Unique Transligamentous Variant of the Recurrent Motor Branch of the Median Nerve.

This case report presents a 72-year-old female with a unique anatomical variation of the median nerve recurrent motor branch that has not been described in the literature. During her open carpal tunnel release, the recurrent motor branch was found to divide from the median nerve within the carpal tunnel, pierce the proximal aspect of the transverse carpal ligament in a transligamentous fashion, and then immediately divide into one branch that pierced the thenar muscles and another branch that traveled superficial to the transverse carpal ligament before piercing the thenar muscles more distal. This variation in anatomy stresses the importance of thoughtful incision design and direct visualization of all structures during carpal tunnel release.

Comparison of median nerve area measurement between MRI and electromyography in patients diagnosed with carpal tunnel syndrome.

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that occurs when the median nerve is compressed within the carpal tunnel. Electromyography (EMG) is accepted as the most frequently used and important diagnostic method for CTS. Recently, magnetic resonance imaging (MRI) has begun to be used in CTS patients to directly visualize the median nerve and examine the changes occurring in the nerve structure. OBJECTIVES: In this study, the area of the median nerve was measured at various levels in the wrist in patients with CTS using MRI, examining its relationship with signal increase, and comparing this to results obtained with EMG. MATERIAL AND METHODS: Overall, 35 patients diagnosed with CTS were included in the study. Patients with normal-mild and moderate-severe EMG tests were included in the study; wrist MRI was taken to investigate the area/mm2 of the median nerve at various levels and whether there was an increase in signal. Thenar muscles included in the imaging were also evaluated. RESULTS: Of the 35 patients included in the study, 24 were women (68.6%) and 11 were men (31.4%). Measurements of the average median nerve area measured in mm2 at the distal radioulnar junction (DRUJ) and the median nerve area measured in mm2 at the hamate bone level were obtained, showing that DRUJ and hamate bone distance measurements were higher in patients with positive EMG. Electromyography findings were also significantly positive in patients with increased signal. CONCLUSIONS: In some cases, the diagnosis of CTS can be easily made with history and physical examination or employing confirmatory tests such as EMG, which is considered the gold standard. Magnetic resonsnace imaging can be used as an alternative method for imaging the median nerve in patients with CTS. In our study, EMG findings were also significantly positive in patients with increased signal on MRI, making it a preferable method, especially in soft tissue-related pathological cases.

The Location of Home Support Services for Older Adults in the Aveiro Region of Portugal.

Home and community-based services are key to an aging society and the aging in place strategies that are preferred by older adults as well as policymakers. But the provision of these kinds of services is often inadequate in territorial terms, raising the question of how to increase their reach and efficiency. This article analyzes the spatial coverage of home support services in the Aveiro Region of Portugal, considering the distribution of their target population and identifying network configurations which would provide these services more efficiently, through a location analysis that minimizes the distance to potential users of these services. This approach showed that, in the Aveiro Region, the spatial coverage of these services is highly uneven and insufficient, considering that the population with difficulties in performing daily tasks exceeds the population benefiting from these services and that the level of coverage differs greatly between territories. It also showed that significant efficiency and equity gains are possible by optimizing the service providers' location at the supra-municipal scale, decreasing the distances to be covered and reducing territorial inequalities.

Median nerve lesions in pediatric displaced supracondylar humerus fracture: A prospective neurological, electrodiagnostic and ultrasound characterization.

BACKGROUND AND PURPOSE: Supracondylar humerus fractures (SCHFs) are the most common elbow fractures in children. Traumatic median nerve injury and isolated lesions of its pure forearm motor branch, anterior interosseus nerve (AIN), have both been independently reported as complications of displaced SCHFs. Our main objectives were to characterize the neurological syndrome to distinguish median nerve from AIN lesions and to determine the prognosis of median nerve lesions after displaced SCHFs. METHODS: Ten children were prospectively followed for an average of 11.6 months. Patients received a standardized clinical examination and high-resolution ultrasound of the median nerve every 1-3 months starting 1-2 months after trauma. Electrodiagnostic studies were performed within the first 4 months and after complete clinical recovery. RESULTS: All children shared a clinical syndrome with predominant but not exclusive affection of AIN innervated muscles. High-resolution ultrasound uniformly excluded persistent nerve entrapment and neurotmesis requiring revision surgery but visualized post-traumatic median nerve neuroma at the fracture site in all patients. Electrodiagnostic studies showed axonal motor and sensory median nerve neuropathy. All children achieved complete functional recovery under conservative management. Motor recovery required up to 11 months and differed between involved muscles. CONCLUSIONS: It was shown that neurological deficits of the median nerve in displaced SCHFs exceeded an isolated AIN lesion. Notably, detailed neurological follow-up examinations and sonographic exclusion of persistent nerve compression were able to guide conservative therapy in affected children. Under these conditions the prognosis of median nerve lesions was excellent despite severe initial deficits, development of neuroma and axonal injury.

