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Lower limb injuries

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https://www.readbyqxmd.com/read/28344966/lower-limb-compartment-syndrome-by-reperfusion-injury-after-treatment-of-arterial-thrombosis-post-laparoscopic-radical-hysterectomy-and-pelvic-lymph-node-dissection-for-cervical-cancer
#1
Jihee Yeon, Ye Won Jung, Shin Seok Yang, Byung Hun Kang, Mina Lee, Young Bok Ko, Jung Bo Yang, Ki Hwan Lee, Heon Jong Yoo
Compartment syndrome is a clinical condition associated with decreased blood circulation that can lead to swelling of tissue in limited space. Several factors including lithotomy position, prolonged surgery, intermittent pneumatic compressor, and reperfusion after treatment of arterial thrombosis may contribute to compartment syndrome. However, compartment syndrome rarely occurs after gynecologic surgery. In this case, the patient was diagnosed as compartment syndrome due to reperfusion injury after treatment of arterial thrombosis, which occurred after laparoscopic radical hysterectomy and pelvic lymph node dissection for cervical cancer...
March 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28344944/human-bite-injuries-on-the-jos-plateau
#2
B T Ugwu
BACKGROUND: Human bite injuries with the associated morbidity are not uncommon in this environment. OBJECTIVE: To determine the pattern, management modalities and treatment outcome of human bites in Jos, Plateau State, Nigeria. DESIGN: A prospective study of all human bite injuries managed at the Jos University Teaching Hospital, Jos, Nigeria between January 2012 and December 2014. SETTING: Jos University Teaching Hospital, Jos, Nigeria...
April 2016: Journal of the West African College of Surgeons
https://www.readbyqxmd.com/read/28339445/transforaminal-endoscopic-decompression-for-a-giant-epidural-gas-containing-pseudocyst-a-case-report-and-literature-review
#3
Bin Zhu, Liang Jiang, Xiao Guang Liu
The isolated epidural gas-containing pseudocyst is an uncommon pathogenic factor for severe pain of the lower limb as a result of nerve root compression. After reviewing these rare cases reported in the literature, we found that the name, pathogenesis, and treatment strategy of this pathology remained controversial. The most common treatment is conservative treatment or percutaneous aspiration which might result inpoor pain relief and high recurrence rates. Moreover, the patient who received open surgery had good clinical outcome; however, he or she might experience a significant soft tissue injury...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338589/managing-hip-fracture-and-lower-limb-surgery-in-the-emergency-setting-potential-role-of-non-vitamin-k-antagonist-oral-anticoagulants
#4
William Fisher
Trauma, immobilization, and subsequent surgery of the hip and lower limb are associated with a high risk of developing venous thromboembolism (VTE). Individuals undergoing hip fracture surgery (HFS) have the highest rates of VTE among orthopedic surgery and trauma patients. The risk of VTE depends on the type and location of the lower limb injury. Current international guidelines recommend routine pharmacological thromboprophylaxis based on treatment with heparins, fondaparinux, dose-adjusted vitamin K antagonists and acetylsalicylic acid for patients undergoing emergency HFS; however, not all guidelines recommend pharmacological prophylaxis for patients with lower limb injuries...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338437/contralateral-peripheral-neurotization-for-a-hemiplegic-hindlimb-after-central-neurological-injury
#5
Mou-Xiong Zheng, Xu-Yun Hua, Su Jiang, Yan-Qun Qiu, Yun-Dong Shen, Wen-Dong Xu
OBJECTIVE Contralateral peripheral neurotization surgery has been successfully applied to rescue motor function of the hemiplegic upper extremity in patients with central neurological injury (CNI). It may contribute to strengthened neural pathways between the contralesional cortex and paretic limbs. However, the effect of this surgery in the lower extremities remains unknown. In the present study the authors explored the effectiveness and safety of contralateral peripheral neurotization in treating a hemiplegic lower extremity following CNI in adult rats...
March 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28331020/isolated-lower-limb-hypoplasia-secondary-to-congenital-varicella-syndrome-a-rare-occurrence-and-management-of-its-complications
#6
Sneha Mehta, Willem Schenk, Stephen Kirker, Amit Atrey
Isolated lower limb hypoplasia is a rare consequence of maternal congenital varicella syndrome (CVS). The hypoplastic limb is susceptible to multiple injuries, including fractures, especially if there is associated muscle weakness and lack of sensation. We describe a unique index case of a woman aged 26 years with a background of CVS who presented with a distal femur fracture following a fall onto her insensate, hypoplastic right leg. This report highlights the complexities involved in the diagnosis and management of fractures in patients with an anaesthetic limb, and in particular describes limb amputation as a successful treatment modality for distal femur fractures...
March 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28329231/cardiac-protective-effects-of-remote-ischaemic-preconditioning-in-children-undergoing-tetralogy-of-fallot-repair-surgery-a-randomized-controlled-trial
#7
Qingping Wu, Tingting Wang, Shiqiang Chen, Quanjun Zhou, Haobo Li, Na Hu, Yinglu Feng, Nianguo Dong, Shanglong Yao, Zhengyuan Xia
Aims: Remote ischaemic preconditioning (RIPC) by inducing brief ischaemia in distant tissues protects the heart against myocardial ischaemia-reperfusion injury (IRI) in children undergoing open-heart surgery, although its effectiveness in adults with comorbidities is controversial. The effectiveness and mechanism of RIPC with respect to myocardial IRI in children with tetralogy of Fallot (ToF), a severe cyanotic congenital cardiac disease, undergoing open heart surgery are unclear. We hypothesized that RIPC can confer cardioprotection in children undergoing ToF repair surgery...
