Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
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Approximately one-third of all injuries of the upper limb and 7% of all injuries in skiing affect the ulnar collateral ligaments of the thumb metacarpophalangeal joint (skier's thumb). In some patients the collateral ligaments are displaced proximally over the adductor aponeurosis, resulting in a so-called Stener lesion. In these cases surgical treatment is indicated. ⋯ A decreased stability was only found after cutting both parts of the ulnar collateral ligaments. A Stener lesion could not be provoked in any of the cadavers at any time by clinical stability testing. Summarizing our findings we conclude that a proper performed clinical stability testing of the thumb MP joint is a safe maneuver, which does not lead to a Stener lesion in patients with skier's thumb.
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Review Meta Analysis
Surgical anatomy of the pectoral nerves and the pectoral musculature.
The pectoral nerves (PNs) may be selectively injured through various traumatic mechanisms such as direct trauma, hypertrophic muscle compression, and iatrogenic injuries (breast surgery and axillary node dissection, pectoralis major muscle transfers). The PN may be surgically recovered through nerve transfers. They may also be used as donors to the musculocutaneous, axillary, long thoracic, and spinal accessory nerves and for reinnervation of myocutaneous free flaps. ⋯ In 50%-100% of cases, it may pass, at least with some branches, through the pectoralis minor muscle. The LPN supplies the upper portions of the pectoralis major muscle; the MPN innervates the lower parts of the pectoralis major and the pectoralis minor muscle. Among the accessory muscles of the pectoral girdle, the LPN may also innervate the tensor semivaginae articulationis humero-scapularis, pectoralis minimus, sternoclavicularis, axillary arch, sternalis, and infraclavicularis muscles; the MPN may innervate the pectoralis quartus, chondrofascialis, axillary arch, chondroepitrochlearis, and sternalis muscles.
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The anatomical variations of the brachial plexus in humans have clinical significance for surgeons, radiologists, and anatomists. In a study of 60 brachial plexuses, four trunked brachial plexuses were encountered in three limbs (two female and one male), all of them being post fixed and on left side of cadavers. The third trunk in all these limbs gave rise to two anterior divisions (upper and lower) and one posterior division. ⋯ No medial cord was formed as such. Further, it is inferred that in postfixed brachial plexus, there is a tendency to failure on part of T1 and T2 to join C8 which continues as the third trunk while T1 and T2 continue as the fourth trunk. Since it was seen in all postfixed brachial plexuses of the present study, it is emphasized to be given a place in the textbooks of anatomy or to conduct a study on a larger database.
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A connective tissue link between the spinal dura mater and the rectus capitis posterior minor muscle was first described in 1995 and has since been readily demonstrated via dissection, magnetic resonance imaging, and plastinated cross-sections of the upper cervical region (Hack et al. [1995] Spine 20:2484-2486). This structure, the so-called "myodural bridge," has yet to be included in any of the American anatomy textbooks or dissection guides commonly used in medical education. This direct anatomic link between the musculoskeletal system and the dura mater has important ramifications for the treatment of chronic cervicogenic headache. This article summarizes the anatomic and clinical research literature related to this structure and provides a simple approach to dissect the myodural bridge and its attachment to the posterior atlanto-occipital membrane/spinal dura mater complex and summarizes the case for its possible inclusion in medical anatomy curricula.
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Suprascapular nerve entrapment caused by the superior transverse scapular ligament (STSL) causes pain, and limitation of motion in the shoulder. To relieve these symptoms, suprascapular nerve decompression is performed through the resection of STSL. To describe and classify the topographic anatomy of the suprascapular notch, 103 cadaveric shoulders were dissected. ⋯ Age was inversely correlated with the length of STSL. The STSL was wider in males than in females. This study provides details of the structural variations in the region of the suprascapular notch.