Simultaneous bilateral bullectomy and coronary artery bypass grafting through median sternotomy approach.

Lung bullae can severely compromise lung function. Smoking is an important cause of chronic obstructive pulmonary disease, as well as coronary artery disease and peripheral arterial disease. Significant diseases in the cardiovascular and thoracic systems may require multiple interventions apart from medical management. We discuss a patient in which simultaneous bilateral bullectomy and coronary artery bypass grafting were performed through the median sternotomy approach.

High-dimensional multivariate analysis of variance via geometric median and bootstrapping.

The geometric median, which is applicable to high-dimensional data, can be viewed as a generalization of the univariate median used in 1-dimensional data. It can be used as a robust estimator for identifying the location of multi-dimensional data and has a wide range of applications in real-world scenarios. This paper explores the problem of high-dimensional multivariate analysis of variance (MANOVA) using the geometric median. A maximum-type statistic that relies on the differences between the geometric medians among various groups is introduced. The distribution of the new test statistic is derived under the null hypothesis using Gaussian approximations, and its consistency under the alternative hypothesis is established. To approximate the distribution of the new statistic in high dimensions, a wild bootstrap algorithm is proposed and theoretically justified. Through simulation studies conducted across a variety of dimensions, sample sizes, and data-generating models, we demonstrate the finite-sample performance of our geometric median-based MANOVA method. Additionally, we implement the proposed approach to analyze a breast cancer gene expression dataset.

Median Nerve Entrapment by Superficial Brachioulnar Artery: Anatomical Insights and Clinical Perspective.

Entrapment neuropathy of the median nerve is typically caused by compression at specific anatomical points. However, idiopathic cases, where the standard anatomical compression points are normal, pose diagnostic challenges. This report highlights a unique case discovered during an anatomical dissection of the right upper limb in a 62-year-old male cadaver, where the median nerve was compressed by an unusual branch of the brachial artery, termed the superficial brachioulnar artery (SBUA). The median nerve formed at the distal half of the arm, receiving additional components from the lateral cord, with a noted communication with the musculocutaneous nerve. The SBUA, originating from the brachial artery, passed between the roots of the median nerve and continued superficially, forming the superficial palmar arch. The coexistence of neurovascular variations is clinically significant as it may lead to nerve compression and subsequent symptoms. This case is the first documented instance of median nerve compression by an SBUA. Such variations are crucial for surgical and diagnostic procedures, as abnormal vascular structures can be mistaken for veins, leading to iatrogenic injuries. In addition, understanding these variations helps explain idiopathic median nerve neuropathies and highlights the need for thorough anatomical knowledge to prevent complications during surgical interventions.

Wrist Immobilization after Surgical Decompression of the Median Nerve in Carpal Tunnel Syndrome: A Systematic Review.

Objective The most common compressive neuropathy of the upper limbs is carpal tunnel syndrome (CTS). Historically, there has been a tendency to apply immobilization in the postoperative period, a practice that has decreased in recent years. This review aims to assess whether there is scientific evidence to justify the use of immobilization in the postoperative care of CTS decompression. Methods The following databases were used: Biblioteca Virtual em Saúde (BVS), PubMed National Library of Medicine - (NLM), Cochrane Library, Scientific Electronic Library Online (SciELO), and EMBASE. The following inclusion criteria were used: 1) discussion of the postoperative period of median nerve decompression surgery in CTS; 2) comparison of results after surgical decompression in CTS between wrist immobilization or local dressing; 3) all languages, regardless of the year of publication; and 4) all types of publications. The following exclusion criteria were used: 1) studies that did not evaluate the postoperative period of CTS decompression; 2) lack of evaluation of the outcome related to the application of local dressing or some form of wrist immobilization after the surgical decompression procedure; and 3) repeated publications. Results The literature search resulted in 336 relevant publications. In the end, 18 publications were chosen. Systematic reviews, randomized clinical trials, and cross-sectional studies were found. Conclusions Due to the scarcity of evidence supporting the use of immobilization coupled with the higher costs associated with the practice, it has become less and less frequent in recent decades. Clinical relevance In the literature, two approaches to postoperative care for CTS decompression are described: immobilization or just local dressing. According to the available scientific evidence, it is worth evaluating which one is better.

