ABSTRACT
Methods@#A cross-sectional measurement study of 293 whole-body dried-bone samples was conducted. We measured the anteroposterior (AP) and transverse diameter of the fourth to sixth cervical vertebrae (C4–C6) and third to fifth lumbar vertebrae (L3–L5). Stenosis of the cervical spine and lumbar spine was defined as an AP diameter of <12 mm and <13 mm, respectively. We also measured the skull circumference, the AP and transverse diameters of the foramen magnum, the inner and outer inter distances between the left and right orbital bones, the humerus length, and the femoral length. Kruskal-Wallis and post hoc analyses were used in the statistical analyses. @*Results@#The age was 22–93 years. DCSS was found in 59 (20.1%) and DLSS in 28 (9.6%). Twelve samples had both DCSS and DLSS (development spinal stenosis, DSS). When compared to the “no spinal stenosis sample,” DSS (−), DCSS and DSS had a significantly smaller skull circumference, the transverse diameter of the foramen magnum, and inner and outer distance between the orbital bone (p<0.05). There was no significant difference in humeral length, femoral length, or AP diameter of the foramen magnum. @*Conclusions@#DCSS was correlated with a small skull, a small transverse diameter of the foramen magnum, and a small orbital bone. A small skull was strongly associated with a small cervical canal. DLSS, on the other hand, was unrelated to either a small cervical canal or a small skull.
ABSTRACT
Background : Making a hole at the piriformis fossa of the femur is one of the important steps in closed intramedullary femoral nailing . This hole is provided for passage of the devices through it. We design a device that is used as a hole making and the sleeve for changing the instruments. This device facikitates and reduces the time for this procedure.Objective : To present the use of a new device for facilitating and reducing the operative time in closed intramedullary femoral nailing procedure.Study design : Experimental studySetting : Orthopedics department, Faculty of Medicine, Khon Kaen UniversityDevice : “Sleeve awl” was innovated from a 14 –mm. diameter Kuntscher nail which was cut at one end and shaping as a bevel. “Sleeve awl” was used instead of the conventional awl in the closed intramedullary femoral nailing procedure. After pointing the bevel of the “Sleeve awl” into the piriformis then it was driven into the medullary canal of the proximal femur. Leaving the sleeve awl at this position as a channel for passage of the T-hand reamer and reamer guide rod.Result : The closed intramedullary femoral nailing was performed in 20 cases. All of them were divided equally into 2 groups. The conventional awl was used in the first group and the sleeve awl was used in the second group. The first group consisted of 8 men and 2 woman, the means age were 30.2 years (10-73years). The femur was on the left in 3 cases and on the right 7 cases. The second group consisted of 7 men and 3 woman, the means age were 30.5 years (15-52 years). The femur was on the left in 4 cases and on the right 6 cases. The average times from insertion of the awl into the medullary canal of the proximal femur to the insertion of the guide rod in the first group was 7.13 ± 2.22 minutes (5.20 – 13.20 minutes), and in the second group was 2.25 ± 0.58 minutes (1.30-5.00 minutes) (t-test, p = 0.00001) mean difference = 4.76;95% confidence interval = 3.03,6.48Conclusion : The “Sleeve awl” is a useful device for facilitation in closed intramedullary femoral nailing procedure. The use of this device will reduce the time for seeking the hole at the piriformis fossa at each time for changing the instrument through this site as in the conventional method.Key words : awl, fracture of femur