Carpal tunnel decompression is one of the most common surgical procedures in hand surgery. Cutaneous innervation of the palm by median and ulnar nerves was evaluated to find a suitable incision preserving cutaneous nerves. A morphometric study was designed to define the safe-zone for mini-open carpal tunnel release. Sixteen fresh-frozen (8 right, 8 left) and 14 formalin-fixed (8 right, 6 left) cadaveric hands were dissected. Anatomy of the palmar cutaneous branch of the median and the ulnar nerve, motor branch of the median nerve, superficial palmar arch were evaluated relative to the surgical incision. We also identified the motor branch of the median nerve. Detailed measurements of the whole palmar region are reported in this study. The motor branch of the median nerve was extraligamentous as 60%, subligamentous as 34%, transligamentous as 6%. The palmar cutaneous branches of the median and the ulnar nerves in the palmar region were classified as Type A (34%), Type B (13%), Type C (13%), Type D (none), Type E (40%) according to forms of palmar cutaneous innervation originating from the ulnar and median nerves. Injury to the palmar cutaneous branch of the median nerve (PCBMN) is the most common complication of the carpal tunnel surgery. Various techniques were described to decrease post-operative morbidity. Based on these anatomic findings mini incision between the superficial palmar arch and the most distal part of the PCBMN in the palmar region is the safe-zone for carpal tunnel surgery.
Dysplasia epiphysealis hemimelica is a rare non-hereditary epiphyseal disease that mimics synovial chondromatosis of the joints. The disease mainly targets long bones of the lower extremities and tarsal bones. We report one such case manifesting in the lateral tibia of a 13-year-old boy. He presented with a 7-month history of pain and a bony mass (3x4 cm) at the right ankle. The mass restricted ankle dorsiflexion over the lateral malleolar area. It was ossific with a lobulated appearance and reached the marrow with the underlying epiphysis and adjacent bones. The mass was excised completely from the epiphysis. The detached syndesmos was sutured anatomically.
Objective: Osteoarthritis (OA) is the most common joint disease. In this study it was aimed to compare the general features of OA such as location, placement, severity and shape of the lesions in terms of radiological and morphological aspects and to determine their relationship with each other. Methods: In our study, the antero-posterior and lateral radiographies of knee talocrural and transverse tarsal joints of 20 cadavers by age between 30 and 50 years were taken. The results obtained from the radiological examination were graded according to the Kellgren and Lawrence scale. For each of the identified regions, the presence of degenerative changes was noted. Then samples were taken from these regions were examined by microscopic methods. The cartilage degeneration changes, presence of fibrillations, density, depth, chondrocyte aggregation, and necrotic changes were evaluated. Results: In the radiological examination OA was found in 35% in knee joint, 25% in the talocrural joint, 15% in the transverse tarsal joint. In the morphological examination OA was found in 31.5% knee joint, 25% ankle joint and 5% transverse tarsal joint. In the microscopic examination OA was found in 94.7% knee joint, in 94.7% ankle joint and in 100% transverse tarsal joint. Conclusion: Although radiological and macroscopic OA was detected in approximately 1/3 of cadavers aged between 30 and 50 years, degeneration of varying degrees was detected in all joints examined in microscopic examination. This shows that an advanced age disease OA, starts at a very early age. Key words: Osteoarthritis, Knee joint, Talocrural joint, Transverse tarsal joint
Objectives: Femoroacetabular impingement syndrome is a painful disorder of the hip formed by movements in the hip joint between the femoral head-neck junction and the acetabular edge. The aim of this study was to determine the prevalence of radiological femoroacetabular impingement syndrome findings in a young, asymptomatic Turkish population. Methods: A total of 1000 abdominal pelvic CT images were collected from patients aged between 18–40 years. Measurements were taken on the CT images of the alpha angle and femoral head offset as signs of cam-type deformity, and of the acetabular version angle and center-edge angle as signs of pincer-type deformity. Results: Femoroacetabular impingement syndrome was determined in 2.3% of the individuals. Pincer type deformity was determined in 56.5%, being 83.3% in females and 47.1% in males. The cam-type deformity was present in 43.5% of all cases, being in 16.7% of the females and in 52.9% of the males. No difference was determined between the genders in respect of alpha angle which is >55°. A head-neck offset which is <8 mm was at a higher rate in females (13.3%) than males. An acetabular anteversion angle which is <15° and centre-edge angle which is >40° was more in males than females at a rate of 11% and 25.2% respectively. Conclusion: The results of this study showed that the incidence of cam-type deformity in the adult males and the incidence of pincer-type deformity in the adult females were lower in the asymptomatic Turkish population than previously reported in literature.
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