[Anatomic bases of the surgical approach to the carpal tunnel. A propos of 50 dissections]. / Bases anatomiques de la voie d'abord chirurgicale du canal carpien. A propos de 50 dissections.

After a classic dissection of 50 wrists in black african cadavers, we have studied carpal tunnel anatomy for therapeutic deductions. By a wide anterior incision following the longitudinal axis of the third finger remounting the inferior third of the forearm we studied both the anatomical limits specially the transcarpal ligament, the volare carpal ligament and also median nerve and flexores digitorum tendons. We have observed in 2 cases an ectopic second lumbrical muscle inside the carpal tunnel; we found numerous variations of the collateral and terminal branches of median nerve; we concluded that it is difficult to definitively establish the cartography of the terminal branches of median nerve. However our anatomical observations allowed us to choose larger and more medial surgical approach of the carpal tunnel to avoid the following complications: incomplete section of the carpal ligament, damages of collateral branches of median nerve, dislocation of flexor tendons of index and middle fingers, ignorance of anomalous muscle.

Comprehensive newborn screening program: ARAMCO experience, the national need and recommendations.

Comprehensive screening programs for congenital diseases of newborn infants are lacking at a national or regional level. A comprehensive newborn screening program modified to the needs and resources available was established in ARAMCO Dhahran Health Center. This program includes screening for congenital hypothyroidism, phenylketonuria, abnormal hemoglobins, glucose-6-phosphate dehydrogenase deficienc, and blood group incompatibilities. Several problems were encountered during the operation which required several modifications of the program. The organization and procedures of the program are described. Since the program was started in 1980, more than 70,000 newborn infants have been screened. Valuable epidemiological data have been collected and necessary information for direct clinical use was obtained. A national program to screen all neonates in the Kingdom of Saudi Arabia is achievable and urgently needed. Recommendations based on ARAMCO experience are given.