By Francesco Ruggieri M.D., Gian Franco Zinghi M.D., Stefano Boriani M.D., Luigi Specchia M.D. (auth.)
Our choice to devote numerous years to the writing of this Atlas used to be in line with the pro acknowledgement of destructive surgical effects as a result of flawed or incomplete techniques to the bones or joints requiring therapy. we're confident that during order to acquire the absolute best anatomic and practical leads to surgical procedure of the locomotor gear, it will be important to obey a number of ideas of behaviour con stituting the foundation for proper surgical execution: a) to recognize the anatomy of the muscular and neural formations; b) to guard the vascularization of those anatomical parts and as a result of the osteoarticular equipment; c) to take advantage of the main acceptable surgical techniques totally respecting the neighborhood anatomy and the least tense publicity of the skeleton; d) to properly practice surgical procedure, hence growing the simplest stipulations for the excel lent restoration of the functionality of the limb. The anatomic findings and surgical ways to the extremities defined listed here are now not entire: now we have dependent our collection of the previous on their frequency within the general surgical job of any specialized ward, and the latter at the surgi cal methods most typically utilized by the third department of the Rizzoli Orthopaedic Institute. vast surgical techniques for the surgical operation of bone tumors were excluded as they take care of particular «compartmental» equipment which don't contain the anatomic principles to be within the basic remedy of orthopaedic and trau matologic affections of the extremities.
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Extra info for Anatomical Exposures and Surgical Approaches to the Limbs Anatomische Darstellungen und Zugangswege in der Chirurgie der Extremitäten
Metakarpalknochens. 1m Bereich des Retinaculum extensorum konnen die Sehnen des M. extensor pollicis longus l und des M. extensor pollicis brevis 2 erkannt werden. - Das Retinaculum wird parallel zum Hautschnitt und genau in der Mitte zwischen den beiden Daumenstreckersehnen durchtrennt. Die A. radialis3* verliiujt quer durch das Operationsjeld , kreuzt die Sehne des M. extensor pollicis brevis 2 und zieht nach Abgabe eines Astes zum Daumen unter den M. extensor pollicis longus l . Nach ulnar sind die Sehnen der Mm.
Der sensible Ast des N. radialis 4 verlauft weiler radial unter dem M. brachioradialis und zieht iiber dessen Sehne auf die Streckseile zum Handriicken. 64 THE RADIAL ARTERY AT THE MID-DISTAL THIRD OF THE FOREARM A. RADIALIS 1M MITTLEREN UNO OISTALEN UNTERARMORITTEL - 65 THE RADIAL ARTERY AT THE ANATOMICAL SNUFF-BOX The hand and forearm are in pronation. A 5 cm long rectilinear incision is made over the distal epiphysis of the radius along the axis of the first metacarpal bone. - The aponeurosis, with the tendinous prominences of the extensor pollicis longus I above and the extensor pollicis brevis 2 below, may be observed.
The patient is in supine decubitus; the limb is extended along the trunk, the forearm and hand are supinated. An incision is made over the ulnar surface of the forearm and, after surpassing the flexion crease of the wrist, it continues over the palmar surface of the hand making a wide curve concave medially to go around the hypothenar eminence. - Above, the antibrachial fascia is dissected to reveal the palmar gracilis 1 (superiorly) and the tendinous prominence of the flexor carpi ulnaris 2 (inferiorly): lower down, access is gained to Guyon's canal by dissecting lengthwise the entire thickness of the transverse palmar ligament 3 and the palmar aponeurosis.
Anatomical Exposures and Surgical Approaches to the Limbs Anatomische Darstellungen und Zugangswege in der Chirurgie der Extremitäten by Francesco Ruggieri M.D., Gian Franco Zinghi M.D., Stefano Boriani M.D., Luigi Specchia M.D. (auth.)