Aligning the acetabular component with the Transverse Acetabular Ligament (TAL) to ensure optimal anteversion has been reported to reduce dislocation rates. However, to our knowledge in vivo measurement of the TAL angle has not yet been reported in a large cohort of normal hips. CT scans of 218 normal hips were analyzed. The TAL and four acetabular rim anteversion angles were measured (superiorly to inferiorly) relative to the anterior pelvic plane. The mean TAL anteversion angle was 20.5° ± 7.0°, and the acetabular rim angles from superior to inferior were 11.0° ± 12.9°, 19.9° ± 8.8°, 20.9° ± 6.2° and 25.1° ± 6.2° respectively. Both the TAL and the acetabular rim were significantly more anteverted in females than in males. The TAL anteversion angle was comparable to the predominant orientation (central rim section) of the native acetabulum while the superior acetabulum was comparatively retroverted and the inferior was relatively more anteverted.

Damage to the palmar cutaneous branch of the median nerve (PCBMN) is a potential complication of surgery at the volar aspect of the wrist. The aim of this study was to determine the relationships of the PCBMN to both surface and bony landmarks using reliable methods. Ten pairs of forearms from cadavers aged 73 to 98 years were dissected. The PCBMN was identified and its course and relationships documented. The situation of the PCBMN was quantified relative to the distal wrist crease, bistyloid line, scaphoid tubercle, radial styloid process and flexor carpi radialis tendon. A PCBMN was identified on 90% of sides. The PCBMN arose from the radial aspect of the median nerve 52.4 (SD 31.0) mm from the bistyloid line and entered the transverse carpal ligament 10.9 (SD 9.5) mm proximal to the bistyloid line. At the level of the distal wrist crease the PCBMN was located 0.6 to 7.5 mm (mean 4.5; SD 1.9 mm) from the ulnar aspect of the flexor carpi radialis tendon. The inter-and intra-observer reliability of the measurement methods ranged from ICC 0.96 to 1.00. Detailed morphometric data of the PCBMN relative to bony landmarks contribute to knowledge of the spatial relationships of the PCBMN to inform the precision of surgical incisions.

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Background: The unstable pelvic fracture has been described as the 'killing fracture' because of the risk of significant vascular compromise. The ability to correctly classify pelvic fractures may therefore be crucial in optimizing patient outcomes. Pelvic fracture classification is difficult and previous research has indicated that ability is suboptimal in orthopaedic registrars. The objective of this study was to examine the efficacy of an educational package in improving orthopaedic registrars' ability to classify pelvic fractures. Methods: A total of 35 orthopaedic registrars were recruited in this classification study. An educational package was used to introduce the AO classification of pelvic fractures and teach the registrars how to classify pelvic fractures using pelvic X-rays and computed tomography scans. A classification test assessed their classification ability before and after using the educational package. A third test was performed 2 weeks after the second to assess the stability of learning. Results:The mean score at baseline of 8.4 AE 0.46 increased to 10.5 AE 0.48 after using the educational package, and this was maintained in the follow-up test (10.7 AE 0.54 (F (2,52) = 15.5, P < 0.001)). The proportion of registrars achieving a satisfactory score increased from 46% (16/35) to 77% (23/30) after training, and 90% (19/21) at follow-up (χ 2 (2) = 6.74, P = 0.035).

This paper uses book provenance information from the town of Memmingen in southern Germany as a basis for discovering its book trade history. It brings together this information with that of some earlier writers to throw light on the scholarly book network that grew in the town, the book buyers and owners, and the book producers with their supporting trades, in Memmingen in the second half of the fifteenth century. It will look at who the buyers were, what they bought, how books were traded, from where their books had come, and, where possible, how much the books cost. The prices of books are put into context of known living costs of the period.