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clavicle neurology

Gregor J Kocher, Adrian Zehnder, Jon A Lutz, Juerg Schmidli, Ralph A Schmid
OBJECTIVE: First rib resection is a well-recognized treatment option for thoracic outlet syndrome (TOS). In case of a vascular insufficiency that can be provoked and/or progressive neurologic symptoms without response to conservative treatment, surgical decompression of the space between the clavicle and the first rib is indicated. The aim of this paper is to present our experience with a new minimally invasive robotic approach using the da Vinci Surgical System®. METHODS: Between January 2015 and October 2017, eight consecutive first rib resections in seven patients were performed at our institution...
April 25, 2018: World Journal of Surgery
Jacek Karski, Łukasz Matuszewski, Paweł Jakubowski, Klaudia Karska, Grzegorz Kandzierski
RATIONALE: Fracture of the clavicle is a very common injury in children. However, association between clavicle fracture and atlantoaxial rotatory displacement is rarely observed. PATIENT CONCERNS: We present a case of an 8-year-old girl, who suffered a right clavicle fracture as a result of a sledge accident. Six weeks after figure of 8 casting for a right clavicle fracture, an 8-year-old girl was brought to the Pediatric Orthopedic Department due to torticollis...
November 2017: Medicine (Baltimore)
Thibault Lafosse, Malo Le Hanneur, Laurent Lafosse
Neurogenic thoracic outlet syndrome is caused by a neurologic compression of the brachial plexus before it reaches the arm. Three anatomic areas are common locations for such an entrapment because of their congenital and/or acquired tightness: the interscalene triangle, the costoclavicular space, and the retropectoralis minor space. Because the compression level usually remains unknown, the treatment is still controversial and most teams focus on only one potential site. We propose an all-endoscopic technique of complete brachial plexus neurolysis that can be divided into three parts, one for each entrapment area...
August 2017: Arthroscopy Techniques
Calum A McCoss, Ross Johnston, Darren J Edwards, Charles Millward
In clinical practice, Osteopaths and Manual Therapists commonly direct treatment towards the diaphragm by the use of a 'Diaphragm Release'. Currently, there is paucity within the literature to support the use of this technique, specifically in pain outcomes. This research aims to support a neurophysiological mechanism based upon the osteopathic principle "The body is a unit". Demonstrating that directing treatment to distal tissue which is neurologically related can reduce pain in the originating spinal segments...
April 2017: Journal of Bodywork and Movement Therapies
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
Giovanni Luigi Di Gennaro, Mattia Cravino, Alessandro Martinelli, Eleonora Berardi, Anish Rao, Stefano Stilli, Giovanni Trisolino
HYPOTHESIS: We aimed to report our experience in treating congenital pseudarthrosis of the clavicle (CPC). MATERIALS AND METHODS: A retrospective search of the archive of our institute was performed; 27 cases (12 male and 15 female patients) affected by CPC were recorded. Among these patients, 19 underwent surgical intervention for cosmetic appearance between 1960 and 2015. Of 19 patients, 18 were treated by pseudarthrosis resection and stabilization with a Kirschner wire, whereas in 1 case, the osteosynthesis was performed with a plate...
March 2017: Journal of Shoulder and Elbow Surgery
Sung-Ju Hsueh, Ni-Chung Lee, Shu-Hua Yang, Han-I Lin, Chin-Hsien Lin
BACKGROUND: Cleidocranial dysplasia (CCD) is a rare hereditary disorder that arises from heterozygous loss of function mutations in the runt-related transcription factor 2 (RUNX2) gene. As RUNX2 is mainly expressed in osteoblasts, CCD typically affects the skeletal and dental systems. Few studies have investigated RUNX2 mutation effects on non-skeletal systems. Here, we describe limb-girdle myopathy, an uncommon phenotype of CCD, in a patient with a heterozygous missense mutation (p.R225Q) in the RUNX2 gene...
