Arthroscopic stabilisation of an acute acromioclavicular dislocation grade III in a patient with ectopic insertion of the pectoralis minor: technical considerations

The different approaches used in arthroscopic stabilisation of the acromioclavicular joint are well known. However, and despite a great incidence of ectopic pectoralis minor insertion, an alternative choice for the use of arthroscopic portal has not being sufficiently described. Here, we describe a case of acute acromioclavicular dislocation grade III. The arthroscopic stabilisation was achieved using the TightRope (Arthrex, Naples, USA) implant. Through this technique, the approach to the articular portion of the coracoid process can be made intra-articularly or from the subacromial space. We accessed intra-articularly, by opening the rotator interval to reach the coracoid process from the joint cavity. After opening the rotator interval, an ectopic insertion of the pectoralis minor was observed. The choice of approach of the coracoid process from the subacromial space would have complicated the intervention, making it necessary to sever the ectopic tendon to complete the technique, lengthening the surgical time and increasing the chance of complications. For this reason, the use of a standard posterior portal providing intra-articular arthroscopic access through the rotator interval is recommended since the aforementioned anatomical variation is not infrequent. Level of evidence Therapeutic studies—investigating the results of treatment, Level V.

RELRANK: Stata module to generate relative data (grade transformation)

relrank generates the so called (quasi-) relative data of a variable compared to an empirical reference distribution. This is also called the grade transformation.

SHRIMP U-Pb dating of high-grade migmatites and related magmatites from Northwestern Oates Land, East Antarctica

High- to very-high-grade migmatitic basement rocks of the Wilson Hills area in northwestern Oates Land (Antarctica) form part of a low-pressure high-temperature belt located at the western inboard side of the Ross-orogenic Wilson Terrane. Zircon, and in part monazite, from four very-high grade migmatites (migmatitic gneisses to diatexites) and zircon from two undeformed granitic dykes from a central granulite-facies zone of the basement complex were dated by the SHRIMP U-Pb method in order to constrain the timing of metamorphic and related igneous processes and to identify possible age inheritance. Monazite from two migmatites yielded within error identical ages of 499 +/- 10 Ma and 493 +/- 9 Ma. Coexisting zircon gave ages of 500 +/- 4 Ma and 484 +/- 5 Ma for a metatexite (two age populations) and 475 +/- 4 Ma for a diatexite. Zircon populations from a migmatitic gneiss and a posttectonic granitic dyke yielded well-defined ages of 488 +/- 6 Ma and 482 +/- 4 Ma, respectively. There is only minor evidence of age inheritance in zircons of these four samples. Zircon from two other samples (metatexite, posttectonic granitic dyke) gave scattered 206Pb-238U ages. While there is a component similar in age and in low Th/U ratio to those of the other samples, inherited components with ages up to c. 3 Ga predominate. In the metatexite, a major detrital contribution from 545 - 680 Ma old source rocks can be identified. The new age data support the model that granulite- to high-amphibolite-facies metamorphism and related igneous processes in basement rocks of northwestern Oates Land were confined to a relatively short period of time of Late Cambrian to early Ordovican age. An age of approximately 500 Ma is estimated for the Ross-orogenic granulite-facies metamorphism from consistent ages of monazite from two migmatites and of the older zircon age population in one metatexite. The variably younger zircon ages are interpreted to reflect mineral formation in the course of the post-granulite-facies metamorphic evolution, which led to a widespread high-amphibolite-facies retrogression and in part late-stage formation of ms+bi assemblages in the basement rocks and which lasted until about 465 Ma. The presence of inherited zircon components of latest Neoproterozoic to Cambrian age indicates that the high- to very-grade migmatitic basement in northwestern Oates Land originated from clastic series of Cambrian age and, therefore, may well represent the deeper-crustal equivalent of lower-grade metasedimentary series of the Wilson Terrane.