Ultrasonographic visualisation of anatomical variation of the medial cutaneous nerve of forearm and its depiction by the novel use of a custom computer program to generate 2D diagrams

Cutaneous nerves display significant anatomical variation, and are therefore vulnerable to iatrogenic injury during various surgical procedures. High-resolution ultrasonography (USG) was used in this study to investigate this variation, and map the course of the medial cutaneous nerve of the forearm (MCNF). We also aimed to develop a method to virtually represent this variation, which could be used to plan procedures involving the MCNF

Technique Review - A Simple Distal Interlocking Aid for Intramedullary Nails

A Steinmann pin is pushed through the spout of a 50 ml bladder syringe as shown (Figure 1). With the plunger withdrawn the syringe can be used as a radiolucent handle to hold the Steinmann pin against the bone through a nick in the skin. The image intensifier is centered on the screw hole so that it appears as a perfect circle. Initially the tip of the Steinmann pin is placed with some angulation in the centre of the hole. With a few seconds of continuous screening it is possible to angulate the pin to the correct trajectory for the nail hole so that it appears as a dot within the nail hole (Figure 2). This confirms that the entry point and orientation of the pin are correct. With some hammering the position of the pin is secured and this acts as a punch to guide the drill

Technique Review - A Simple Distal Interlocking Aid for Intramedullary Nails

A Steinmann pin is pushed through the spout of a 50 ml bladder syringe as shown (Figure 1). With the plunger withdrawn the syringe can be used as a radiolucent handle to hold the Steinmann pin against the bone through a nick in the skin. The image intensifier is centered on the screw hole so that it appears as a perfect circle. Initially the tip of the Steinmann pin is placed with some angulation in the centre of the hole. With a few seconds of continuous screening it is possible to angulate the pin to the correct trajectory for the nail hole so that it appears as a dot within the nail hole (Figure 2). This confirms that the entry point and orientation of the pin are correct. With some hammering the position of the pin is secured and this acts as a punch to guide the drill

The influence of postoperative coronal alignment on revision surgery in total knee arthroplasty

This study examines the association between postoperative coronal tibiofemoral alignment and revision surgery in knee arthroplasty. We retrospectively reviewed the case notes and post-operative long-leg radiographs of 197 Kinemax knee arthroplasty with mean follow-up of 9 years (SD 2.2). They were divided into three groups: neutral, valgus and varus. Revision or decision to revise was used as a hard endpoint. There was no statistical difference among the three groups (p=0.78). We conclude that aseptic failure of a total knee is multifactorial. Coronal tibio-femoral alignment may not be as important a cause of failure as has been previously thought