scholarly journals Symphysiotomy Using Posterior Approach

2021 ◽  
Vol 12 (1) ◽  
pp. 374-377
Author(s):  
Ali S Al-Qahtani ◽  
Osamah A Al-Qahtani
Keyword(s):  
Stainless Steel ◽  
Posterior Approach ◽  
Posterior Part ◽  
Symphysis Pubis ◽  
Front Part ◽  
Posterior Aspect ◽  
Life Saving ◽  
Skin Scar ◽  
And Cartilage

The invention relates to an apparatus used in the separation of the Symphysis pubis joint from its posterior aspect. This process medically named as Symphysiotomy. The apparatus consists of 3 parts: (1). Size 14G cannula which is 14cm in length, made of stainless steel and has a sharp bevel and thickened posterior part to enable the user to have a good grip on it during usage. (2). A stylet 14cm long made of stainless steel to fit in the inside of the cannula to prevent coring of the tissues during the introduction of the cannula. It has a vertical end to stop the advancement inside the cannula. (3). A cutter which is 14cm long and made of stainless steel and fits inside the cannula when the stylet is removed. Its front part is sharp on one side to cut through the ligament and cartilage of the symphysis pubis from its posterior aspect. Its back has a half-circle end to prevent the cutter from advancing beyond the bevel of the cannula inside the tissues. This is a life-saving operation and used to widen the diameter of the pelvis during certain situations of obstructed delivery of the baby. The design of the apparatus and instructions of its use enable doctors and midwives to perform the symphysiotomy procedure once they are trained on its use. The use of the invention avoids bleeding, injury to urethra and bladder, and avoids the formation of skin scar. The symphysiotomy scalpel obtained patent status from the King Abdulaziz City for Science & Technology (5910 dated 20 May 2018).

scholarly journals Location of the radial nerve along the humeral shaft between the prone and lateral decubitus positions at different elbow positions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sitthiphong Suwannaphisit ◽  
Wachirakorn Aonsong ◽  
Porames Suwanno ◽  
Chaiwat Chuaychoosakoon
Keyword(s):  
Radial Nerve ◽  
Minimum Distance ◽  
Posterior Approach ◽  
Elbow Flexion ◽  
Lateral Decubitus Position ◽  
Full Extension ◽  
Posterior Aspect ◽  
Lateral Epicondyle ◽  
Lateral Decubitus ◽  
The Mean

AbstractIdentification of the radial nerve is important during the posterior approach to a humerus fracture. During this procedure, the patient can be placed in the prone or lateral decubitus position depending on the surgeon’s preference. The distance from the radial nerve to the osseous structures will be different in each position. The purpose of this study was to identify the safety zones in various patient and elbow flexion positions. The distances from the olecranon to the center of the radial groove and intermuscular septum and lateral epicondyle to the lateral intermuscular septum were measured using a digital Vernier caliper. The measurements were performed with cadavers in the lateral decubitus and prone positions at different elbow flexion angles. The distance from where the radial nerve crossed the posterior aspect of the humerus measured from the upper part of the olecranon to the center of the radial nerve in both positions at different elbow flexion angles varied from a mean maximum distance of 130.00 mm with the elbow in full extension in the prone position to a minimum distance of 121.01 mm with the elbow in flexion at 120° in the lateral decubitus position. The mean distance of the radial nerve from the upper olecranon to the lateral intermuscular septum varied from 107.13 to 102.22 mm. The distance from the lateral epicondyle to the lateral edge of the radial nerve varied from 119.92 to 125.38 mm. There was not significant contrast in the position of the radial nerve with osseous landmarks concerning different degrees of flexion, except for 120°, which is not significant, as this flexion angle is rarely used.

A Case Report of Simultaneous Ipsilateral Floating Knee and Hip

2020 ◽  
Author(s):  
Babak Siavashi ◽  
Seyyed Hossein Shafiei ◽  
Farhad Mahdavi ◽  
Salar Baghbani ◽  
Mohammad Reza Golbakhsh
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Posterior Approach ◽  
Pelvic Ring ◽  
Posterior Part ◽  
Femoral Shaft ◽  
Rare Injury ◽  
Standard Guideline

Background: Simultaneous ipsilateral floating knee and hip is a very rare injury and so far, no standard guideline has been determined for its treatment. Case Report:In the current study, we report a surgical technique for the treatment of a 17-year-old patient with this condition on his left side. Conclusion: We recommend to start the fixation from proximal and stabilize the pelvic ring at first, then fix the posterior part of the acetabulum and femoral shaft with the same posterior approach.

