This was a 2020 project; the client was a female orthopaedic surgeon (cool!) in Taichung, Taiwan.
She was troubled then by the task of trying to complete a surgical case report about a patient who developed Horner's syndrome (presenting as drooping of the eyelids and constriction of the pupils) after a serious shoulder injury left her with a fractured clavicle.
It was speculated that the fracture and surrounding hematoma had caused irritation and swelling of the adjacent muscle and somehow affected the nearby sympathetic chain.
The challenge here was to simplify and demonstrate the bizarre chain reaction from the traumatic incident and make it persuasive, so the readers understand easily how such a rare complication could have happened.
The skeletal-muscular structures in this area and the lower neck sympathetic trunk are often mentioned in completely different fields of literature and one do not see them highlighted together often in one single illustration; and thus our references were scarce.
The client had hand-drawn a sketch of what was to be included in the illustration:
The first draft shows the fracture and cervical ganglia; but we feel that the presence of the hematoma was too overly exaggerated and the structure of the picture was a bit loose:
In the second version, we added muscles to fill-in the gaps and decreased the size of the hematoma:
The main point of a compression on the sympathetic neurons was to be emphasized and so swelling of the muscles was amplified. Also, it was important to show which segment of the clavicle was fractured, thereby we decided to include the entire clavicle into the illustration. With a final touch of annotations, voilà:
However after submitting, one of the editors suggested that we put more information in the annotations, so that readers could relate to the anatomical structures mentioned in the article. We managed to finish the task with a few more adjustments here and there...and this is the final FINAL result:
(Congratulations to Dr. Chia-Yu Lin for the marvelous job!!!)
A warm remark from Dr. Lin on social media. Thank you for involving me in this case!
**All the above artworks are customized for and to be used by Dr. Chia-Yu Lin only.
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