Space of Poirier

*Space of Poirier:

Diagram of arcuate ligament (greater arc, zone of fractures and dislocations),
lesser arc (zone of dislocations), and
space of Poirier (vulnerable zone between greater and lesser arcs),

superimposed on wrist radiograph.

>Fibers of radioscaphocapitate ligament (yellow) and
ulnocapitate ligament (purple) interdigitate and form an arclike ligamentous structure, termed the arcuate ligament, in the greater arc region (black line). Note lesser arc that outlines the lunate (dashed red line).
>The scapholunate ligament and lunotriquetral ligament are part of the lesser arc, which does not extend to the distal radius and ulna.

*{The space of Poirier (white arrows) is located between the lesser and greater arcs.}

Comment on the xray & the implantation done

It’s an post op xray of kochs disease of C1,C2,C3 +AAD.
Titanium wire fixation done with an iliac grafting.

Evaluation of patients with musculoskeletal complaints from Harrison’s principles

Approach:

1.Anatomic localization of complaint (articular vs nonarticular)
2.Determination of the nature of pathologic process (inflammatory vs noninflammatory)
3.Determination of the extent of involvement (monoarticular va polyarticular, focal, widespread)
4.Determination of chronology (acute vs chronic)
5.Consider the most common disorders first
6.Formulation of a differential diagnosis.