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Purpose: To project the distance between the tip of the greater tubercle (GT), respectively, the proximal border of the tip of the coracoid process (CP) and the entry point of the coracobrachialis by the musculocutaneous nerve (MCN) proportionally onto the humeral length. Methods: Sixty-six upper extremities were included in the study. The distance between the tip of the GT and the distal tip of the lateral humeral epicondyle (LE) was evaluated as the humeral length (HL). The interval between the tip of the GT and the entry point of the coracobrachialis muscle by the MCN was measured. The distance between the proximal border of the tip of the CP and the distal portion of the medial humeral epicondyle (ME) and the entry point of the MCN into the coracobrachialis were evaluated. Proportions were used to project the entry point of the coracobrachialis by the MCN along the HL, respectively, the interval between the proximal border of the tip of the CP and the distal tip of the ME. Results: The entry point of the MCN into the coracobrachialis muscle can be expected at an interval between 14.9 and 33.9% of the HL (between the tip of the GT and the LE), starting from the tip of the GT. Regarding the reference line between the proximal border of the CP and the ME, the nerve’s entry point was located between 14.2 and 34.4%, starting from the CP. Conclusion: Results represent easily applicable intervals for intraoperative localisation of the MCN.

Social Distancing - so lautet die Formel, auf die sich der pandemische Alltag in kürzester Zeit umstellen musste. In der öffentlichen Debatte gerät jedoch häufig aus dem Blick, dass damit nicht nur ein Phänomen der Gegenwart bezeichnet wird. Der Beitrag erweitert die Diskussion um eine historische Perspektive auf soziale Distanz, bei der Szenen der Hygiene und Krankheitsprävention aus dem 18. und 19. Jahrhundert zur Sprache kommen. Deutlich wird, dass die sozial distanzierten Verhaltensweisen, die in Zeiten erhöhter Ansteckungsgefahren zum Einsatz kommen, nicht nur Produkte des medizinischen Fortschritts sind, sondern die erstarkende bürgerliche Lebensführung zum Vorbild haben.

Background The introduction of reverse total shoulder arthroplasty (RSA) as a treatment option in complex proximal humeral fractures, including patients with poor bone quality, has significantly extended the surgical armamentarium.The aim of this study was to investigate the mid-term outcome following fracture RSA (FRSA) in acute or sequelae, as well as salvage procedures. It was hypothesized that revision FRSA (SRSA) leads to similar mid-term results as primary fracture treatment by RSA (PRSA).Methods This retrospective case-series study describes the radiological and clinical mid-term outcome in a standardized single-center and one-material Inlay design. Patients who underwent FRSA between 2008 and 2017 were matched (minimum follow-up: two years, minimum age at the time of operation: 60 years).The assessment tools used for functional findings were range of motion (ROM), Visual Analogue Scale, absolute (CS) plus normative Constant Score, Quick DASH, and Subjective Shoulder Value. All adverse events and the radiological results and their clinical correlations were analyzed statistically (using α = 5% and 95% confidence intervals).Results Following FRSA, 68 patients were included (mean age: 72.5 years, mean FU: 46 months). Forty-two underwent primary RSA (PRSA), 26 revision RSA (SRSA). Adverse advents were observed in 13% (n = 9/68).No statistically significant results were found in PRSA and SRSA in effect sizes by scores, whereby the failed osteosynthesis SRSA subgroup obtained significantly negative values in ROM subzones (flexion: p = .046, abduction: p = .037). Decreased tubercle healings in PRSA relative to SRSA were observed (p = .006). A missing bony healing of the tubercles was related to significant negative clinical outcome (all scores: p < .05, external rotation: p = .019). In SRSA, significant postoperative improvements could be stated (CS: 23 to 56 at mean, p = .001), the time from index surgery to operative revision revealed no associations in functional findings.Conclusions RSA is an effective option in severe shoulder fracture management with predictable results as salvage as well as first-line treatment. Promising mid-term functional results, reasonable implant survival rates, and a high patient satisfaction could be achieved.Trial RegistrationNot applicable, level of evidence III.

1. 1. This CT study was designed to assess brain morphology in 21 patients with agoraphobia and 21 normal control subjects matched for age and sex. 2. 2. Internal and external CSF spaces were evaluated by qualitative assessment on a 3-point scale (normal, questionable, abnormal). 3. 3. Patients showed bilateral enlargement of prefrontal CSF spaces (p