January 6, 2017: BMC Neurology
T Dung Nguyen, Tim Sandhaus, Torsten Doenst
Perforation of the heart or great vessels by orthopedic wires is a rare complication that mostly results in severe or even lethal organ injury. Therefore, such conditions mostly require immediate surgical removal of the wires. However, in some individual cases, a conservative approach may be preferable. We describe a case of a 70-year-old woman whose aortic arch has been penetrated by two Kirschner wires used for fixation of a right clavicle fracture 13 years ago. Notably, the complication was an incidental finding during computed tomography angiography for clarification of transient nonspecific neurological symptoms...
December 2016: Thoracic and Cardiovascular Surgeon Reports
Kathrin Studer, Markus P Baker, Andreas H Krieg
Congenital pseudarthrosis of the clavicle (CPC) is a very rare condition with a predilection for the right clavicle. Young children are often only symptomatic with activities and as they grow. Operative management in an asymptomatic child is debatable, with various techniques reported in the literature. This is a retrospective, single-centre case series study. All children with CPC treated surgically by resection, bone grafting (nonvascular iliac crest) and plate fixation between 2004 and 2012 at our centre were included...
May 2017: Journal of Pediatric Orthopedics. Part B
Athanasios Raikos, Thomas English, Omar Khalid Yousif, Mandeep Sandhu, Allan Stirling
PURPOSE: The great auricular point (GAP) marks the exit of the great auricular nerve at the posterior border of the sternocleidomastoid muscle (SCM). It is a key landmark for the identification of the spinal accessory nerve, and its intraoperative localization is vital to avoid neurological sequelae. This study delineates the topography and surface anatomy landmarks that used to localize the GAP. METHODS: Thirty cadaveric heminecks were dissected on a layer-by-layer approach...
May 2017: Surgical and Radiologic Anatomy: SRA
Bartosz Mankowski, Tadeusz Polchlopek, Marcin Strojny, Pawel Grala, Krzysztof Slowinski
BACKGROUND: Penetrating neck trauma involving foreign bodies is a rare event in European countries. Due to its relatively high mortality rate, the correct management strategy must be initiated from the beginning to prevent fatal complications. In the medical literature, there are only a few cases describing foreign bodies penetrating the cervical spine. Because of its rareness, many trauma centers lack the proper routine to adequately manage such injuries. CASE PRESENTATION: This case report describes a 34-year-old white man of Central European descent with Kirschner wire migration and perforation of his vertebral foramen...
March 24, 2016: Journal of Medical Case Reports
Kadir Agladioglu, Mustafa Serinken, Onur Dal, Halil Beydilli, Cenker Eken, Ozgur Karcioglu
BACKGROUND: The appropriate sequence of different imagings and indications of thoracic computed tomography (TCT) in evaluating chest trauma have not yet been clarified at present. The current study was undertaken to determine the value of chest X-ray (CXR) in detecting chest injuries in patients with blunt trauma. METHODS: A total of 447 patients with blunt thoracic trauma who had been admitted to the emergency department (ED) in the period of 2009-2013 were retrospectively reviewed...
2016: World Journal of Emergency Medicine
Mathew Rawlings, David Knox, Minoo Patel, David Ackland
BACKGROUND: The purpose of this study was to demonstrate the strength characteristics of a hybrid uni-cortical construct for clavicle fixation. The technique reported aims to combine benefits of uni-cortical fixation with stability comparable to traditional bi-cortical fixation. The approach utilises long, oblique uni-cortical screws at the distal ends of the plate acting as surrogate bi-cortical screws. Locked uni-cortical screws positioned centrally provide bending and torsion strength to the construct...
April 2016: Injury
Gerbrich Galema, Vincent M A Stirler, Marcel J H Ariës
A 48-year-old woman presented with a cervicothoracic seat belt sign after a car accident as a front seat passenger. The CT scan showed right common carotid artery dissection with a pseudoaneurysm, a right clavicle fracture, sternal fracture, multiple rib fractures left and a laceration of the spleen. She did not develop any neurologic deficits.