Use of an aiming device in posterior atlantoaxial transarticular screw fixation

2002 ◽  
Vol 97 (1) ◽  
pp. 123-127 ◽  
Author(s):  
Masashi Neo ◽  
Mutsumi Matsushita ◽  
Tadashi Yasuda ◽  
Takeshi Sakamoto ◽  
Takashi Nakamura
Keyword(s):  
Posterior Approach ◽  
Screw Fixation ◽  
Guide Wire ◽  
Posterior Part ◽  
Cannulated Screw ◽  
Atlantoaxial Joint ◽  
Transarticular Screw ◽  
Content Type ◽  
Transarticular Screw Fixation ◽  
Fine Print

✓ Posterior atlantoaxial transarticular screw fixation is an excellent procedure associated with high fusion rates. There is, however, the potential risk of vertebral artery (VA) injury. The authors designed a special aiming device that allows a cannulated screw to be inserted accurately in the most posterior part of the C1–2 joint via the most posterior and medial part of the isthmus of C-2; this screw pathway most safely avoids VA injury. The instruments include an aiming device and a flexible screw-inserting system. The tip of the aiming device is placed on the ridge of the C-2 isthmus just posterior to the atlantoaxial joint. The guide wire should then pass 1 mm below the device tip. The system consists of flexible guide wires, a drill, a tap, and a screwdriver, and the screw is inserted easily via a posterior approach in which the patient's back is not obstructive. Ten patients with atlantoaxial subluxation or osteoarthritis underwent surgery in which the device was used. In all cases, the screws were inserted safely without causing VA injury, although preoperative computerized tomography (CT) reconstructions revealed a high-risk high-riding unilateral VA in three patients. Postoperative CT reconstructions demonstrated that all screws but one were inserted as planned, and successfully cleared the vertebral groove. In conclusion, this newly designed device is practical and useful for the accurate insertion of screws, thus avoiding VA injury during atlantoaxial transarticular screw fixation.

Using a ring to locate femoral head centre in total hip arthroplasty

2021 ◽  
pp. 112070002110054
Author(s):  
Owen J Diamond ◽  
Janet C Hill ◽  
Aaron J McCann ◽  
Cormac McGrath ◽  
Richard J Napier ◽  
...  
Keyword(s):  
Fixed Point ◽  
Femoral Head ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Posterior Approach ◽  
Circular Ring ◽  
Analysis Program ◽  
Leg Length ◽  
Posterior Aspect ◽  
Total Hip

Aims: Traditional methods of determining femoral head centre (FHC) during total hip arthroplasty (THA) rely on measuring the distance from a fixed point on the femur or using a calliper. The aim of this experiment was to investigate how accurately a simple circular ring could locate FHC. Methods: 144 consecutively available femoral heads (FHs) were collected from patients undergoing THA. Each FH was orientated and mounted on a Sawbone, to create a model of its position on a proximal femur. The ring was applied to the posterior aspect of the FH and a head-centre pin (HCP) was then drilled into the FH and the ring removed, leaving the HCP in place. Each FH was then photographed normal to the axis of the HCP. A MATLAB analysis program then assessed the accuracy of the ring in locating FHC. Results: Mean location accuracy for FHC was 1.77 (range 0.07–5.83) mm with 97.2% within 4 mm and all but 1 within 5 mm. Conclusions: This ring device located FHC to within 4 mm in 97% of a series of osteoarthritic FHs. This indicates that the posterior aspect of the FH maintains its sphericity late into the osteoarthritic process. Having a simple FHC location device during THA would be of value to control leg length and offset when using the posterior approach.

