Evaluation of portal locations and periarticular structures in canine coxofemoral arthroscopy: a cadaver study

2004 ◽  
Vol 17 (04) ◽  
pp. 184-188 ◽  
Author(s):  
D. A. Hulse ◽  
K. S. Schulz ◽  
W. B. Saunders
Keyword(s):  
Cadaver Study ◽  
Neutral Position ◽  
Anatomical Landmarks ◽  
Greater Trochanter ◽  
Limb Position ◽  
Joint Pathology ◽  
Hip Flexion ◽  
Neurovascular Structures ◽  
Gross Examination ◽  
The Ideal

SummaryThe objectives of this study were to determine the optimum limb position for the creation of safe arthroscopy portals for coxofemoral arthroscopy, to determine anatomical landmarks for arthroscopy portals, and to determine distances of portals to periarticular neurovascular structures. Eight hemipelves were harvested from adult dogs that died for reasons unrelated to this project and were free of joint pathology as determined by gross examination at the conclusion of the study. The results suggest that the ideal limb position for canine coxofemoral arthroscopy was slight limb adduction, thirty degrees of hip flexion, with the stifle in a neutral position. With the limb in the ideal position, the arthroscope portal was 5 mm cranial (range 0 mm 10 mm) and 15 mm proximal (range 12 mm 18 mm) to the greater trochanter. The instrument portal was 10.2 mm cranial (range 5 mm 18 mm) and 14 mm proximal (range 7 mm 20 mm) to the greater trochanter. The sciatic nerve and the caudal gluteal artery were 9 mm caudal (range 6 mm 15 mm) to the arthroscope portal. This is the first study to evaluate the location of both arthroscopy portals and periarticular neurovascular structures in relation to surrounding surgical landmarks.

scholarly journals Is the Greater Trochanter the Ideal Freehand Landmark for the S2AI Screw Angle in the Caudal Direction? Commentary on “Extra-articular Portion of the Sacroiliac Joint—Between the Sacral and Pelvic Tuberosities: An Anatomical Guide for the S2-Alar-Iliac Screw Trajectory” by Tatara et al

2021 ◽  
Vol 11 (6) ◽  
pp. 1008-1009
Author(s):  
Panyi Yang ◽  
Xueyang Tang
Keyword(s):  
Anatomical Landmarks ◽  
Greater Trochanter ◽  
Clinical Safety ◽  
Caudal Direction ◽  
Freehand Technique ◽  
Iliac Screw ◽  
Navigation Software ◽  
Guidance Technique ◽  
The Relationship ◽  
The Ideal

The author introduced a novel freehand technique for S2-Alar-Iliac screw placement Which demonstrated good clinical safety. However the optimal anatomical landmarks of the screw angle in the caudal direction have not been unified. The tip of the greater trochanter(TGT) was one of the most frequently chosen landmark in fluoroscopic or navigation guidance technique. Additional adjustments are always needed according to these studies. The freehand technique of the present study also choose the TGT as the as the landmark of the S2AI screw angle in the caudal direction, whether it also need any adjustment? We hope the author could explain more about this issue. Besides, the relationship between TGT and the sacral iliac bone is not static, which will make the reliability of the pre-surgery navigation software simulation doubtful.

scholarly journals Defining the limits of caesarean scar niche repair: new anatomical landmarks

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Tanushree Rao ◽  
Neera Lambert ◽  
Bhaswati Ghosh ◽  
Timothy Chang
Keyword(s):  
Laparoscopic Repair ◽  
Anatomical Landmark ◽  
Anatomical Landmarks ◽  
Video Presentation ◽  
Surgical Method ◽  
Caesarean Scar ◽  
Reproducible Technique ◽  
The Ideal

Abstract Background Caesarean scar niche is increasingly being seen due to the rise in the number of caesarean sections worldwide. Indications and the ideal route for niche repair are still being researched. If the residual myometrium is less than 3 mm thick and potential fertility is needed, laparoscopy is the ideal surgical method for caesarean scar niche repair. The aim of this video presentation is to demonstrate techniques of identifying new anatomical landmarks during laparoscopic uterine niche repair. Results As seen in the video, Caesarean scar niche repair can be done in a step-by-step manner, with lateral bands serving as anatomical landmarks. Conclusions Lateral bands are a consistent anatomical landmark which identify the level and width of the uterine niche and thus simplify the laparoscopic repair making this a reproducible technique.