Minimally invasive technique facilitates early extubation after cardiac surgery: a single-center retrospective study.

BACKGROUND: Postoperative time to extubation plays a role in prognosis after heart valve surgery; however, its exact impact has not been clarified. This study compared the postoperative outcomes of minimally invasive surgery and conventional sternotomy, focusing on early extubation and factors influencing prolonged mechanical ventilation. METHODS: Data from 744 patients who underwent heart valve surgery at the Zhejiang Provincial People's Hospital between August 2019 and June 2022 were retrospectively analyzed. The outcomes in patients who underwent conventional median sternotomy (MS) and minimally invasive (MI) video-assisted thoracoscopic surgery were compared using inverse probability of treatment weighting (IPTW) and Kaplan-Meier curves. Clinical data, including surgical data, postoperative cardiac function, postoperative complications, and intensive care monitoring data, were analyzed. RESULTS: After propensity score matching and IPTW, 196 cases of conventional MS were compared with 196 cases of MI video-assisted thoracoscopic surgery. Compared to patients in the conventional MS group, those in the MI video-assisted thoracoscopic surgery group in the matched cohort had a higher early postoperative extubation rate (P < 0.01), reduced incidence of postoperative pleural effusion (P < 0.05), significantly shorter length of stay in the intensive care unit (P < 0.01), shorter overall length of hospital stay (P < 0.01), and lower total cost of hospitalization (P < 0.01). CONCLUSIONS: Successful early tracheal extubation is important for the intensive care management of patients after heart valve surgery. The advantages of MI video-assisted thoracoscopic surgery over conventional MS include significant reductions in the duration of use of mechanical ventilation support, reduced length of intensive care unit stay, reduced total length of hospitalization, and a favorable patient recovery rate.

Biopsy of the anterior interosseous motor branch for the pronator quadratus muscle: a safe and minimally invasive diagnostic tool for peripheral neuropathies. Anatomical surgery and surgical technique.

BACKGROUND AND OBJECTIVES: Choosing the correct site for a nerve biopsy remains a challenge due to nerve sacrifice and major donor site complications, such as neuroma, as seen in sural nerve biopsy. Selecting a deeper donor nerve can help in burying nerve stumps in deep soft tissues, preventing neuroma. Moreover, using an expendable, deeply situated motor nerve can aid indiagnosis when a motor neuropathy is suspected. The authors propose using the pronator quadratus (PQ) branch for this purpose, as it is located deep between the bellies of the flexor muscles and the interosseous membrane in the forearm. This branch is expendable since the denervation of the PQ has a negligible effect on forearm pronation, which is primarily sustained by the pronator teres. METHODS: The surgical approach is the same as the approach for anterior interosseous nerve transfer to the motor component of the ulnar nerve in the distal forearm: access is in the midline in the middle third of the forearm under local anesthesia Blunt dissection is performed, separating and retracting the flexor musculotendinous junction to reach the interosseous membrane where the PQ branch is identified. A careful dissection of the nerve branch is performed, allowing a 2 cm long segment to be cut and removed. The proximal stump is then buried into an adjacent muscle belly and the surgical site is closed. RESULTS: The technique is safe and reproducible in experienced hands. CONCLUSION: This technique may be especially applicable in cases where neurologists need to study motor neuropathies. Contraindications of the technique include wrist instability and high median nerve palsies.

Unusual Motor Hand Neuropathies: Causes, Diagnosis, and Evaluation of Motor Impairments.

Background Isolated hand motor nerve injuries, specifically those affecting the recurrent motor branch of the median nerve and the deep motor branch of the ulnar nerve, are rarely reported in medical literature. Diagnosing and quantifying these injuries pose significant challenges due to their uncommon nature and the variety of mechanisms that can cause them. Methodology This study reviews six unusual cases of isolated damage to the recurrent motor branch of the median nerve and the deep motor branch of the ulnar nerve, including cases with combined injuries. The etiologies include various traumatic and compressive mechanisms, such as a blow from the thenar to the back of a knife blade, long-distance cycling, impact from a broken shovel handle, knife injury, and damage from a screw while using a cordless screwdriver. In one case, the cause was indeterminate. Diagnostic methods involved clinical evaluation, electrophysiological testing (nerve conduction studies and electromyography), and high-resolution ultrasound imaging. A thorough medical history was also crucial in understanding the injury mechanisms. Results The cases demonstrated a range of causes for isolated hand motor nerve injuries, with both traumatic and compressive mechanisms identified. The diagnostic process highlighted the value of integrating clinical assessments, electrophysiological data, and ultrasound imaging to accurately diagnose and understand the extent and nature of the injuries. Conclusions Isolated motor nerve injuries in the hand can arise from diverse and often unexpected causes. Comprehensive clinical evaluation, supported by electrophysiological testing and ultrasound imaging, is essential for accurate diagnosis and management. A detailed medical history is invaluable in identifying the mechanism of injury, which is critical for developing an appropriate treatment plan. The study underscores the importance of a multidisciplinary approach in diagnosing and treating these rare neuropathies.

