Alexandros Tzaveas

Left common carotid artery arising from the brachiocephalic trunk: a case report

An abnormal origin of the left common carotid artery from the initial portion of the brachiocephalic trunk was found in the superior mediastinum in a 81-year-old Caucasian male cadaver during dissection practice. We report on the exact morphology of that variant that is appeared in an incidence of 0,2% in the literature. We discuss the relative literature and pay attention on the significance of such a variation for clinicians in its recognition and protection.

Lumbosacral transitional vertebra causing Bertolotti’s syndrome: a case report and review of the literature

IntroductionLumbosacral transitional vertebra is an anatomical variation of the fifth lumbar vertebra in which an enlarged transverse process can form a joint or fusion with the sacrum or ilium. The association of that variant with low back pain and the change in the biomechanical properties of the lumbar spine is called Bertolottis syndrome.Case presentationWe report a case of a 40-year-old male patient with chronic low back pain extending to the left buttock, just above the ipsilateral sacroiliac joint. Radiographic investigation revealed an anomalous enlargement of the left transverse process of the fifth lumbar vertebra forming a pseudarthrosis with the infrajacent ala of the sacrum.ConclusionIn young patients with back pain the possibility of Bertolottis syndrome should always be taken in account.

Morphological parameters of the superior articular facets of the atlas and potential clinical significance

BackgroundAlthough remarkable investigations exist in regard to the morphology of the superior articular facets of the atlas in the literature, only a few data exist concerning the correlation of these facets with the age of the specimens.MethodsThe superior articular facets of the atlas were studied in 86 dried vertebrae. Several non-metric parameters were recorded, like presence of notches, grooves, complete or partial dissociation, rough surfaces as well as their morphology.ResultsNo notch was found in 37.2% of the superior articular facets. The incidence of notch is decreased as the age progresses. No transverse groove was found in 24.4% and the presence is increased with the age. The incidence of complete and partial dissociations was also found to be age-related. The incidence of rough surfaces, which corresponds to the site of maximum weight bear, was found to be increased in the old age. We classified the shape of the facets into the following types: oval-shaped, kidney-shaped, S-like, triangle, circular and two portioned.ConclusionsWe assume that the increase of incidence of the dissociation, the rough surfaces, the grooves and the decrease of notches could be possibly the result of a restriction of the atlanto-occipital motion in the old age.

Kaplan anastomosis of the ulnar nerve: a case report

IntroductionThe sensory innervation of the hand is usually unvarying and anomalies in this area are uncommon.Case presentationWe report the case of a rare ulnar nerve branch called a Kaplan anastomosis, which anastomosed the dorsal cutaneous branch with the ulnar nerve prior to its bifurcation into the superficial and deep ramus.ConclusionMany authors have reported unusual ulnar nerve branches and knowledge of these anatomical variations is important for the interpretation of pain and sensory loss in the area sustained during injuries or surgical procedures. Our finding is the fourth case of a Kaplan anastomosis to be described in the literature.

Metastasis of bronchogenic carcinoma to the 5thmetacarpal bone: a case report

BackgroundMetastatic lesions to the hand are very rare and represent 0.1% of all osseous metastases.Case presentationWe present a patient with metastasis of bronchogenic carcinoma of the lung to the 5th metacarpal to draw the attention for the potential of such lesions to be developed in this region. Due to the extensive metastasis to the hand the patient was referred to the oncologists.ConclusionThe surgeon should be cautious regarding the differential diagnosis, the usual poor prognosis of such patients and the questionable need for reconstructive surgery.

Anatomical variation of co-existence of 4th and 5th short metacarpal bones, sesamoid ossicles and exostoses of ulna and radius in the same hand: a case report

IntroductionThe anatomical variations of bones in the hand are common. The existence of exostosis and shortening of metacarpal bones has been described in the literature as part of the hereditary multiple exostosis syndrome but no case has been reported with the co-existence of sesamoid ossicles in the same patient.Case presentationWe report a case with co-existence of distal ulnar and radial exostoses, 4th and 5th short metacarpals and sesamoid ossicles in the wrist area.ConclusionThis variation may help the interpretation of pain or sensory disorders in the hand and wrist areas.

Metastasis of bronchogenic carcinoma to the 5th metacarpal bone: a case report

BackgroundMetastatic lesions to the hand are very rare and represent 0.1% of all osseous metastases.Case presentationWe present a patient with metastasis of bronchogenic carcinoma of the lung to the 5th metacarpal to draw the attention for the potential of such lesions to be developed in this region. Due to the extensive metastasis to the hand the patient was referred to the oncologists.ConclusionThe surgeon should be cautious regarding the differential diagnosis, the usual poor prognosis of such patients and the questionable need for reconstructive surgery.

Supracondylar process of the humerus: A rare case with compression of the ulnar nerve

Abstract A patient presented with a 6–month history of numbness and pain in the left forearm and hand over the ulnar nerve distribution. Radiographs showed a supracondylar process, which was excised. The ulnar nerve had been compressed. The patient was symptom–free two months postoperatively.

A Rare Case of Quadratus Femoris Muscle Rupture After Yoga Exercises.

We present a case of a female patient with left groin pain after intense yoga exercises. The patient presented abnormal pattern of gait with no swelling over the groin, thigh, or buttock. Magnetic resonance imaging demonstrated a tear of the quadratus femoris muscle with an associated extensive hematoma formation. Patient was treated with a rehabilitation program consisting of nonsteroidal anti-inflammatory drugs and physiotherapy. At the follow-up control, the patient had improved her pain and flexibility of the hip, and gradually she returned to daily activities and yoga exercises. Such an entity is a rare cause of hip pain after exercise and should be kept in mind by the orthopedic surgeon, in cases of gluteal pain after intense physical activity. Moreover, such a condition should be included in the diagnostic algorithm of unknown origin hip pain.