The relationship of the axillary nerve and the acromion.

The relationship of the axillary nerve in 77 cadavers was studied. The distance of the axillary nerve from the angle of the acromion is between 43 to 82 mm (mean = 63 mm). The distance from the axillary nerve to the tip of the acromion varies from 47 to 89 mm (mean = 67 mm). The distance in the female is less than that in the male. The length of the acromion and of the arm are not correlated with the distance between the axillary nerve and the acromion. In addition, the course of the axillary nerve is not constantly parallel to the lateral border of the acromion. Therefore, the acromion is not a good surgical landmark for locating the axillary nerve.

A biomechanic study of the surgical repair technique of pars defect in spondylolysis.

To find out which wiring technique of direct repair of the pars defect is the strongest in resisting anteroposterior translation displacement, fifteen fresh human cadaveric L4-L5 spines were biomechanically tested by a universal testing machine. Two millimeters wide pars defect was created on both sides of L4 vertebrae. Each of the five specimens was wired using Nicol's technique (A), modified Nicol's technique (B) and modified pedicular screw technique respectively (C). At each test, motion was observed to occur initially at the pars defect. The mean minimum tensile strength (increment of the pars defect) for technique A, B and C was 87.64, 82.04 and 110.08 Kg Force respectively. By statistical analysis, technique C was the strongest in resisting anteroposterior displacement of the spinal column. There was no statistically significant difference between technique A and B.

Comparison of ketoprofen and morphine for post-operative analgesia in orthopaedic patients.

A prospective, open label, randomized study to compare efficacy of intramuscular administration of ketoprofen and morphine for post operative analgesia in elective orthopaedic surgery was performed in 50 patients. The procedures were open reduction and internal fixation of long bone fractures (26 cases), hip replacement (9 cases) and spinal surgery (15 cases). Pain intensity and pain relief in both groups were evaluated at 1, 3 and 6 hours post-injection. There was no significant differences in pain relief of both groups (P = 0.05). The side effects of intramuscular ketoprofen were encountered in only 8 per cent. Ketoprofen injection is an alternative for post operative pain relief.

Repair of nonunion lateral humeral condyle: a case report.

Epiphyseal injury of the lateral condyle of distal humerus is found commonly in children. Complications following such an injury can result in nonunion with late development of angular deformity and ulnar nerve neuritis. Nonunion at this area is extremely troublesome and difficult to treat. Controversy exists as whether late open reduction and fixation can restore the anatomy of the elbow joint and improve the function. We describe a technique of corrective osteotomy to correct the cubitus valgus deformity and repair the nonunion. The patient was treated successfully with 4 years follow-up.

The size of the vertebral canal and the significance of epidural fat in lumbar spinal stenosis.

Measurements of mid sagittal diameter (MSD) and interpedicular diameter (IPD) in patients operated on for central lumbar spinal stenosis were compared to the control group. Both groups can be matched in terms of gender and age. We found that in the stenotic patients the MSD and the IPD were smaller than in the control group, all of the measurements except the IPD in male stenotic patients was statistically different. Sagittal and axial MR images of the stenotic patients were used to evaluate the status of the posterior epidural fat which was graded as normal, small, very small and absent. All the patients were surgically treated for lumbar stenosis, imaging studies and intraoperative finding were correlated. Reduction or absence of the posterior epidural fat (PEF) by the imaging studies were found to be related to the intraoperative findings and the duration of symptoms. PEF may be used as an intraoperative indicator for optimal surgical decompression.