Clinical anatomy : official journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists
-
The birth of conjoined twins occurs in approximately 1 in 50,000 to 1 in 100,000 deliveries, and the majority are either stillborn or die early in life. Approximately 184 successful separations have been described. The authors describe the preoperative radiologic evaluation of a set of thoracopagus-omphalopagus twins and their successful surgical separation. ⋯ Successful separation of twins conjoined by several organ systems requires a multispecialty approach. Preoperative knowledge of shared anatomy is necessary for adequate preparation and planning. Despite meticulous preoperative investigations, certain anatomy can only be discovered at the time of surgery, and the ability to adjust to these findings is imperative.
-
The safe and successful performance of a central venous catheterization (CVC) requires a specific knowledge of anatomy in addition to a working knowledge. Misunderstanding the anatomy may result in failure or complications. ⋯ CVC is common practice amongst surgeons, anesthesiologists, and emergency room physicians during the preparations for major surgical procedures such as open-heart surgery, as well as, for intensive care monitoring and rapid restoration of blood volume. Associated with this technique are certain anatomical pitfalls and complications that can be successfully avoided if one possesses a thorough knowledge of the contraindications, regional anatomy, and rationale of the technique.
-
Crossed renal ectopia is one of the rarest urinary system anomalies. It is more often seen at autopsy than in clinical practice. Most cases of renal ectopia remain asymptomatic during life and are diagnosed incidentally. ⋯ Both had left-to-right inferior crossed renal ectopia with fusion. Additionally, the first patient had a history of surgery for a recurrent inguinal hernia, whereas the second had crossed fused renal ectopia associated with nephroptosis. Surgeons should be aware of ectopic and fused kidneys to minimize perioperative complications because of the uncertain anatomy.
-
Case Reports
Isolated deep peroneal (fibular) nerve palsy in association with primary total hip arthroplasty.
We present two patients suffering isolated deep peroneal (fibular) nerve (DPN) palsies post primary total hip arthroplasty. The consistent factor in both patients was difficulty with initial dislocation and subsequent relocation. Both developed immediate isolated DPN palsies, with loss of dorsiflexion and paraesthesia over the first web space. ⋯ Common peroneal nerve (CPN) palsy is common than due to a number of important anatomical factors. It is thought that the deep and superficial branches of this nerve also exist as discrete fascicles and these same factors make the deep division more frequently affected. Recovery is prolonged and incomplete despite intensive physiotherapy, thus putting emphasis on prevention.
-
Although the arachnoid membranes have been known for more than 300 years, the anatomy of the arachnoid membranes has not been studied in detail. This study was performed to explore the microanatomical features of the cranial arachnoid membranes. The arachnoid membranes and cisterns were observed in eight Han Chinese adult human cadaveric brains with an operating microscope, without staining of intracranial structures or injection of colored material into blood vessels. ⋯ On the basis of the arachnoid membranes we identified, the arachnoidal limits of the cisterns were discussed. The microsurgical anatomical research on the arachnoid membranes is a supplement to the anatomical study of the subarachnoid cisterns. The understanding of the topographical features of the arachnoid membranes is valuable to the reasonable dissection of the cisterns and the minimally invasive manipulations during microsurgical procedures.