Stable and painless elbow motion is essential for activities of daily living. The elbow joint is the second most commonly dislocated joint in adults. The goals of treatment are to perform a stable fixation of all frac...Stable and painless elbow motion is essential for activities of daily living. The elbow joint is the second most commonly dislocated joint in adults. The goals of treatment are to perform a stable fixation of all fractures, to achieve concentric and stable reduction of the elbow and to provide early motion. The treatment modality for complex elbow instability is almost always surgical. The treatment objectives are anatomic reduction, stable fixation, and early rehabilitation of the elbow. The common complications of these unstablefractures include recurrent instability, stiffness, myositis ossifications, heterotopic calcification, and neurovascular dysfunction. We analyzed the management of complex elbow fractures and instabilities on the basis of recent literature and suggested possible guidelines for the treatment in this paper. In conclusion, recognition of the injury pattern and restoration of the joint stability are the prerequisites for any successful treatment of an unstable elbow injury.展开更多
This article has the objective of studying the myth of the vagina dentata.Based on an exploratory review of the literature and on clinical experience,the present article discusses this myth through manifestations of t...This article has the objective of studying the myth of the vagina dentata.Based on an exploratory review of the literature and on clinical experience,the present article discusses this myth through manifestations of the archetype of the Terrible Mother and its manifestations in the contemporaneous clinic in the context of Analytical Psychology.The presence of the myth will first be considered in the context of cultural anthropology and then specifically on the basis of Neumann’s Analytical Psychology.In this article the author shows how the manifestation of the Terrible Mother is related to the archetype of the Great Mother,represented by horrendous figures such as serpents,gorgons,and the Egyptian Mother Goddess.The Terrible Mother has a devouring aspect and,in some cultures,is often intertwined with the symbol of the vagina dentata.Later,in the clinical context,these archetypical manifestations will be associated to intense degrees of anxiety associated with the anima in male patients,feeding intense degrees of aggressiveness in the shades of individuals of the male sex.In conclusion,the author emphasises the importance of manifestations of the Terrible Mother as depicted in individual symbols,in view of the process of individuation in clinical settings.展开更多
Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures sur...Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures surgically fixed in our institution using a buttress plate technique via a medial approach between June 2012 and April 2015 by the senior author was performed.These fractures were all sizeable fractures contributing to persistent elbow instability in terrible triad or varus posteromedial rotatory instability injury patterns.A prospective telephone questionnaire was conducted to assess patient outcomes using the disabilities of the arm,shoulder and hand(DASH)score and Mayo hlbow performance score(MEPS).Results:Twelve patients were included in the study,comprising 10 males and 2 females with an average age of 39 years(range,19-72 years).Mean follow-up was 16 months(range.4-18 months).The average time to radiographic union was 4 months(range.3-7 months).Range of motion measurements at final follow-up were obtained in 11 out of 12 patients,with one patient defaulting follow-up.All 11 patients displayed a functional elbow range of motion of at least 30°-130°.with an average arc of motion of 130°(range.110°-140°).mean elbow flexion of 134°(range.110°-140°)and mean flexion contracture of 3°(range.0°-20°).The mean DASH score was 16(range.2.5-43.8)and the mean MEPS was 75(range.65-100).Complications observed included one patient with a superfic ial wound infection which resolved with a course of oral antibiotics and one patient with radiographic evidence of heterotopic ossification which was conservatively managed.No residual elbow instability was observed and no reoperations were performed.Conclusion:Buttress plate fixation via a medial approach of coronoid process fractures that contribute to persistent elbow instability represents a reliable method of treatment that produces satisfactory and predictable outcomes.展开更多
Dear Xiao Lan. ’Several times a week, no matter which of the major television news networksI turn to, the screen is filled with tragic pictures of flooding along the YangtzeRiver, and I grieve for the suffering peopl...Dear Xiao Lan. ’Several times a week, no matter which of the major television news networksI turn to, the screen is filled with tragic pictures of flooding along the YangtzeRiver, and I grieve for the suffering people whose lives are being so terriblydisrupted by this disaster. Even more to be grieved is the terrible number of peoplewho have been killed by the floods and their effects.展开更多
文摘Stable and painless elbow motion is essential for activities of daily living. The elbow joint is the second most commonly dislocated joint in adults. The goals of treatment are to perform a stable fixation of all fractures, to achieve concentric and stable reduction of the elbow and to provide early motion. The treatment modality for complex elbow instability is almost always surgical. The treatment objectives are anatomic reduction, stable fixation, and early rehabilitation of the elbow. The common complications of these unstablefractures include recurrent instability, stiffness, myositis ossifications, heterotopic calcification, and neurovascular dysfunction. We analyzed the management of complex elbow fractures and instabilities on the basis of recent literature and suggested possible guidelines for the treatment in this paper. In conclusion, recognition of the injury pattern and restoration of the joint stability are the prerequisites for any successful treatment of an unstable elbow injury.
