The traditional Kocher approach for lateral elbow exposure is often complicated by injury to the posterior interosseous nerve (PIN) and the lateral ulnar collateral ligamentous (LUCL). Kaplan approach is less commonly used, due to its known proximity to the PIN. Extensor Digitorum Communis (EDC) splitting approach allows possible wide surgical exposure and low risk of LUCL damage. The comparison of PIN injury during surgical dissection among these 3 common lateral approaches was not previously evaluated. We aim to determine the anatomical proximity of the PIN in these 3 common lateral elbow approaches and to define a safe zone of dissection for the surgical exposure. Cadaveric dissections of 9 pairs of fresh frozen adult upper extremities were performed using EDC splitting, Kaplan and Kocher approach to the radial head sequentially in a randomised order. The radial head and PIN were exposed. A mark was made on the radial head upon the initial exposure during dissection. Measurements from the marked point of the radial head to the PIN were made. Study has been approved by the ethics committee.Background
Methods
Tandem stenosis is a prevalent condition in an Asian population with the narrowest cervical canal diameters and risk factors include advanced age and increased levels of lumbar canal stenosis. Tandem spinal stenosis (TSS) is defined as patient with concomitant spinal canal stenosis found in both cervical (C) and lumbar (L) spinal region. Few studies have reported the incidence of TSS is ranged from 5–25%, but these are all noncomparative, small cohort studies. To the best of author knowledge this is the 1st study aims to compare the prevalence of TSS and its risk factors of development in a large multiracial Asian population.Summary Statement
Introduction
To evaluate management, direct-medical-costs and clinical outcome profile of a large trauma unit with respect to simple elbow dislocations. All simple elbow dislocations that were defined as not requiring acute surgical intervention, post-reduction, were considered between Jan-2008 and Dec-2010. Inclusion criteria consisted of age greater than 13; absence of major associated fractures, successful closed reduction, and follow-up as an outpatient. The management of these patients was classified in terms of immobilisation time into: short (< 2weeks), standard (2–3weeks) and prolonged (>3weeks). Direct-medical-costs were calculated based on current tariff rates associated with radiology, admission, theatre time (for reductions and recovery) and outpatient attendances. Clinical outcome was evaluated with respect to complications, secondary procedures, and time before discharge from clinic.Objectives
Methods
