摘要:

AbstractIn a patient with symptoms attributable to lumbar spine disease, computed tomography (CT) demonstrated the descending colon lying in an exceptionally posteromedial position. The colon, within the retroperitoneal fat, passed between the psoas major and quadratus lumborum muscles, thereby abutting the normal left L4 ventral ramus lateral to the L5 pedicle. Although it remains debatable whether this curious anatomical arrangement was responsible for this patient's symptoms, the case prompted us to see how often the colon was situated so posteromedially. Among 33 consecutive patients whose abdominal CT images were analyzed, this close anatomical relationship was seen in only one patient; it was not seen in any of 50 randomly selected patients undergoing magnetic resonance imaging (MRI) of the lumbar spine. As judged by CT measurements, the average position of the most posteromedial portion of the descending colon lies 5 mm anterolateral to a plane joining the anterolateral margins of the psoas major, quadratus lumborum, and iliacus muscles and 54 mm from the ventral ramus. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060502

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractSkin and soft tissue necrosis of the heel are the main problems following operative treatment of calcaneal fractures with the classical medial (McReynolds, 1982), lateral (Palmer, 1948), enlarged lateral, and the bilateral approaches. In order to show how classical approaches harm the vessels supplying the adjacent soft tissues, we studied the vascularization to both the calcaneus and its surrounding soft tissues. Our findings show that the calcaneus is well supplied by a collateral circulation derived from the posterior tibial, peroneal, lateral tarsal, the medial and lateral plantar arteries. The soft tissue supply is less rich. On the medial side, the soft tissue supply comes from the posterior tibial and lateral plantar arteries. On the lateral side, it is supplied by a thin anastomotic arch that runs between the lateral tarsal and peroneal arteries. Based on our anatomical findings we have proposed two modified approaches which minimize damage to the vessels of the adjacent soft tissues and still allow exact reposition of the fractures. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060503

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThis study evaluates the most valid and reproducible method for directly measuring anteversion (torsion) in dried femora using a commercially available measuring machine. Each femur was placed horizontally on the surface of the machine and readings were obtained from the head, the shaft distal to the lesser trochanter, and the distal end. Using computer software, four different anteversion angles were calculated: the center head‐neck line to the retrocondylar line (Method 1); the center head‐neck line to the transcondylar line (Method 2); the anterior head‐trochanter line to the retrocondylar line (Method 3); and the anterior head‐trochanter line to the transcondylar line (Method 4). The methods were applied to 20 femora, which were measured twice by one observer. The most reproducible method of measuring femoral anteversion uses the bone surfaces on the anterior aspect of the head and greater trochanter and on the posterior aspect of the condyles (Method 3.95% confidence limits of ± 0.4°). The other methods are shown to be reproducible to ±2.4°, ±3.3° and ±1.7° (Methods 1, 2, and 4, respectively, 95% confidence limits). Conversion factors between the different methods are: 12.5° + 0.8 x (anteversion angle) to change each of Method 2 to Method 1 and Method 4 to Method 3; and 8° + 0.7 x (anteversion angle) to change each of Method 1 to Method 3 and Method 2 to Method 4 (correct to within ±3°). ©

ISSN:0897-3806    

DOI:10.1002/ca.980060504

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe origin and branching of the middle meningeal artery (MMA), as well as the length and development of its three main branches, were analyzed by following the arterial sulci on skull bones. We examined 186 macerated skulls (128 male and 58 female). Variations were classified into nine types. Some of the previously ignored communications of the branches of MMA with other arteries of the external carotid systems such as the deep temporal a., deep auricular a., occipital a., and anterior tympanic a. are described. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060505

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe lateral costal branch (LCB) of the internal thoracic artery (ITA) was studied because its presence sometimes may reduce the blood flow of the ITA when it is used for myocardial revascularization (Singh and Sosa, 1981). The ITA of 90 cadavers of adults of both sexes, whose ages ranged from 20 to 84 years, was studied after neoprene latex injection to determine its incidence, its relation to the phrenic nerve and first rib, its diameter, and the distance between the origin of the ITA and the origin of the LCB. We found the LCB in 16.6% of the cases, with bilateral presence in 5.5%. Unilateral rightside incidence was 11.1%, and left unilateral incidence was not observed. The LCB originated from the ITA in all cases, with a distance of origin along the ITA of 23.7 + 6.7 mm on the right side and 29.5 ± 6.4 mm on the left side. The mean diameter of the LCB was 1.7% ± 0.8 mm. © 1993 Wiley‐Liss,

ISSN:0897-3806    

DOI:10.1002/ca.980060506

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractThe relationship of topographical landmarks to the deep structures of the wrist and hand has not been clearly defined and would be of benefit to surgeons performing endoscopic carpal tunnel surgery. To this end, 10 fresh cadaveric wrist specimens had radiopaque markers placed adjacent to key anatomic structures within the wrist and hand. A new technique for localizing the hook of the hamate was established. We found that the thick segment of the flexor retinaculum, often defined as the transverse carpal ligament, was 2.2 cm in length. Its distal border was 1 cm distal to the distal aspect of the hook of the hamate. The proximal ligamentous portion had a mean length of 1.2 cm, whereas the distal aponeurotic portion (distal to the hook of the hamate) had a mean length of 1.0 cm. The position of the superficial palmar arch was 2.7 cm distal to the hook of the hamate or at a line bisecting three‐fourths of the distance from the distal flexor wrist crease to the proximal palmar crease. The relationship of the superficial palmar arch to topographical landmarks was more consistent than it was when the standard reference of Kaplan's cardinal line was used. © 1993 Wiley‐Liss,

ISSN:0897-3806    

DOI:10.1002/ca.980060507

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractDe Quervain's tenosynovitis can be treated either by conservative or operative measures. Harvey et al. (1990) have shown that treatment by local injection of corticosteroid into the lateral extensor compartment can effect cure in 80% of cases without surgical intervention. However, the lateral extensor compartment may be anatomically divided by septa into subcompartments, and this prevents the distribution of steroid throughout the compartment, and hence may lead to failure of conservative treatment. This study was undertaken to develop an injection technique that will ensure that, even if septa are present, both subcompartments are penetrated by the needle and receive steroid. The technique is shown to enhance the accuracy of injection and hence should further increase the proportion of patients treated conservatively with success. © 1993 Wiley‐Liss, I

ISSN:0897-3806    

DOI:10.1002/ca.980060508

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

摘要:

AbstractExtra‐anatomic arterial bypass grafts provide an exciting opportunity to teach gross anatomy. We describe a study of axillobifemoral bypass grafts and how a simulation of this procedure can be used in a modified problem‐based learning exercise for first‐year medical students. The axillobifemoral bypass exercise adds a new clinical perspective to the traditional approach to review the gross anatomy of the axillary region, the anterolateral thoracoabdominal wall, and the anterior thigh and femoral triangle. This clinically relevant problem challenges students to devise a surgical approach to the axillary and femoral arteries. Students become active participants because they must discover the anatomical details of the axilla, femoral triangle, and thoracoabdominal wall, from shoulder to groin. Important nerves and blood vessels have to be identified in relation to anatomical landmarks. In addition, students must decide which structures can be cut and/or ligated, keeping in mind the functional consequences of these actions. Finally, the exercise provides an opportunity to integrate functional concepts of collateral circulation, hemodynamics, and relevant biomechanics with anatomical structures. © 1993 Wiley‐L

ISSN:0897-3806    

DOI:10.1002/ca.980060509

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980060510

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980060511

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1993

数据来源: WILEY