文摘This article has the objective of studying the myth of the vagina dentata.Based on an exploratory review of the literature and on clinical experience,the present article discusses this myth through manifestations of the archetype of the Terrible Mother and its manifestations in the contemporaneous clinic in the context of Analytical Psychology.The presence of the myth will first be considered in the context of cultural anthropology and then specifically on the basis of Neumann’s Analytical Psychology.In this article the author shows how the manifestation of the Terrible Mother is related to the archetype of the Great Mother,represented by horrendous figures such as serpents,gorgons,and the Egyptian Mother Goddess.The Terrible Mother has a devouring aspect and,in some cultures,is often intertwined with the symbol of the vagina dentata.Later,in the clinical context,these archetypical manifestations will be associated to intense degrees of anxiety associated with the anima in male patients,feeding intense degrees of aggressiveness in the shades of individuals of the male sex.In conclusion,the author emphasises the importance of manifestations of the Terrible Mother as depicted in individual symbols,in view of the process of individuation in clinical settings.
文摘Purpose:To assess the clinical and radiographic outcomes of coronoid process fractures surgically managed with buttress plate fixation via a medial approach.Methods:A retrospective review of all coronoid fractures surgically fixed in our institution using a buttress plate technique via a medial approach between June 2012 and April 2015 by the senior author was performed.These fractures were all sizeable fractures contributing to persistent elbow instability in terrible triad or varus posteromedial rotatory instability injury patterns.A prospective telephone questionnaire was conducted to assess patient outcomes using the disabilities of the arm,shoulder and hand(DASH)score and Mayo hlbow performance score(MEPS).Results:Twelve patients were included in the study,comprising 10 males and 2 females with an average age of 39 years(range,19-72 years).Mean follow-up was 16 months(range.4-18 months).The average time to radiographic union was 4 months(range.3-7 months).Range of motion measurements at final follow-up were obtained in 11 out of 12 patients,with one patient defaulting follow-up.All 11 patients displayed a functional elbow range of motion of at least 30°-130°.with an average arc of motion of 130°(range.110°-140°).mean elbow flexion of 134°(range.110°-140°)and mean flexion contracture of 3°(range.0°-20°).The mean DASH score was 16(range.2.5-43.8)and the mean MEPS was 75(range.65-100).Complications observed included one patient with a superfic ial wound infection which resolved with a course of oral antibiotics and one patient with radiographic evidence of heterotopic ossification which was conservatively managed.No residual elbow instability was observed and no reoperations were performed.Conclusion:Buttress plate fixation via a medial approach of coronoid process fractures that contribute to persistent elbow instability represents a reliable method of treatment that produces satisfactory and predictable outcomes.
文摘Dear Xiao Lan. ’Several times a week, no matter which of the major television news networksI turn to, the screen is filled with tragic pictures of flooding along the YangtzeRiver, and I grieve for the suffering people whose lives are being so terriblydisrupted by this disaster. Even more to be grieved is the terrible number of peoplewho have been killed by the floods and their effects.