An Anatomical Variant of Bilateral Persistent Median Artery and Bifid Median Nerve: A Cadaveric Case Report.

An 89-year-old Caucasian male cadaver with prostate cancer demonstrated bilateral persistence of the median artery and bifid median nerve (BMN) during upper limb dissection. The persistent median artery (PMA) originated from the common interosseous artery and coursed alongside the median nerve. Proximal to the carpal tunnel, the median nerve bifurcated into medial and lateral branches. To our knowledge, this is the first documented case of a bilateral PMA and BMN. While the majority of existing literature focuses on a unilateral PMA or unilateral BMN, bilateral occurrences of either variation are rare. This report presents a novel finding by documenting the simultaneous presence of a bilateral PMA and BMN.

Navigating Complexities: A Case of Multiple Abdominopelvic Vascular Compression Syndromes in Ehlers-Danlos Syndrome.

Abdominopelvic vascular compression syndromes (VCS) refer to conditions where blood vessels in the abdomen or pelvis are compressed by nearby structures, leading to various symptoms and complications. These conditions include superior mesenteric artery syndrome (SMAS), nutcracker syndrome (NCS), May-Thurner syndrome (MTS), and median arcuate ligament syndrome (MALS). Each syndrome is characterized by specific compressions of blood vessels, resulting in symptoms such as pain, nausea, vomiting, weight loss, leg swelling, and other related issues. Ehlers-Danlos syndrome (EDS), characterized by hyperelasticity, altered collagen, and mobility of the viscera, has been associated with VCS, although the exact prevalence is unknown. We report a case of a patient with EDS who presented with multiple VCS, including NCS, MTS, SMAS, and MALS.

Carotid Artery Wall Echogenicity Measured by Gray Scale Median of the Intima-Media Complex From Childhood to Young Adulthood.

BACKGROUND: Echogenicity of the carotid arterial wall, measured by gray scale median of the intima-media complex (IM-GSM), is a novel subclinical atherosclerosis marker with lower values indicating greater lipid deposition. Our longitudinal study investigated IM-GSM from childhood to adulthood and its associated risk factors. METHODS AND RESULTS: A total of 240 participants from the Southern California CHS (Children's Health Study) underwent carotid artery ultrasounds in 2008 (mean age±SD): (11.2±0.6 years), and again around 2022 (24.2±1.6 years) to assess IM-GSM, carotid artery intima-media thickness, and carotid artery distensibility. Questionnaires and anthropometric and blood pressure measurements were completed by participants at both times. Mean and SD of IM-GSM were 108.2±24.6 in childhood and 75.6±15.8 in adulthood. Each 1-year increase in age was associated with -2.52 change in IM-GSM (95% CI, -2.76 to -2.27). Childhood and adulthood IM-GSMs were highly correlated (ß=0.13 [95% CI, 0.05-0.22]). In childhood, Hispanic ethnicity, lower parental education levels and prenatal father smoking were significantly associated with lower IM-GSM. In adulthood, higher systolic blood pressure, carotid artery intima-media thickness, hypertension, and lower distensibility were significantly associated with lower IM-GSM. Weight status exhibited a consistent association with both childhood and adulthood IM-GSM. During the transition from childhood to adulthood, individuals who shifted from normal weight to overweight/obese or normal blood pressure to hypertension or experienced an increase in carotid artery intima-media thickness displayed lower levels of IM-GSM in adulthood. CONCLUSIONS: IM-GSM decreases with age. Maintaining healthy weight and blood pressure levels in children could potentially aid in preventing subclinical atherosclerosis.

[Trends in the choice of internal medicine (and clinical immunology) at the end of the national ranking examination since 2010]. / Évolution du choix de la médecine interne (et immunologie clinique) à l'issue des épreuves classantes nationales depuis 2010.

