Faculty Bibliography

Juvenile aponeurotic fibroma is a distinctive fibroblastic tumor usually found in young children. The tumor has a predilection for the palms and soles, although it can occur elsewhere, either superficially in subcutaneous tissues or in deeper musculofascial and paraskeletal tissues. In this case the tumor occurred in an adult within the substance of the flexor pollicis longus tendon, a location not previously reported in the literature. Because of the unique location of the tumor, it was excised without sacrificing the tendon. Since recurrence of these lesions is common, continued observation was necessary. Magnetic resonance imaging in this patient 26 months after the operation showed restoration of the normal tendon contour

Neck pain is common in the elderly. An outline of the relevant anatomy and pathological conditions which affect the cervical spine and an approach to diagnosis are presented. Intrinsic causes of pain arise in the vertebral column itself--arthritis, discogenic disorders, trauma, tumors, and infection; in the cervical musculature--myofascial pain syndrome, torticollis, and whiplash; and in the spinal cord from tumors. Differentiation of these causes from extrinsic causes of neck pain will enable the appropriate management protocols to be implemented. Many of these problems can be treated effectively at the primary care level. Guidelines for specialist referral are suggested

Normal neck motion is a complicated phenomenon. A primary motion results from an applied force or torque. Secondary coupled motions also result as a consequence of the primary motion. These resulting coupled motions were measured in isolated cervical motion segments using three-dimensional videophotogrammetry with a coordinate system fixed in space. A cross coupling algorithm provided error correction and conversion from local to true cartesian coordinates. The data were analyzed by computer, and the true coupled motions resulting from any applied force were obtained. A second group of specimens was facetectomized, and the experiments were repeated. After facetectomy, a moment about the anteroposterior axis resulted in marked reduction in lateral displacement, decrease in vertical displacement, and decrease in rotation about the vertical axis. Results were significant at P less than 0.01 and represent a significant decrease in coupled motions resulting from lateral bending. At P less than 0.05, a laterally applied force causes less lateral displacement and lateral flexion, but more longitudinal displacement. Flexion and extension movements are not significantly altered after facetectomy

Pin placement in the proximal tibia is commonly performed by passing the pins percutaneously, without visualization of the underlying neurovascular and anatomic structures. Neurovascular injuries are uncommon. Complications are avoidable through a thorough familiarity with the location of the neurovascular structures. Six cadaveric legs were dissected and the three-dimensional anatomy of the peroneal nerve in the proximal one-third of the leg defined, with the use of profile radiography. The nerve is situated predominantly posterior to the tibia. The pin should be passed through the middle of the tibia (in cross section) strictly in the coronal plane to avoid neural damage. Skeletal traction or external fixation pins may, therefore, safely be placed in the proximal tibia

Compression of the third or fourth part of the duodenum by the superior mesenteric artery or one of its branches is the anatomic basis for some cases of duodenal obstruction. Two cases of vascular obstruction of the duodenum after surgical correction of scoliosis are presented. The embryologic and pathoanatomic bases for this condition, and the rationale for treatment, are described

The authors present a method they have devised to measure limb length intraoperatively in total hip replacement using readily available operating room materials