. MOSTAFA KAMEL IBRAHIM ELSAYED

Professor of Anatomy
Head of Anatomy Department,
Faculty of Medicine
Ain Shams University

DR. FOUAD YEHIA AHMED

Professor of Anatomy
Anatomy Department, Faculty of Medicine
Ain Shams University

DR. HASSAN MOSTAFA SERRY

Professor of Anatomy Assistant
Anatomy Department, Faculty of Medicine
Ain Shams University

2003

Introduction and Aim of the work

Each skeletal muscle has at least two attachments; one at
each end. These attachments might be purely tendinous, fleshy, or
an admixture of flesh and tendon. The pure tendinous, always
leave a smooth mark on the bone, the fleshy ones generally leave
no mark on the bone, while the rough marks are made where there
is an admixture of flesh and tendon (Last, 1978). Tendons are
usually attached to mark bony processes either on the epiphyses
e.g. the attachment of iliopsoas to the lesser trochanter, or the
diaphyses as in most of the fleshy attachments e.g. Deltoid
insertion. (Biermann et al., 1975).
Most tendons present four histological zones at their bony
attachments: dense fibrous tissue, uncalcified fibrocartilage,
calcified fibrocartilage, and bone (Benjamin et al., 1986; Benjamin
& Ralphs, 2001). The presence of the uncalcified fibrocartilage
offers some protection from wear and tear, while the calcified
fibrocartilage anchors the tendon to the bone and enables it to
withstand shear so that traumatic avulsion of tendon insertion
rarely occur at the actual interface with bone (Clark &
Stechschulte, 1998).
The muscle bone interface show considerable regional
heterogenicity in different tendons ,that should be taken in
consideration for selecting tendons for particular surgical transfers
or joint reconstruction (Benjamin et al., 1995).
Reviewing literature, a lot of papers dealt with the
tendinous bone attachment while few studies has been found to
investigate the fleshy- bone attachment .Therefore ,the present
study aims at investigating the structure of fleshy muscle-bone
interface in selected limb muscles of man, both macroscopically
and microscopically .

Material and Methods

Two types of muscle bone interface will be used in the present

study; namely: muscle with broad attachment as brachialis and
another possessing a linear attachment as brachioradialis. The
specimens will be taken from the dissecting room dissected by
scalpel and bone nibbling forceps to remove the whole interface
up to the bone.
The specimens will be fixed in 10% neutral formalin,
decalcified in Eddeta followed by ascending dehydration and
paraffin embedding.
Serial sections of 8 thick will be taken with the long axis of
the tendon, and at right angle to the bone. They will be stained
with haematoxylin and eosin, Masson's trichrome for light
microscopy examination.

References
1. Benjamin, M., Evans, E.J., and Copp, L. (1986): The histology of
tendon attachments to bone in man. J. Anat., 149: 89-100.
2. Benjamin, M. Qin, S., and Ralphs, J.R. (1995): Fibrocartilage
associated with human tendons and their pulleys. J. Anat., 187:
625-633.
3. Benjamin, M., and Ralphs J.R. (2001): Entheses - the bony
attachments of tendons and ligaments. Ital. J. Anat. Embryol.,
106: 151-157.
4. Biermann,H.(1975): Die knochenbildung im Bereich periostalerdiaphysarer Sehnen- und Bandansatze. Zeitschrift fur
Zellforschung und mikroskopische Anatomie 46,635-671.
5. Clark, J., and Stechschulte, D.J. Jr. (1998): The interface
between bone and tendon at an insertion site: a study of the
quadriceps tendon insertion. J.Anat., 192: 605-616.
6. Last, R. J., (1978): Tissues and structures. In: Anatomy Regional
and Applied, 6th ed., Churchill Livingstone. pp6.