The Use of Superelasticity in Modern Medicine

MRS Bulletin ◽  
2002 ◽  
Vol 27 (2) ◽  
pp. 101-104 ◽  
Author(s):  
T. W. Duerig
Keyword(s):  
Stainless Steel ◽  
Magnetic Susceptibility ◽  
Medical Device ◽  
Fatigue Resistance ◽  
Modern Medicine ◽  
Life Saving ◽  
Good Biocompatibility

AbstractThe value of Nitinol (Ni-Ti) in the field of medicine has proven to be far greater than just as the simple “springy metal” it was once considered to be. In particular, its use in vascular implants highlights many valuable yet subtle behaviors, including a “biased stiffness,” enhanced fatigue resistance, low magnetic susceptibility, and good biocompatibility. Nitinol today is nearly as well known to medical-device designers and physicians as are stainless steel and titanium, and it is the enabling ingredient in a growing number of successful and profitable life-saving devices.

A Two-Portal Posterior Endoscopic Approach in the Treatment of a Complex Talus Fracture

2009 ◽  
Vol 99 (5) ◽  
pp. 443-446 ◽  
Author(s):  
Tahir Ogut ◽  
Aksel Seyahi ◽  
Onder Aydingoz ◽  
Nafiz Bilsel
Keyword(s):  
Subtalar Joint ◽  
Posterior Approach ◽  
Posterior Part ◽  
Endoscopic Approach ◽  
New Technique ◽  
Treatment Alternative ◽  
Talus Fracture ◽  
Hindfoot Endoscopy

The two-portal hindfoot endoscopy is a relatively new technique that is becoming increasingly popular. It gives excellent access to the posterior ankle compartment, the subtalar joint, and extra-articular structures. We report a 24-year-old man with a complex talus fracture involving the posterior part of the talar body and posterolateral process. He was treated endoscopically, with a two-portal posterior approach to the hindfoot. This approach allowed a better visualization and treatment of accompanying pathologies. Combined excision of the posterolateral process and fixation of the fracture was performed with the two-portal hindfoot endoscopy, which has not been previously described to our knowledge. The two-portal posterior endoscopic approach can be an attractive treatment alternative for the posterior part fractures of the talus, which can in turn, be a new indication for this technique. (J Am Podiatr Med Assoc 99(5): 443–446, 2009)

scholarly journals Approaches to Thoracic and Lumbar Spine: Our 10 Years Review

2019 ◽  
Vol 7 (08) ◽  
Author(s):  
Parthasarahi Datta
Keyword(s):  
Lumbar Spine ◽  
Retrospective Analysis ◽  
Anterior Approach ◽  
Posterior Approach ◽  
Perioperative Complications ◽  
Complete Recovery ◽  
Neurological Deficits ◽  
Posterior Aspect ◽  
Thoracic And Lumbar Spine

Background: Lesions of the Thoracic and lumbar spine (TL) are numerous. These lesions affect one or more columns (anterior, middle and posterior) of the spine and compress the spinal cords either from anterior and posterior, giving rise to the features of radiculo-myelopathy. These lesions can be approached either from the anterior or posterior aspect of the spine. We present our last 10 years experience regarding the comparison between two approaches. Methods: Retrospective analysis of records of all patients with thoracic and lumbar lesion treated in our hospital between January 2005 and June 2014 was performed. Over the last 10 years, we came across 186 patients of thoracic and lumbar lesion lesion who were operated either by anterior or posterior approach and were the focus of this study. Follow up ranged from 6 months to 7 years. Results: All the patients presented with neurological deficits. They were evaluated with investigation protocol of our hospital. Anterior approach was done in 38 cases (n = 38) and posterior approach was done in 148 cases (n = 148). We compared between the two groups in terms of perioperative complications, recovery, persisting symptoms and mortality. Conclusion: Complete recovery is better in the posterior approach (74.3%) v/s 52.6%) and morality is more in the anterior approach (7.9% v/s 1.3%). Keywords: Columns, radiculo-myelopathy, thoracic, lumbar

The nature of congenital posterior cervical or cervicothoracic midline cutaneous mass lesions

1991 ◽  
Vol 75 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Paul Steinbok ◽  
D. Douglas Cochrane
Keyword(s):  
Spinal Cord ◽  
Spinal Dysraphism ◽  
Large Body ◽  
Posterior Part ◽  
Cervical Region ◽  
Posterior Aspect ◽  
Content Type ◽  
Chiari Ii ◽  
Spina Bifida Cystica ◽  
Mass Lesions

