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At least 37 records · Page 2Linked to original sources

The vascular anatomy of the dorsal part of the caudal ribs in the dog. A microangiographic study with special reference to the microvascular free transfer of living rib grafts.

The arterial blood supply to the head, neck and tubercle of the caudal ribs in the adult dog was studied by means of microangiography. While the tubercle and the neck are supplied solely by medullary branches of the main nutrient artery, the rib head receives an additional supply via two groups of epiphyseal arteries. This vascular pattern is discussed with special reference to the free microvascular transfer of composite posterior rib grafts.

Animals↗

Tuberculosis of the ribs: a recurrent attack of rib caries.

Rib tuberculosis is an extremely rare condition with the incidence not exceeding 3 percent of all skeletal tuberculosis. The authors experienced a recalcitrant case of pulmonary tuberculosis accompanied by chest wall cold abscesses involving ribs recurring at a new site in approximately 10 months despite of medical and surgical treatment. The patient has twice taken thoracotomy for abscess drainage and during the second thoracotomy, a partial resection of involved ribs was performed.

Adolescent↗

Study of the rib cage deformity in children with 10 degrees-20 degrees of Cobb angle late onset idiopathic scoliosis, using rib-vertebra angles--aetiologic implications.

UNLABELLED: The aim of the study is to compare the rib-vertebra angles (RVAs) between children with 10 degrees - 20 degrees of Cobb angle late onset idiopathic scoliosis (LOIS) and non-scoliotic children. MATERIALS AND METHOD: The RVAs of 47 children, with mean age 12.4 years, who presented LOIS with a Cobb angle 10 degrees - 20 degrees, were studied. The children were classified into three groups according to the site of the scoliotic curve: 17 children had thoracic (T), 14 children had thoracolumbar (TL) and 16 children had lumbar (L) curves. The RVAs of the scoliotic children were compared to the RVAs of 60 non-scoliotic children of a similar age group, who were studied in the past. RESULTS: The comparison of the right and left RVAs within each group showed that the children who had: T curves differ at the level T4, T5, T6, T7 and T8, TL curves differ at the level T3, and L curves differ at the level T7 and T12. The comparison of the ipsilateral RVA's between the scoliotic groups showed that between: T and TL curves there are no differences at any thoracic level, between T and L curves the RVAs differ at the T7 level on the right side, whereas there are no differences between the RVAs on the left side, between TL and L curves the RVAs differ at the level T5, T6, and T7 on the right and at the level T5 on the left side. Comparing the RVAs between the scoliotic and nonscoliotic children, it was apparent that the scoliotic children rib cage had lower RVAs (p<0.01) at almost all thoracic levels. DISCUSSION: It has been reported that RVAs is an expression of the resultant muscle forces, which act on each rib. It was also suggested that RVA asymmetries by weakening the spinal rotation-defending system are aetiological for idiopathic scoliosis, (Burwell et al 1992). This study shows that scoliotic children with small curves have underdeveloped thoracic cage compared to nonscoliotic counterparts. The differences are more apparent in the scoliotic children with thoracic curves. It is suggested that the differences of the RVAs between right and left side in this group are an expression of asymmetric muscle forces acting on the thoracic cage. It is concluded that asymmetric muscle forces participate in the pathogenesis of idiopathic scoliosis on the thoracic cage, which deforms early.

Adolescent↗

Rebound rib: stress-induced first rib fracture.

Reported are two cases of stress-induced fracture of the first rib in young, healthy basketball players. Presumably the fractures resulted from violent contraction of the scalene musculature. This is the usual method of production of stress-induced first rib fracture, but basketball-related cases have not been reported previously. This entity probably is underdiagnosed, and is amenable to conservative outpatient management in most cases.

Adolescent↗

Surfer's rib: isolated first rib fracture secondary to indirect trauma.

A case of anterolateral first rib fracture produced by indirect trauma in a surfer is presented. A 17-year-old man was seen in the emergency department with the complaint of left shoulder pain that developed while he performed a so-called lay back maneuver on a surfboard. No history of direct trauma was elicited. After physical examination revealed point tenderness high in the left axilla, radiographic evaluation of the chest showed an isolated fracture of the anterolateral aspect of the left first rib. No morbidity was associated with this fracture which, when produced by other forces, can have serious sequelae.

Adolescent↗

[The importance of excision of the first thoracic rib and accessory cervical rib in the treatment of deep venous thrombosis of the upper extremities].

This paper presents 15 cases of deep venous thrombosis of the upper extremity as a complication of previously asymptomatic thoracic outlet syndrome. The diagnosis was based on clinical examination and phlebography. To achieve prompt recanalisation of the vein streptokinase was used. Fibrinolytic treatment was followed by surgical treatment carried out 6 to 8 weeks after resolution of acute symptoms. The surgery consisted of excision of first rib and accessory cervical rib when present through the axillary approach. In 73% of cases complete lysis of the thrombus was achieved which was confirmed by phlebography and resolution of symptoms of venous hypertension.

Acute Disease↗

An extrapleural approach with rib removal for the eleventh rib flank incision.

The transcostal extrapleural flank approach to the kidney requires an understanding of the anatomy of the thoracic and abdominal wall to prevent injury to the pleura and subsequent pneumothorax. Isolation of the intercostal neurovascular bundle, division of the lumbodorsal fascia inferior to the rib bed, and simultaneous dissection of the diaphragmatic insertion along the superior and posterior aspect of the twelfth rib toward the lumbocostal arch are necessary surgical maneuvers. This should be done prior to the release of the diaphragm, exposure of Gerota's fascia and positioning of a flank retractor. Pneumothorax usually results from attempts to separate the pleura from the diaphragm, dissection within the intercostal space rather than along the diaphragmatic insertions, and failure to release fully the diaphragm as far as the lumbocostal arch prior to placement of the retractor. Precise appreciation of the pericostal anatomy allows the urologic surgeon to remain in the extrapleural space during this commonly used flank incision.

Abdominal Muscles↗

Subclavian vein stenosis and axillary vein 'effort thrombosis'. Age and the first rib bypass collateral, thrombolytic therapy and first rib resection.

Three patients presented with axillary vein 'effort thrombosis'. Intravenous streptokinase for 3 days followed by heparin for 10 days restored patency and relieved symptoms. Pretreatment diagnosis and the effect of streptokinase were confirmed venographically and an abnormality in the subclavian vein just medial to the first rib was demonstrated. This stenosis was most severe and had a prominent bypass collateral in the oldest patient. It is proposed that, in the absence of superimposed thrombosis, the damage to the vein in predisposed patients is progressive with age, with establishment of permanent collaterals. Transaxillary first rib resection is advised to prevent compression of the veins in the thoracic outlet.

Adult↗

[Radiologically detectable modifications in the cartilaginous parts of the first pair of ribs in connection with age, sex and the cartilaginous part of the other ribs (author's transl)].

2154 thorax radiograms of 1099 male and 1055 female patients with transformations of the costal cartilage were analysed and statistically evaluated in dependence on age. The calcification of the cartilage parts of the first rib was observed on both sides in the same way and concerning the frequency there were no sex conditioned differences. In the age group between 35 and 45 years more than 95% calcifications have been demonstrated. Men show more frequently advanced stages and types of calcification than women. In complete or heavy calcified cartilage zones disconnections in form of splitted parts without calcium have been observed. The lower cartilage skirt is regarded as the localization of the beginning of calcification. The other costal cartilages will be calcified later and less rapidly than the first costal cartilage. Significant differences of type and localization of the calcification were found between men and women. Physiological processes of ageing and mechanical stress as the prevailing calcification-causing factors are discussed.

Adolescent↗