China
Africa
Explore chapters and articles related to this topic
Amputations and ring avulsions
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
Which structures are avulsed? Are the neurovascular bundles intact? Make a distinction between normal circulation, no vascular filling with low turgor, and venous congestion. Test the sensibility. Test flexion and extension.
The Spastic Forearm and Hand
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
The neurovascular bundle was protected and retracted. The FCU tendon was detached from its insertion to the pisiform bone, and the muscle fibres of the FCU taking origin from the distal half of the ulna were carefully released. A short incision was made over the dorsum of the wrist just lateral to Lister’s tubercle. The ECRB and ECRL were identified by demonstrating extension of the wrist when the tendons were pulled up with a blunt hook. A tendon tunneller was passed from the second wound around the medial border of the ulna through a liberal longitudinal slit made in the medial intermuscular septum, and the free end of the FCU tendon was grasped and withdrawn into the dorsal wound. The forearm was held in supination and the wrist in extension, and the FCU tendon was passed through the ECRB and the ECRL tendons and sutured to itself under tension (Figure 54.4).
Hand and Upper Limb Emergencies
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
On examination, assess perfusion by checking warmth and capillary refill time at the tip. Examine the wound to ascertain whether it is likely that both neurovascular bundles have been compromised. Avoid using a ring block as this can decrease vascular flow.
The role of computed tomography and magnetic resonance imaging in surgical planning for thoracic outlet syndrome: the experience of a single third level reference center for peripheral nerve surgery
Published in Neurological Research, 2023
Alessandra Turrini, Carlo Maria De Masi, Carlo Sacco, Camilla Mencarani, Vanni Veronesi, Guido Staffa, Crescenzo Capone
The evaluation of radiological images by the surgeon represents an important step, because their diagnostic interpretation is not always reliable, and those details of topographic anatomy useful for surgical planning are not always described in radiological reports. Indeed, there are anatomical anomalies such as abnormal course of blood vessels or anomalous insertion muscles that are not involved in TOS pathophysiology but may complicate surgical access. On the left side, the presence of the thoracic duct and its numerous lymphatic vessels should be taken into account to avoid lymphoceles. In patients with a history of trauma, neurovascular bundles can be compressed, attached to surrounding structures and displaced by fibrosis, contributing to compression. Fibrosis can make neurolysis and arteriolysis difficult and surgeons should be prepared. Any potential cause of compression must be actively searched during surgery. The surgeon can perceive the tension that other anatomical structures apply on the brachial plexus and/or on the axillo-subclavian vessels with palpation and test the sufficient opening of the costoclavicular space. First rib removal or addition of anterior deltopectoral approach can be predicted after evaluation of radiological images but assessed definitively during surgery.
Morphometry and anatomical variations of the inferior oblique muscle as relevant to the strabismus surgeries
Published in Strabismus, 2023
Tulika Gupta, Chetan Kharodi, Neelkamal Cheema
The nerve to inferior oblique is a branch of the inferior division of the oculomotor nerve. It enters the IO after the muscle passes the lateral border of the inferior rectus muscle.1 The topographic anatomy of the entry point of the nerve is important surgically due to the following reasons. Myectomy is performed between the insertion and the nerve entry point, while in nasal myectomy, a section of muscle is excised between the nerve & the origin of the muscle. In the rarely performed procedure of denervation and extirpation, the neurovascular bundle is identified and transacted along with the removal of muscle segment distal to it.20 Lastly, to predict the post-operative functional status in the anterior transposition of the IO as the neuro-vascular bundle is supposed to act as the new origin of the IO.12,13
Latissimus Dorsi Myocutaneous Flap Procedure in a Swine Model
Published in Journal of Investigative Surgery, 2021
Joanna W. Etra, Samuel A. J. Fidder, Christopher M. Frost, Franka Messner, Yinan Guo, Dalibor Vasilic, Sarah E. Beck, Steven Bonawitz, Gerald Brandacher, Damon S. Cooney
The muscle is bordered by the slightly superficially overlapping trapezius muscle cranial-dorsally, the underlying serratus on the caudal and ventral sides, and the triceps muscle where the tendon dives to insert onto the humerus (Figures 1 and 3, Panel 3). The latissimus muscle fans from its insertion in the posterior axillary fold superficial to a fascial layer. The neurovascular bundle – containing the thoracodorsal artery, vein, and nerve – is found on the deep surface of the muscle superficial to the fascia (Figure 4). The pedicle runs deep to the teres major and enters the latissimus muscle distal to its tendon origin [17,18]. The thoracodorsal nerve – which supplies the motor innervation for the latissimus muscle – runs parallel to the vascular bundle inserting slightly more cranially. The nerve is easily identified and accessed for a neurotized flap model.