Coracoid Process Fracture in a High School Football Player

We presented a unique case of a high school athlete who suffered from a coracoid process fracture following a collision with an opposing player. This fracture is commonly misdiagnosed as a clavicular fracture or AC joint sprain. Initial radiographic examination may fail to identify the fracture site. Understanding the clinical features of this injury is an important prerequisite to its overall management. Any misdiagnosis or alteration from the appropriate course of treatment can inhibit return to play and may be avoided by using indicated diagnostic evaluation tools.

Approches arthroscopiques et description de l'anatomie articulaire normale du carpe et du tarse chez le bovin adulte

Les approches arthroscopiques et l’anatomie normale des articulations antébrachiocarpienne, carpienne moyenne et tarsocrurale n’ont jamais été décrites spécifiquement chez les bovins. Notre étude avait pour buts de définir les abords chirurgicaux et de décrire l’anatomie arthroscopique de ces trois articulations. Deux carpes et deux tarses issus du cadavre frais d’une vache adulte ont été injectés avec un mélange de latex, puis disséqués afin de déterminer les sites arthroscopiques d’intérêt. Par la suite, l’arthroscopie des articulations antébrachiocarpienne et carpienne moyenne (approche dorsale) et de l’articulation tarsocrurale (approches dorsale et plantaire) a été réalisée sur six cadavres frais de vaches adultes ne présentant ni boiterie ni distension articulaire avant leur euthanasie. Les approches dorsolatérale et dorsomédiale des articulations antébrachiocarpienne et carpienne moyenne ont été réalisées de part et d’autre de l’extenseur radial du carpe. Les structures observées étaient le radius distal, les os radial, intermédiaire, ulnaire, II et III fusionnés et IV du carpe, ainsi que des ligaments palmaires. Les approches dorsolatérale et dorsomédiale de l’articulation tarsocrurale ont été réalisées latéralement au long extenseur des doigts et médialement au troisième péronier respectivement. Les approches plantarolatérale et plantaromédiale ont été réalisées latéralement au fléchisseur latéral des doigts et latéralement au fléchisseur médial des doigts respectivement. Les structures observées étaient le tibia distal, les trochlées proximale et plantaire du talus, le processus coracoïde du calcanéus, l’articulation fibulo-calcanéenne et des ligaments articulaires. Quelle que soit l’articulation, l’approche latérale était préférée à l’approche médiale. L’arthroscopie du carpe et du tarse pourra être proposée dans un contexte hospitalier comme outil diagnostique, thérapeutique et pronostique des maladies articulaires bovines.

Functional and historical determinants of shape in the scapula of Xenarthran mammals: Evolution of a complex morphological structure

The mammalian scapula is a complex morphological structure, composed of two ossification plates that fuse into a single structure. Most studies on morphological differentiation in the scapula have considered it to be a simple, spatially integrated structure, primarily influenced by the important locomotor function presented by this element. We used recently developed geometric morphometric techniques to test and quantify functional and phylogenetic influences on scapular shape variation in fossil and extant xenarthran mammals. The order Xenarthra is well represented in the fossil record and presents a stable phylogenetic hypothesis for its genealogical history. In addition, its species present a large variety of locomotor habits. Our results show that approximately half of the shape variation in the scapula is due to phylogenetic heritage. This is contrary to the view that the scapula is influenced only by functional demands. There are large-scale shape transformations that provide biomechanical adaptation for the several habits (arboreality, terrestriality, and digging), and small scale-shape transformations (mostly related to the coracoid process) that are not influenced by function. A nonlinear relationship between morphometric and phylogenetic distances indicates the presence of a complex mixture of evolutionary processes acting on shape differentiation of the scapula. J. Morphol. 241,251-263, 1999. (C) 1999 Wiley-Liss, Inc.

Taxonomic revision of extant Doras Lacepede, 1803 (Siluriformes: Doradidae) with descriptions of three new species

Extant Doras are newly diagnosed among Doradidae by the unique combination of maxillary barbels long and fimbriate; mesethmoid with anterior lateral margins converging towards narrow tip; single anterior cranial fontanel contained largely within frontals and anteriorly by mesethmoid (posterior cranial fontanel occluded); anterior nuchal plate wide, pentaganol or roughly hexagonal, sharing distinct lateral suture with epioccipital and isolating supraoccipital from middle nuchal plate; nuchal foramina absent; coracoid process short, posterior tip falling well short of that of postcleithral process; dentary with acicular teeth; and skin immediately ventral to postcleithral process perforated with conspicuous pores. One fossil species, dagger D. dioneae, and two nominal extant species, D. carinatus and D. micropoeus, are recognized as valid and the latter two redescribed. Three additional extant species, D. phlyzakion, D. higuchii and D. zuanoni, are newly described from the middle Amazon and tributaries, lower Amazon tributaries and rio Araguaia (Tocantins drainage), respectively. Doras phlyzakion and D. zuanoni form a monophyletic group that is found in lowland, lentic habitats, and is characterized by multiple conspicuous pores in skin on breast and abdomen, a trait unique among doradids and rare if not unique among all catfishes. The remaining extant species, D. carinatus, D. higuchii and D. micropoeus, with uncertain relationships, are found in upland, lotic habitats. The occurrence of D. carinatus in the Orinoco basin suggests a historical link between right-bank tributaries of the lower Orinoco (e.g., Caroni) draining the western Guiana Shield and more eastern rivers (e.g., Cuyuni-Essequibo) that drain the Shield directly into the Atlantic Ocean. A key to extant species is provided, a neotype is designated for Silurtis carinatus Linnaeus 1766, and Mormyropsis Miranda Ribeiro, 1911, is placed in the synonymy of Doras Lacepede, 1803.

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.