The objectives of the present study were to find the prevalence of foramen of Vesalius and to discuss its morphology. The embryological basis of this foramen and its surgical highlights are emphasized. The study comprised 78 human adult dried skulls, which were obtained from the anatomy laboratory of our institution. The greater wing of the sphenoid bone was macroscopically observed for the presence of foramen of Vesalius. It was observed that the foramen was present in 29 skulls (37.2%). It was seen bilaterally in 13 (16.7%) skulls and unilaterally in 16 (20.5%) specimens.Anatomical literature has explained the variation of this foramen by the developmental considerations. We believe that the details of this foramen are known to have significant implications for the medical and surgical literature. The details are also enlightening to the clinical anatomists and other broad specialties of medicine.This sphenoidal emissary foramen contains a bridging vein, which connects the pterygoid venous plexus with the cavernous sinus. This communication is clinically important, since an extra cranial infection may sometimes reach the cavernous sinus through this foramen, which may lead to cavernous sinus thrombosis. Foramen of Vesalius can get injured during the trigeminal nerve block technique performed for the trigeminal neuralgia. In this procedure, the foramen can get hurt by a displaced instrument, which would end up in intracranial bleeding, which can spread the extracranal infection into the cavernous sinus. This may lead to serious disorders like Tolosa Hunt and Gradenigo syndromes. Keywords: Foramen ovale, middle cranial fossa, morphology, skull base, sphenoid bone
Sphenoid Bon

Introduction: The acromioclavicular joint (ACJ) is a major link connecting the upper limb to the torso. The acromioclavicular and coracoclavicular (CC) ligaments help in stabilising the joint. We feel it is prudent to address both these ligament injuries, to achieve optimum result. This study was undertaken to analyse the results of a simple frugal surgical technique we used to deal with this injury considering stabilisation for both these ligaments. Materials and methods: In this retrospective study, skeletally mature patients with Type III, IV or V ACJ dislocations who underwent open reduction and stabilisation of the joint with temporary K-wires, repair of the capsule and augmentation of CC ligaments with suture anchors were included. Clinico-radiological and functional outcome was evaluated. Functional assessment of the upper limb was analysed using the Disabilities of Arm, Shoulder, and Hand Score (DASH), Constant shoulder score (CSS) and Oxford shoulder score (OSS). Results: Clinical and radiological evaluation of the 32 patients who had completed two years from the index surgery, was done. Out of the 37 patients included initially, five were lost in follow-up. Majority of the subjects included were males and type V was the most common injury. Mean pre-operative CC distance on the affected side was 13.92±4.94mm. In the immediate post-operative radiograph, it was 7.63±2.08mm and in the final follow- up was 9.36±2.75mm. Measurements were taken by two independent investigators and inter, and intra-observer reliability were analysed by Interclass correlation coefficient. Excellent functional outcome was noted despite the 1.81±1.50mm average loss of correction. At final followup, mean DASH score was 4.67±4.18, Oxford shoulder score was 44.06±2.44 and Constant shoulder score was 86.37±5.81. The severity of the injury had no significant effect on the functional outcome post our method of stabilisation and rehabilitation. Conclusion: Bifocal fixation restores the multidirectional stability of the disrupted ACJ. Adequate radiological reduction, good functional outcome and simplicity of execution make this technique an undemanding one for use in regular practice.