Anatomical relations of anterior and posterior ankle arthroscopy portals: a cadaveric study.

BACKGROUND: Ankle arthroscopy is an increasingly used technique. Knowledge of the anatomical structures in relation to its portals is paramount to avoid complications. METHODS: Twenty cadaveric ankles were analysed to assess the distance between relevant neurovascular structures to the anteromedial, anterolateral, posteromedial, and posterolateral arthroscopy portals. RESULTS: The intermediate dorsal branch of the superficial peroneal nerve was the closest structure to any of the portals (4.8 mm from the anterolateral portal), followed by the posterior tibial nerve (7.3 mm from the posteromedial portal). All structures analysed but one (posterior tibial artery) were, at least in one specimen, <5 mm distant from one of the portals. DISCUSSION: This study provides information on the anatomical relations of ankle arthroscopy portals and relevant neurovascular structures, confirming previous studies identifying the superficial peroneal nerve as the structure at highest risk of injury, but also highlighting some important variations. Techniques to minimise the injury to these structures are discussed.

Approach to the diagnosis of unusual carpal ankylosis from ancient Egypt.

OBJECTIVES: Carpal fusion is not an uncommon finding in archaeological bones. The majority of cases are due to inflammatory or infectious diseases and those are usually associated with other major alterations in the skeleton. METHODS: Two distinct individual cases, both adult females recovered from the Necropolis of Sharuna in the Middle Egypt from the Ptolemaic Period (IV to I BC) are presented in this study. Specimen 4323/1 shows a fusion of the scaphoid, lunate and triquetral bones in the right wrist. Specimen 4323/2 is a very rare fusion of a dysplastic lunate bone with the radius in the left wrist. In the proximal end of that left wrist, two possible remains of the flattened scaphoid and triquetral bones are also present. RESULTS: A differential diagnosis of both abnormalities as well as broad research into similar paleopathological cases were carried out: the most probable diagnosis for the specimen 4323/1 is an uncommon carpal coalition of three bones from the same row; the diagnosis of the specimen 4323/2 is more dubious with both rheumatoid arthritis and septic arthritis being strong candidates. CONCLUSIONS: In archaeological remains, carpal fusion should be thoroughly studied in order to ensure an accurate differential diagnosis.

Peripheral venous embolized intracardiac foreign body.

Embolized intracardiac foreign bodies have been previously described in the literature. Those related to iatrogenic procedures, such as catheters and pacemaker electrodes, are the most common. However, traumatic embolization of a metal foreign body is scantily described. We report a case of a peripheral venous embolized intracardiac metal foreign body after traumatic elbow injury. A review of the literature is therefore performed. Intracardiac foreign body removal must be considered when its diameter exceeds 5 mm, its shape is irregular or when symptomatic.