Cubital tunnel syndrome is the second most common peripheral nerve compression seen by hand surgeons. A thorough understanding of the ulnar nerve anatomy and common sites of compression are required to determine the cause of the neuropathy and proper treatment. Recognizing the various clinical presentations of ulnar nerve compression can guide the surgeon to choose examination tests that aid in localizing the site of compression. Diagnostic studies such as radiographs and electromyography can aid in diagnosis. Conservative management with bracing is typically trialed first. Surgical decompression with or without ulnar nerve transposition is the mainstay of surgical treatment. This article provides a review of the ulnar nerve anatomy, clinical presentation, diagnostic studies, and treatment options for management of cubital tunnel syndrome.

Background Instrumented posterior lumbar fusion (IPLF) with and without transforaminal interbody fusion (TLIF) is a common treatment for low back pain when conservative interventions have failed. Certain patient comorbidities and lifestyle risk factors, such as obesity and smoking, are known to negatively affect these procedures. An advanced cellular bone allograft (CBA) with viable osteogenic cells (V-CBA) has demonstrated high fusion rates, but the rates for patients with severe and/or multiple comorbidities remain understudied. The purpose of this study was to assess fusion outcomes in patients undergoing IPLF/TLIF using V-CBA with baseline comorbidities and lifestyle risk factors known to negatively affect bone fusion. Methods This was a retrospective study of de-identified data from consecutive patients at an academic medical center who underwent IPLF procedures with or without TLIF, and with V-CBA. Baseline patient and procedure characteristics were assessed. Radiological outcomes included fusion rates per the Lenke scale. Patient-reported clinical outcomes were evaluated via the Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back and leg pain. Operating room (OR) times and intraoperative blood loss rates were also assessed. Results Data from 96 patients were assessed with a total of 222 levels treated overall (mean: 2.3 levels) and a median follow-up time of 16 months (range: 6 to 45 months). Successful fusion (Lenke A or B) was reported for 88 of 96 patients (91.7%) overall, including in all IPLF-only patients. Of 22 patients with diabetes in the IPLF+TLIF group, fusion was reported in 20 patients (90.9%). In IPLF+TLIF patients currently using tobacco (n = 19), fusion was reported in 16 patients (84.3%), while in those with a history of tobacco use (n = 53), fusion was observed in 48 patients (90.6%). Successful fusion was reported in all 6 patients overall with previous pseudarthrosis at the same level. Mean postoperative ODI and VAS scores were significantly reduced versus preoperative ratings. Conclusion The results of this study suggest that V-CBA consistently yields successful fusion and significant decreases in patient-reported ODI and VAS, despite patient comorbidities and lifestyle risk factors that are known to negatively affect such bony healing.

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Summary A 15‐year‐old Clydesdale mare presented for further diagnostics and treatment of waxing and waning lameness and recurrent subsolar abscesses. Radiographs and computed tomography revealed biaxial masses extending from the hoof capsule, causing bone resorption of the distal phalanx. Surgery was performed to remove the masses and post operative care included regional limb perfusions, systemic antibiotics and therapeutic shoeing. Histopathology was consistent with the diagnosis of keratoma for each of the masses; this is the first case of confirmed biaxial keratomas. Two months after surgery the horse is sound at the walk and is expected to return to full function within the next year.

Abstract. The thickness of Earth's mechanical lithosphere is poorly defined. To investigate whether rheology controls the thickness of the overriding plate's mechanical lithosphere in subduction zones, the thermal structure was modelled numerically assuming a temperature dependent mantle viscosity. It was found that the overriding lithosphere was ablated such that very high temperatures reached close to the surface near the apex of the wedge comer, leading to unrealistiCally high heat flow. Since temperature dependent rheology clearly does not control the thickness of the mechanical lithosphere, we suggest that it is instead controlled by buoyancy. The source of buoyancy we assume is compositional, e.g. buoyant crust. Two end-member models with crustal thickness of 10 and 70 km respectively were then undertaken, these had lower heat flow. This work sUppOrts the assumption of some earlier workers (e.g. Plank and Langmuir, 1988) who equated the mechanical lithosphere with the crust of the overriding plate.