Syndesmotic Fixation With Suture Button: Neurovascular Structures at Risk: A Cadaver Study

2019 ◽  
Vol 13 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Eva J. Lehtonen ◽  
Martim C. Pinto ◽  
Harshadkumar A. Patel ◽  
Nicholas Dahlgren ◽  
Eildar Abyar ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Cadaver Study ◽  
Saphenous Nerve ◽  
Nerve Branch ◽  
Suture Button ◽  
Level Ii ◽  
Direct Injury ◽  
Prospective Comparative Study ◽  
Neurovascular Structures ◽  
Respective Rate

Objectives: The objective of this study was to describe the anatomic variations in the saphenous nerve and risk of direct injury to the saphenous nerve and greater saphenous vein during syndesmotic suture button fixation. Methods: Under fluoroscopic guidance, syndesmotic suture buttons were placed from lateral to medial at 1, 2, and 3 cm above the tibial plafond on 10 below-knee cadaver leg specimens. The distance and position of each button from the greater saphenous vein and saphenous nerve were evaluated. Results: The mean distance of the saphenous nerve to the suture buttons at 1, 2, and 3 cm were 7.1 ± 5.6, 6.5 ± 4.6, and 6.1 ± 4.2, respectively. Respective rate of nerve compression was as follows, 20% at 1 cm, 20% at 2 cm, and 10% at 3 cm. Mean distance of the greater saphenous vein from the suture buttons at 1, 2, and 3 cm was 8.6 ± 7.1, 9.1 ± 5.3, and 7.9 ± 4.9 mm, respectively. Respective rate of vein compression was 20%, 10%, and 10%. A single nerve branch was identified in 7 specimens, and 2 branches were identified in 3 specimens. Conclusion: There was at least one case of injury to the saphenous vein and nerve at every level of button insertion at a rate of 10% to 20%. Neurovascular injury may occur despite vigilant use of fluoroscopy and adequate surgical technique. Further investigation into the use of direct medial visualization of these high-risk structures should be done to minimize the risk. Levels of Evidence: Therapeutic, Level II: Prospective, comparative study

Sonographically Assisted Percutaneous Release of the A1 Pulley: A New Surgical Technique for Treating Trigger Digit

2006 ◽  
Vol 31 (2) ◽  
pp. 191-199 ◽  
Author(s):  
I. M. JOU ◽  
T. C. CHERN
Keyword(s):  
Cadaver Study ◽  
Safe Zone ◽  
Prospective Clinical Study ◽  
Percutaneous Technique ◽  
Direct Visualization ◽  
Percutaneous Release ◽  
Neurovascular Structures ◽  
A1 Pulley ◽  
New Surgical Technique

This study introduces a sonographically assisted percutaneous technique for releasing trigger digits which provides direct visualization of the release and avoids the risks of incomplete release and injury to adjacent neurovascular structures associated with other percutaneous release techniques. The “safe zone” and an estimate of the size of the A1 pulley were determined in a separate cadaver study. We then used these landmarks in a prospective clinical study of 107 digits in 83 consecutive patients treated by this technique. During the follow-ups of between 9 and 15 months, we evaluated 104 digits in 80 patients. Pain was absent in 101 digits (97%) and considerably improved in the other three (3%). All mechanical problems had been resolved and none recurred during follow-up. This technique allows the surgeon to see and monitor, precisely, the percutaneous division of the A1 pulley without open surgery and, therefore, to avoid the inherent risks of percutaneous and open surgical release.