INTRODUCTION: The 2017 reform of the third cycle of medical studies (R3C) was accompanied by modifications in the formats and number of specialty diplomas. The aim of this study was to investigate the evolution of the choice of the internal medicine and clinical immunology specialty before and after 2017. METHODS: We used the median ranking and its evolution, as well as incoming and outgoing remorse rights, as markers of attractiveness. Data on the number of position offered, rankings and affectation were collected from decrees published in the French "Journal Officiel" each year. A survey conducted by the "Amicale des Jeunes Internistes" investigated the reasons for the outgoing or incoming rights to remorse. RESULTS: Before 2017, internal medicine was accessible to 52% of students on average, with a median rank of 1118 [339-2640]. From 2017 onwards, the internal medicine specialty was accessible to an average of 76.6% of students, with a median rank of 2772 [1039-5155]. The balance of incoming and outgoing remorse rights was -4.7% before 2017 and varied between -4.1 and -12.4% from 2017. CONCLUSION: Since 2017, the median and cut-off ranks of students choosing internal medicine specialty have increased, and balance of incoming and outgoing remorse rights was increasingly negative. A reflection on the attractiveness of the internal medicine specialty is undertaken by the National College of Internal Medicine Teachers in order to make the richness of the specialty and its different modes of practice known to future residents.

Association of Anthropometry With Nerve Conduction Parameters of Median Nerve: A Cross-Sectional Study in a North Indian Medical University Hospital.

Background Nerve conduction studies ease the understanding of the various pathologies of the peripheral nervous system. It helps physicians to delineate between the two principal types of peripheral etiologies: axonal degeneration and demyelination. An increase in weight in the form of excessive fat deposition or obesity could have a worrisome effect on nerve conduction. So, to find the association of various anthropometric parameters (age, gender, height, weight, waist-hip ratio and body mass index) with motor and sensory median nerve conduction parameters (latency, amplitude and velocity) this cross-sectional study was conducted. Materials and method A total of 87 subjects were taken and their height, weight, waist-hip ratio and body mass index were measured using standard techniques. Motor and sensory nerve conduction parameters were measured on an electromyography machine. Data was stored, tabulated and analyzed. Results The average height of male and female subjects ± SD was 1.699 ± 0.072 m and 1.589 ± 0.067 m respectively. The average weight of male and female subjects ± SD was 64.089 ± 11.497 kg and 52.949 ± 8.404 kg, respectively. The average BMI of normal, underweight and overweight subjects ± SD was 21.668 ± 2.048 kg/m2, 17.074 ± 0.794 kg/m2 and 26.595 ± 0.915 kg/m2 respectively. Weight showed a significant (p = 0.0025) correlation with the latency of motor median nerve conduction. Waist-hip ratio showed a significant (p = 0.042 and p = 0.036) correlation with motor median nerve conduction velocity in both male and female subjects, respectively. BMI in the overweight category showed a significant (p = 0.0156 and p = 0.0290) correlation with latency and amplitude of motor median nerve conduction study, respectively. Conclusions This study exemplifies that an increase in BMI of our body can affect nerve conduction. This could serve as a preliminary study to assess the effect of obesity on peripheral nerve conduction, especially in the Indian population.

Refractory Duodenal Ulcer in a Patient With Median Arcuate Ligament Compression: A Treatment Challenge.

Flexible esophagogastroduodenoscopy is the gold standard for the management of acute upper gastrointestinal bleeding. This is a case of a man who was admitted in the emergency department because of melena with hypotension because of an ulcer in the anterior face of the duodenal bulb, refractory to 3 attempts of endoscopic therapy. Then, a gastroduodenal arterial embolization was tried, being impossible because of the presence of the median arcuate ligament, compressing the celiac trunk. A balloon-expandable stent was inserted in the celiac trunk, and then, the embolization was performed. After unsuccessful endoscopic management, the arterial embolization is one of the treatment options in nonvariceal acute upper gastrointestinal bleeding.

Successful use of ultrasound guided pecto-intercostal fascial plane block to provide intraoperative analgesia in four dogs undergoing median sternotomy.