✓ Between 4% and 8% of cases of spina bifida cystica occur in a cervical or cervicothoracic location. Despite a large body of literature concerning spinal dysraphism, there has been little written specifically about patients afflicted with this disorder in a cervical location. Eight children who presented at birth with posterior cervical or cervicothoracic lumps, all of which represented a dysraphic state, are discussed. Two types of abnormalities were noted. Three patients had hydromyelia with an associated myelocystocele herniating posteriorly into a meningocele sac. In these three patients there was an associated Chiari II malformation and hydrocephalus. The other five children had a meningocele in which a band of tissue extended from the posterior aspect of the spinal cord through a defect in the bone and fascia to the posterior part of the meningocele sac itself. No patient had a lesion that could be described as a meningomyelocele. The investigation and surgical management of these conditions are discussed and the need for intradural exploration to untether the spinal cord in the cervical region is stressed.

scholarly journals Localized Amyloidosis of Tongue: A Rare Case from India

2016 ◽  
Vol 7 (4) ◽  
pp. 225-227
Author(s):  
Amit Sharma ◽  
Kanwaljeet Singh
Keyword(s):  
Rare Case ◽  
Histopathological Examination ◽  
Posterior Part ◽  
Surgical Excision ◽  
Systemic Amyloidosis ◽  
Benign Tumors ◽  
Posterior Aspect ◽  
Localized Amyloidosis ◽  
Congo Red Staining ◽  
Rule Out

ABSTRACT Involvement of the tongue by amyloid is mostly secondary to systemic amyloidosis, with less than 9% of all types of amyloidosis presenting as isolated amyloidosis of the tongue. This is a case report of a 56-year-old patient who presented with mass lesion in the posterior part of tongue since 2 years duration. Magnetic resonance imaging revealed nodular area on posterior aspect of tongue without focal signal intensity and no contrast enhancement. On histopathological examination, the lesion exhibited homogeneous extracellular eosinophilic material. Congo red staining revealed amyloid material as red color under light microscopy and as apple green birefringence under polarized microscope. A definitive diagnosis of localized isolated amyloidosis of tongue was made after detailed workup to rule out the systemic form of amyloidosis. Isolated and localized amyloidosis of tongue is very rare and often mimics benign tumors, thus making the job of the treating doctor more challenging. The foremost task in management of these patients is to rule out the possibility of systemic amyloidosis because the localized forms of the disease may be treated with wide local surgical excision. How to cite this article Singh K, Sharma A. Localized Amyloidosis of Tongue: A Rare Case from India. Int J Head Neck Surg 2016;7(4):225-227.

MALIGNANT PERIPHERAL NERVE SHEATH TUMOR OF THE OCCIPITAL REGION

Neurosurgery ◽  
2007 ◽  
Vol 61 (6) ◽  
pp. E1334-E1335 ◽  
Author(s):  
Piyush Kumar ◽  
Shishir Jaiswal ◽  
Tanu Agrawal ◽  
Ashish Verma ◽  
Niloy Ranjan Datta
Keyword(s):  
Peripheral Nerve ◽  
Postoperative Radiotherapy ◽  
Posterior Part ◽  
Intracranial Extension ◽  
Nerve Sheath Tumor ◽  
Occipital Region ◽  
Posterior Aspect ◽  
Peripheral Nerve Sheath Tumor ◽  
Nerve Sheath ◽  
Satisfactory Outcome

Abstract OBJECTIVE A rare case of a malignant peripheral nerve sheath tumor of the occipital region is presented. The role of postoperative radiotherapy in such cases is reviewed. CLINICAL PRESENTATION A 36-year-old man presented with a small spongy swelling in the posterior aspect of the cranium since childhood. The swelling gradually increased for 2 years and then rapidly over the next 7 months. There were no associated symptoms of headache, vomiting, vertigo, focal weakness, or visual impairment. INTERVENTION A small occipital craniectomy for total excision of the tumor was attempted. However, as a result of intracranial extension to the transverse sinus, the tumor could not be completely excised. Local radiotherapy to a dose of 59.4 Gy in 33 fractions over 6.5 weeks was delivered to the residual microscopic disease in the posterior part of the cranium. The patient has been followed up regularly for the past 28 months and continues to remain asymptomatic. CONCLUSION An aggressive malignant peripheral nerve sheath tumor of an atypical site such as the scalp, in which complete surgery may not always be possible, could benefit from postoperative radiotherapy. A dose of approximately 60 Gy could be effectively delivered with a satisfactory outcome.

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