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Resource-Limited Environment Plastic Surgery
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Johann A. Jeevaratnam, Charles Anton Fries, Dimitrios Kanakopoulos, Paul J. H. Drake, Lorraine Harry
The nine compartments of the foot fall into four groups – intrinsic, medial, central, and lateral (Figure 17.3) – and should be decompressed via a single medial incision (Figure 17.4).Mark the incision from a point below the medial malleolus (midway between malleolus and sole) to the base of the first metatarsal.Incise through skin and plantar fascia.The neurovascular bundle is identified and retracted.Incise the fascia over abductor hallucis and flexor hallucis brevis to enter the medial compartment.Incise the medial intermuscular septum longitudinally to enter the central compartment.Note the lateral plantar neurovascular bundle runs over quadratus plantae.The remaining compartments (lateral and intrinsic) are entered by blunt dissection.
Posterior Approach to Distal Humerus
Published in Raymond Anakwe, Scott Middleton, Trauma Vivas for the FRCS (Tr & Orth), 2017
Raymond Anakwe , Scott Middleton
The medial head lies deep to the other two heads. The radial nerve runs in the spiral groove just proximal to the medial head of triceps. To expose the posterior humeral shaft, the medial head is incised in its mid-line down to the periosteum. Remaining in the subperiosteal plane avoids damage to the ulnar nerve which pierces the medial intermuscular septum to enter the posterior compartment of the arm approximately 8 cm proximal to the medial epicondyle.
The Heart (HT)
Published in Narda G. Robinson, Interactive Medical Acupuncture Anatomy, 2016
Medial intermuscular septum: Extends from the deep surface of the brachial fascia to the medial supracondylar ridge of the humerus. Divides the arm into anterior and posterior, or dorsal and ventral, compartments.
Quality of life and satisfaction in patients surgically treated for cubital tunnel syndrome
Published in Neurological Research, 2023
María Elena Córdoba-Mosqueda, Lukas Rasulić, Andrija Savić, Jovan Grujić, Filip Vitošević, Milan Lepić, Aleksa Mićić, Stefan Radojević, Stefan Mandić-Rajčević, Ivana Jovanović, Carlos Alberto Rodríguez-Aceves
AT involves placing the nerve in a new tissue bed either subcutaneously, submuscularly, or intramuscularly [1]. With the patient in the supine position under general anesthesia, a curvilinear skin incision was made posterior to the medial epicondyle, extending from 7 cm above to 5 cm below the condyle (Figure 3-A). After locating the ulnar nerve below the fascia proximally, the arcade of Struthers and the distal part of the medial intermuscular septum were excised. The cubital tunnel was then unroofed, and the nerve was dissected distally to free it from the posterior aspect of the condylar groove. Inferiorly, it was traced deep to the fascia of Osborne and between the two heads of the flexor carpi ulnaris. The arcade of Osborne, fascia, or the extensor carpi ulnaris muscle and its deep aponeurosis were then divided longitudinally, sparing the motor branches. Once the nerve was identified, it was isolated with a soft rubber loop that is used to decrease focal pressure on the nerve during gentle retraction (Figure 3-B).
Effect of dry needling on cubital tunnel syndrome: Three case reports
Published in Physiotherapy Theory and Practice, 2019
Sudarshan Anandkumar, Murugavel Manivasagam
The cubital tunnel is an anatomical space containing the ulnar nerve and ulnar collateral artery and extends from the medial epicondyle of the humerus to the olecranon process of the ulna (Shen, Masih, Patel, and Matcuk, 2016). The floor is formed by the joint capsule and medial collateral ligament of the elbow and the roof is formed by Osborne’s ligament (also known as cubital tunnel retinaculum), a fibrous band running between the two heads of flexor carpi ulnaris (FCU) (Green and Rayan, 1999). After the ulnar nerve exits the cubital tunnel, it penetrates between the ulnar and humeral heads of the FCU and passes through the flexor–pronator aponeurosis (which forms the common origin of the flexor and pronator muscles) (Amadio and Beckenbaugh, 1986). Multiple sites of ulnar nerve entrapment around the elbow have been described in the literature and include the Arcade of Struthers (about 8 cm proximal to the medial epicondyle), medial intermuscular septum, medial epicondyle (with osteophytes irritating the nerve), cubital tunnel, and deep flexor aponeurosis of the FCU (5 cm distal to the medial epicondyle) (Kroonen, 2012) (Figure 1).