2015: Nederlands Tijdschrift Voor Geneeskunde
Jens Heyn, Alexandra Ozimek, Mojtaba Sadeghi-Azandaryani, Dominik Bürklein, Bernd Steckmeier
Clavicle fractures are common, with the majority treated conservatively. If treated conservatively, pseudarthrosis of the clavicle is reported in up to 3% of the cases. In rare cases, pseudarthrosis of the clavicle may cause pseudoaneurysm formation, resulting in compression of the brachial plexus and the adjoining vessels, which may produce neurological symptoms and circulatory disorders. Here, we describe two cases of the late onset of pseudoaneurysm formation after pseudarthrosis of the clavicle. Both cases were remarkable because they showed clinical symptoms of TOS...
October 2008: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Steve A Petersen, Johnathan A Bernard, Evan R Langdale, Stephen M Belkoff
BACKGROUND: Treating anterior glenoid bone loss in patients with recurrent shoulder instability is challenging. Coracoid transfer techniques are associated with neurologic complications and neuroanatomic alterations. The purpose of our study was to compare the contact area and pressures of a distal clavicle autograft with a coracoid bone graft for the restoration of anterior glenoid bone loss. We hypothesized that a distal clavicle autograft would be as effective as a coracoid graft. METHODS: In 13 fresh-frozen cadaveric shoulder specimens, we harvested the distal 1...
June 2016: Journal of Shoulder and Elbow Surgery
Shivinder Singh, Rakhee Goyal, Kishan Kumar Upadhyay, Navdeep Sethi, Ram Murti Sharma, Anoop Sharma
BACKGROUND AND AIMS: This study was carried out to evaluate the difference in efficacy, safety, and complications of performing brachial plexus nerve blocks by using a nerve locator when compared to ultrasound (US) guidance. MATERIAL AND METHODS: A total of 102 patients undergoing upper limb surgery under supraclavicular brachial plexus blocks were randomly divided into two groups, one with US and the other with nerve stimulator (NS). In Group US, "Titan" Portable US Machine, Sonosite, Inc...
July 2015: Journal of Anaesthesiology, Clinical Pharmacology
Xin-Hua Wang, Wei-Jun Guo, A-Bing Li, Guang-Jun Cheng, Tao Lei, You-Ming Zhao
Literature searches of the Cochrane Library, PubMed, EMBASE, Web of Science, LILACS, China National Knowledge Infrastructure, and Wanfang Data databases were performed from 1966 to September 2014. Only randomized and quasi-randomized controlled clinical trials comparing operative and nonoperative treatments for displaced midshaft clavicle fractures were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Thirteen studies were considered in the meta-analysis...
August 2015: Clinics
Patrice Bergeron
PURPOSE: To describe a direct percutaneous carotid access technique for carotid artery stenting (CAS) that circumvents the potential for embolization that can occur during catheter manipulation in the aortic arch during femoral access. TECHNIQUE: After inducing anesthesia, an ultrasound transducer is placed at the base of the neck above the clavicle. A 21-G, 7-cm needle from a micropuncture introducer is used for single-wall puncture of the common carotid artery (CCA)...
February 2015: Journal of Endovascular Therapy
Karl A Illig, Wesley Gabbard, Aurelia Calero, Charles Bailey, Murray Shames, Paul Armstrong, Peter R Nelson
BACKGROUND: A substantial number of patients with threatened arteriovenous (AV) access are found to have stenoses at the costoclavicular junction (CCJ), which frequently are resistant to angioplasty and stenting. We believe that stenoses in this location will not resolve unless bony decompression is performed to relieve the extrinsic compression on the vein. This article describes our short- to medium-term results following such decompression in patients with failing fistulae. METHODS: We reviewed a prospectively maintained database to identify all patients with threatened AV access operated on for stenoses at the CCJ...
2015: Annals of Vascular Surgery
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