During the medical student’s training in the Anatomy we have studied the arterial constitutions of the superior limb in 100 bodies from the Laboratory of the Descriptive Anatomy of the Medical School, University of Athens. We have examined the brachial artery and the superficial brachial artery. Superficial brachial artery is called the major artery that is found superficially of the middle nerve. Such an artery can either substitute or complete the brachial artery. For reasons of classification we took into account the arteries only and neglected the smaller branches. The superficial brachial artery often origins from the proximal part of the forearm and the clinical interest of this remark consists on the fact that this artery leads to the forearm, in front of the biceps brachial muscle’s aponeurosis. By this way it can easily be mistaken as a vein and an “intravenous” injection can be disastrous. Our results were: A. Only one brachial artery: 76% The classic case of the books of Anatomy: the brachial artery is found opposite of the middle nerve, crossing under it at the upper arm: 74% The middle nerve’s constitution is not the typical one at the armpit, but the artery crosses under it: 2% B. Presence of one brachial artery only: 10% One brachial artery in front of the two radixes of the middle nerve: 2% The major artery is found opposite of the radixes of the middle nerve, but crosses in front of it at the arm:4% The dorsal artery is found behind the middle nerve from the dorsal part but comes over the nerve between the musculocutaneous and the middle nerve: 2% There is not the typical constitution of the middle nerve from two radixes and the artery is found in front of the middle nerve:2% C. Two major arterial branches: 14% The axillary artery is divided in two branches one in frond of and the other behind of the radixes of the middle nerve: 5% The brachial artery is divided in two branches one of which is found in frond of the middle nerve: 9%
During the medical student’s training in the Anatomy we have studied the arterial constitutions of the forearm in 100 bodies from the Laboratory of the Descriptive Anatomy of the Medical School, University of Athens. On our efforts to classify the complexity of the forearm concerning its blood supply we accepted that we might have some basic groups that can be explained by the embryology. Our results were: A. “Regular” hematosis of the forearm (with the presence of the radial, the ulnar and the interosseous artery): 81% All the forearm’s arteries ramify from the brachial artery: 68% All the forearm’s arteries ramify from the superficial brachial artery: 7% The radial artery origins from the superficial brachial artery, the ulnar and the interosseous arteries from the brachial artery: 4% As in 3 with a wide osculation between the brachial and the radial artery in the elbow: 2% B. Forearm’s superficial arteries: 10% The superficialulnar artery substitutes the ulnar artery: 4% Superficial middle artery: 2% Superficial radial artery in addition to the normal radical artery: 2% The forearm’s superficial artery is short and ends at the forearm’s proximal part: 2% C. Presence of the middle artery (embryo remnant): 9% The middle artery origins from the ulnar artery with the interosseous artery: 3% The middle artery origins from the ulnar artery far from the common interosseous artery: 2% The middle artery origins from the common interosseous artery: 2% The middle artery origins from the radical artery: 2%
In many cases, treatment of intercondylar T- or Y- fractures of numerous is complex, technically difficult and consideration to many factors is needed. The purpose of this study was to review the results of treatment in 20 isolated fractures in 20 patients that were operated between 1991 and 2001. All patients were operated as soon as possible after the laboratory studies were completed. In no case there was a delay beyond the 5th fracture day. The mean age of the patients was 48.4 years and men to women ratio was 6/1. The fractures were closed, type III according to Riseborough and Radin classification. In 8 cases the fracture was fixed with one 3.5 compression plate with lag screws. In 12 cases two 3.5 compression plates oriented in two planes at 90° angles to each other were needed for fixation. The posterior approach included chevron osteotomy of the olecranon and exposure of the ulnar nerve. Minimum follow up period was 9 months. The time needed for the sound union of the fracture, range of motion and elbow axis were some of the factors that were examined. Five of the eight fractures that were fixed with one plate achieved union in the expected period of time. In two cases delayed union and malalignment was noticed without the need for surgical intervention. In one case grafts were needed to help the union of the osteotomy site. We had one case of myossitis ossificans. All fractures that were fixed with two plates achieved union without any complications. In one case there was a 30° extension lag of the elbow. The rest of the patients, in both groups had a satisfactory range of motion with an extension lag less than 10°.