OBJECTIVE: To evaluate the impact of pecto-intercostal fascial plane block on providing intraoperative analgesia in dogs undergoing median sternotomy. ANIMALS: 4 dogs. CLINICAL PRESENTATION: The dogs were presented with a history of inappetence, lethargy and respiratory distress. Thoracic radiographs, point of care ultrasound, thoracocentesis, bronchoscopy and computed tomography was performed to characterize the disease. RESULTS: 4 male castrated, 5.3 ± 3 years old dogs weighing 19.7 ± 13.5 kg and belonging to Dalmatian, Beagle, Siberian Husky and Rottweiler breeds were included. Three dogs were diagnosed with suppurative pleural effusions because of pulmonary abscesses and one dog with spontaneous pneumothorax due to the presence of pulmonary bullae. All dogs underwent median sternotomy under general anesthesia to explore the thorax. A pecto-intercostal fascial plane block was performed by injecting local anesthetic bupivacaine in the parasternal fascial plane between the deep pectoral and external intercostal muscles to provide antinociception by anesthetizing ventral cutaneous branches of intercostal nerves second through sixth. Analgesia from the block resulted in reduced requirement of inhalant anesthesia and minimal requirement for opioid to augment analgesia intraoperatively. CLINICAL RELEVANCE: Median sternotomy is required to perform thoracic surgery in dogs with various thoracic pathologies. Pecto-intercostal fascial plane block is a locoregional technique that can blunt nociception arising from the ventral thorax and can significantly improve perioperative patient care in dogs undergoing median sternotomy by providing effective intraoperative and potentially postoperative analgesia.

[Preliminary comparative study of spinal robot-assisted pedicle screw placement using different surgical approaches].

Objective: To compare the effectiveness of spinal robot-assisted pedicle screw placement through different surgical approaches and to guide the clinical selection of appropriate robot-assisted surgical approaches. Methods: The clinical data of 14 patients with thoracolumbar vertebral diseases who met the selection criteria between January 2023 and August 2023 were retrospectively analyzed, and all of them underwent pedicle screw placement under assistant of the Mazor X spinal surgery robot through different surgical approaches. The patients were divided into posterior median approach (PMA) group ( n=6) and intermuscular approach (IMA) group ( n=8) according to the surgical approaches, and there was no significant difference in age, gender, body mass index, disease type, and fixed segment between the two groups ( P>0.05). The operation time, intraoperative blood loss, screw-related complications, and reoperation rate were recorded and compared between the two groups; the inclination angle of the screw, the distance between the screw and the midline, and the caudal inclination angle of the screw were measured based on X-ray films at immediate after operation. Results: There was no significant difference in operation time and intraoperative blood loss between the two groups ( P>0.05). There was no screw-related complication such as nerve injury in both groups, and no patients underwent secondary surgery. At immediate after operation, the inclination angle of the screw, the distance between the screw and the midline, and the caudal inclination angle of the screw in the IMA group were significantly greater than those in the PMA group ( P<0.05). Conclusion: There are differences in the position and inclination angle of screws placed with robot-assisted surgery through different surgical approaches, which may be due to the obstruction of the screw path by soft tissues such as skin and muscles. When using spinal robot-assisted surgery, selecting the appropriate surgical approach for different diseases can make the treatment more reasonable and effective.

Parasternal thoracotomy via sternocostal disarticulation: a novel surgical approach to the canine thorax.

OBJECTIVE: To describe the technique and outcomes of a modified paramedian thoracic approach in dogs involving a parasternal thoracotomy via rib disarticulation at the sternocostal joint. ANIMALS: 93 client-owned dogs. METHODS: Medical records of dogs that underwent parasternal thoracotomy at a private practice between the years 2015 and 2021 were reviewed. Signalment, weight, clinical presentation, surgical details, complications, and short-term outcomes were recorded. Cox proportional hazards regression models were utilized to analyze the impact of covariates on hazard events. Kaplan-Meier curves were employed to evaluate survival functions for select variables. RESULTS: Parasternal thoracotomy via sternocostal disarticulation was performed in 93 dogs. Eighty-eight dogs (94.6%) survived the procedure. Eighty-three dogs (89.2%) survived to discharge from the hospital. Age, weight, postoperative time to eating, postoperative ambulation, and surgical or anesthetic duration were not significantly associated with survival to discharge. Thoracostomy tube duration significantly decreased the likelihood for survival to discharge; for each additional hour of thoracostomy tube placement, the odds of survival to discharge diminished by 5.7% (hazard ratio, 0.94; 95% CI, 0.912 to 0.976). CLINICAL RELEVANCE: Parasternal thoracotomy via rib disarticulation at the sternocostal joints may be a viable alternative to median sternotomy that does not require specialized equipment for bilateral hemithoracic visualization. Postoperative complications and short-term outcomes are comparable to those reported for the traditional median sternotomy approach. Prolonged thoracostomy tube duration may impact survival to discharge.