Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jan 1997
Anatomic considerations for uncovertebral involvement in cervical spondylosis.
Morphometric analysis of 54 dry cervical spines from C3 to C7 (a total of 270 cervical vertebrae) and bilateral dissection of 10 anatomic specimen cervical spines were performed. The uncinate processes were significantly higher at C4 to C6 (5.8 +/- 1.1 mm to 6.1 +/- 1.3 mm) levels than at C3 or C7 levels. ⋯ A combination of higher uncinate process, smaller anteroposterior diameter of intervertebral foramina, and longer course of nerve roots in close proximity of the uncovertebral joints at the C4 to C6 levels may explain the predilection of nerve root compression by uncovertebral osteophytes at these levels. The distance from apex of the uncinate process to medial border of the transverse foramen gradually increased from C3 (1.7 +/- 0.8 mm) to C7 (3.3 +/- 1.0 mm), which may predispose the midcervical level to compression of the vertebral artery by laterally projecting uncovertebral osteophytes.
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Clin. Orthop. Relat. Res. · Jan 1997
Case ReportsAnatomic considerations for a modified posterior approach to the scapula.
A modified posterior approach to the scapula was tested on 20 cadavers. The approach also was used in 2 cases with fractures involving the scapular neck and glenoid fossa. The incision is C shaped, with the convexity directed toward the lateral angle of the scapula. ⋯ The circumflex scapular artery is protected at the lateral border of the scapula at an average of 2.8 +/- 0.5 cm from the inferior glenoid margin. The axillary nerve is protected inferior to the teres minor. However, care should be taken not to excessively retract the teres minor because the nerve lies in close proximity to the shoulder joint capsule.
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From the earliest times, medical practitioners have sought divine help and support to aid them as they go about their busy rounds. In the early Christian era, 4 individuals were singled out as patron saints of medicine, and particularly of physicians and surgeons. ⋯ They were the Apostle Luke, Saints Cosmas and Damian and Saint Panteleimon. Through the centuries, they have served as worthy role models for the physicians who have invoked their aide.
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Clin. Orthop. Relat. Res. · Jan 1997
Analgesia for emergency centers' orthopaedic patients: does an ethnic bias exist?
Several prior studies have demonstrated that Hispanics treated in some emergency centers were prescribed less analgesia than white patients with similar extremity trauma. The purpose of this study was to determine if other institutions had a similar experience with regard to undermedication of certain ethnic groups. Two cohorts were studied, 1 adult and 1 pediatric group. ⋯ The pediatric group consisted of 63 children younger than 16 years, seen between January 1, 1992, and April 30, 1993, with isolated distal radius or ulna fractures requiring a closed reduction. Results indicated that Hispanics were not likely to be undermedicated for fracture reduction in this level I trauma emergency center compared with whites. It is thought that a hospital with a larger populations of underrepresented minorities may be more sensitive than other private institutions.