scholarly journals Component Approach to the Temporomandibular Joint and Coronoid Process

2014 ◽  
Vol 7 (4) ◽  
pp. 323-326 ◽  
Author(s):  
Miles J. Pfaff ◽  
James Clune ◽  
Derek Steinbacher
Keyword(s):  
Facial Nerve ◽  
Temporomandibular Joint ◽  
Coronoid Process ◽  
Aesthetic Outcome ◽  
Limited Access ◽  
Superficial Musculoaponeurotic System ◽  
Ideal Approach ◽  
Component Approach ◽  
Neurovascular Structures ◽  
The Ideal

Reconstruction of the temporomandibular joint (TMJ) region is challenging. The conventional direct preauricular incision permits only limited access to the TMJ and surrounding structures, therefore risking injury to the facial nerve during retraction. The ideal approach allows sufficient exposure, preservation of underlying neurovascular structures, and achieves an optimal aesthetic outcome. We describe a preauricular posttragal incision with a superficial musculoaponeurotic system flap to allow wide exposure of the zygomatic arch, TMJ, condyle, and coronoid process. We postulate that this approach improves access, lessens the amount of retraction required, and creates a more inconspicuous scar.

Quadrant anatomy of the articular pillars (lateral cervical mass) of the cervical spine

1995 ◽  
Vol 82 (6) ◽  
pp. 1011-1014 ◽  
Author(s):  
T. Glenn Pait ◽  
Phillip V. McAllister ◽  
Howard H. Kaufman
Keyword(s):  
Anatomical Landmarks ◽  
Cervical Mass ◽  
Content Type ◽  
Bony Landmarks ◽  
Fixation Devices ◽  
Human Cadavers ◽  
Lateral Mass Screws ◽  
Neurovascular Structures ◽  
Lateral Facet ◽  
Fine Print

✓ Knowledge of the relevant anatomy is important when developing a strategy for introducing screws into the lateral masses to secure internal fixation devices. This paper defines key bony landmarks and their relationship to critical neurovascular structures and identifies a location for safe placement of cervical articular pillar (lateral mass) screws. Measurements of anatomical landmarks in 10 spines from human cadavers aged 61 to 85 years were made by caliper and a metric ruler. Landmarks were the lateral facet line, rostrocaudal line, medial facet line, intrafacet line, and medial facet line—vertebral artery line. The average distances and ranges were recorded. Such great variance existed in measurements from spine to spine and within the same spine as to render averages clinically unreliable. Dissection revealed that division of the articular pillar into four quadrants leaves one, the superior lateral quadrant, under which there are no neurovascular structures; this may be considered the “safe quadrant” for placement of posterior screws and plates.

scholarly journals Hip and groin pain in sub-elite South African footballers

2016 ◽  
Vol 27 (4) ◽  
pp. 114
Author(s):  
D J Dowson
Keyword(s):  
Range Of Motion ◽  
Groin Pain ◽  
Medical Practitioner ◽  
Medical Professional ◽  
Average Score ◽  
Hip Strength ◽  
Joint Pathology ◽  
Flexion Extension ◽  
Hip Flexion ◽  
Groin Injury

Background. Groin injuries are common in football. This can be attributed to the nature of the sport involving rapid accelerations, decelerations, abrupt directional changes and kicking. Groin injuries require lengthy rehabilitation times and predispose players to further injuries. Previous groin injury is a risk factor for future groin injuries, suggesting players are inadequately rehabilitated or the original cause has not been addressed. Objectives. To describe the prevalence, nature and treatment patterns of groin injuries in sub-elite players, and to investigate differences in hip strength and range of motion between players with and without a history of groin injury. Method. Thirty sub-elite, senior university male players were interviewed and questioned regarding groin injuries sustained in the preceding three years. They were assessed using the HAGOS questionnaire, and underwent isokinetic hip flexion/extension strength, adductor squeeze and range of motion tests. Results. Seventeen players (57%) reported having a previous groin injury, with an average score of 83 (16) [mean (SD)] on the HAGOS, compared with 92 (5) for non-injured players. Of the previously injured players, 29% did not seek treatment from a medical professional. Injuries included adductor strain (35%), inguinal-related (18%), iliopsoas-related (12%) and hip joint pathology (6%). The average time off was 25 days. There were no significant differences in isokinetic hip flexion/extension strength, adductor strength and range of motion. Conclusion. The prevalence of groin injuries in this population is relatively high (57%) and requires lengthy rehabilitation time. The HAGOS is a suitable tool to identify groin pain in this population within the sports and recreation and quality of life subscales. Isokinetic hip strength and range of motion testing lacked sensitivity in detecting deficits in players with a previous groin injury. Only two-thirds of injured players consulted a medical practitioner, increasing the likelihood that rehabilitation was inadequate. It is therefore recommended that player/coach education regarding injury management improve in order to reduce subsequent injuries. Keywords. HAGOS, groin injury, prevalence, range of motion, isokinetic strength

Risk of Injury to the Neurovascular Structures in the Pararectus Approach Used in Acetabular Fractures: A Cadaver Study

2021 ◽  
Vol 35 (1) ◽  
pp. e13-e17
Author(s):  
Yusuf A. Kati ◽  
Ozkan Kose ◽  
Baver Acar ◽  
Adil Turan ◽  
Serra Ozturk ◽  
...  
Keyword(s):  
Cadaver Study ◽  
Acetabular Fractures ◽  
Risk Of Injury ◽  
Pararectus Approach ◽  
Neurovascular Structures

Endoscopic Flexor Hallucis Longus Decompression: A Cadaver Study

2007 ◽  
Vol 28 (7) ◽  
pp. 810-814 ◽  
Author(s):  
John J. Keeling ◽  
Gregory P. Guyton
Keyword(s):  
Sural Nerve ◽  
Significant Risk ◽  
Cadaver Study ◽  
Flexor Hallucis Longus ◽  
Lateral Plantar Nerve ◽  
Endoscopic Release ◽  
Incision Size ◽  
Large Joint ◽  
Fresh Frozen ◽  
Neurovascular Structures

Background New indications for arthroscopy are being considered because arthroscopy limits incision size and potentially decreases operative morbidity. This cadaver study investigated the utility of performing an all-endoscopic flexor hallucis longus (FHL) decompression. Methods Eight fresh-frozen cadaver legs were used. In the simulated prone position with large joint arthroscopic equipment, posterolateral and posteromedial portals were used to perform posterolateral talar process bony excision and FHL sheath debridement and release. We noted the integrity of the sural nerve, FHL tendon, and medial tibial neurovascular bundle. After open dissection, values for sural nerve distance to the posterolateral portal, the amount of FHL sheath released and the proximity of the arthroscopic instrumentation to the medial tibial neurovascular structures were recorded. Results Three of eight FHL tendons were injured during the attempted FHL release. Furthermore, no FHL sheath was completely released down to the level of the sustentaculum. Although posterolateral portal placement was on average 12.1 mm from the sural nerve, it was only 6.1 mm from the lateral calcaneal branch of the sural nerve. Moreover, in all cases the medial calcaneal nerve and first branch of the lateral plantar nerve were closely juxtaposed and in some cases adherent to the FHL fibro-osseous sheath. Conclusions Although os trigonum or posterolateral talar process excision was performed without difficulty, endoscopic release of the FHL tendon proved technically demanding with significant risk to the local neurovascular structures. Given the reliability and low morbidity of open techniques, this cadaver study calls into question the clinical use of complete endoscopic FHL release to the level of the sustentaculum. Moreover, hindfoot endoscopic surgery should be performed by surgeons familiar with open posterior ankle anatomy and experienced in hindfoot endoscopy.

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