February 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28325673/lower-limb-dynamics-and-clinical-outcomes-for-habitually-shod-runners-who-transition-to-barefoot-running
#8
Rami Hashish, Sachithra D Samarawickrame, Susan Sigward, Stanley P Azen, George J Salem
OBJECTIVES: Recent investigations have revealed lower vertical loading rates and knee energy absorption amongst experienced barefoot runners relative to those who rear-foot strike (RFS). Although this has led to an adoption of barefoot running amongst many recreational shoe runners, recent investigations indicate that the experienced barefoot pattern is not immediately realized. Therefore, the purpose this investigation was to quantify changes in lower-extremity dynamics and clinical outcomes measures for habitually shod runners who perform a transition to barefoot running...
December 10, 2016: Physical Therapy in Sport
https://www.readbyqxmd.com/read/28324946/characterization-of-motor-cortex-activity-of-the-lower-limb-region
#9
Fadi Mikhail, Karthikeyan Balasubramanian, Matthew D Best, Kazutaka Takahashi, Nicholas G Hatsopoulos
Understanding the functional properties of the motor cortex is a key step to developing effective neuroprosthetic and computer interfaces for amputees and patients with spinal cord injury. Most efforts have been directed towards studying the upper limb region of the motor cortex. Little has been done in the way of addressing lower limb motor cortical physiology. In this study, we implanted multiple microelectrode arrays along the central sulcus in the primary motor cortex of a macaque monkey. Using intracortical microstimulation, we identified neurons that evoked leg movements, either exclusively or mostly, and we studied their firing activity during a center-out arm movement task...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28324353/the-fast-d-protocol-a-simple-method-to-rule-out-traumatic-vascular-injuries-of-the-lower-extremities
#10
Miguel Angel Montorfano, Lisandro Miguel Montorfano, Federico Perez Quirante, Federico Rodríguez, Leonardo Vera, Luca Neri
BACKGROUND: The aim of this study is to assess the accuracy of a Fast Doppler protocol for the examination of an injured lower limb, namely 2-Point Fast Doppler (2PFD), in order to rapidly triage arterial lesions after penetrating trauma. METHODS: The presence of flow and the aspects of the Doppler waveform of the dorsalis pedis artery (DPA) and posterior tibial artery (PTA) of the injured lower limb (2PFD) were evaluated immediately before the execution of a standardized Color Duplex Doppler (SD) evaluation in 149 limbs of 140 patients with gunshot penetrating injuries...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28324130/the-oblique-popliteal-ligament-an-anatomic-and-mri-investigation
#11
Mandy Hedderwick, Mark D Stringer, Liam McRedmond, Grant R Meikle, Stephanie J Woodley
PURPOSE: Despite being the largest ligament on the posterior aspect of the knee, relatively little is known about the normal morphology of the oblique popliteal ligament (OPL). The aim of this study was to investigate the detailed anatomy of the OPL in cadavers and healthy volunteers. METHODS: The posterior knee was investigated in 25 cadaver lower limbs (mean age 76 ± 9.5 years; 7 men) by dissection, histology, and serial plastination and in 14 healthy individuals (mean age 23 ± 3...
March 21, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#12
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#13
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323136/self-reported-knee-pain-and-disability-among-healthy-individuals-reference-data-and-factors-associated-with-the-knee-injury-and-osteoarthritis-outcome-score-koos-and-koos-child
#14
Jennifer N Baldwin, Marnee J McKay, Claire E Hiller, Niamh Moloney, Elizabeth J Nightingale, Joshua Burns
OBJECTIVE: To develop normative reference data for the Knee injury and Osteoarthritis Outcome Score (KOOS) and KOOS-Child, as well as investigate socio-demographic, psychological and physical factors associated with knee pain and disability among healthy adults. METHOD: The KOOS or KOOS-Child (each containing five subscales) was administered to participants aged 8-101 years within the 1000 Norms Project, an observational study of 1000 self-reported healthy individuals...
March 16, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28321477/total-knee-arthroplasty-after-varus-distal-femoral-osteotomy-vs-native-knee-similar-results-in-a-case-control-study
#15
Romain Gaillard, Timothy Lording, Sebastien Lustig, Elvire Servien, Philippe Neyret
PURPOSE: The aim of this study was to investigate the results of total knee arthroplasty (TKA) performed after varus distal femoral osteotomy (VrDFO), in comparison to a control group of TKAs performed as the primary intervention for arthrosis. Main hypothesis was that the medium term results for the two groups would be similar. METHODS: All TKAs performed after VrDFO were extracted from a single centre, prospective database of 4046 arthroplasties. A case-control study was performed with a control group comprising two TKAs performed as the primary intervention for each TKA after VrDFO, and matched for sex, age at intervention, body mass index, the type of arthrosis and the type of implant...
March 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#16
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28320371/possible-factors-influencing-the-duration-of-hospital-stay-in-patients-with-psychiatric-disorders-attempting-suicide-by-jumping
#17
Tsubasa Omi, Hiroshi Ito, Keisen Riku, Koji Kanai, Hiromune Takada, Satoshi Fujimi, Hidenori Matsunaga, Kazutaka Ohi
BACKGROUND: Patients with psychiatric disorders have a high rate of suicide. The present study investigated factors influencing hospital stays for Japanese patients with psychiatric disorders attempting suicide by jumping. METHODS: We diagnosed all suicide attempts (n = 113) by jumping based on the International Classification of Diseases 10th Revision (ICD-10) and investigated the mean hospital stays of patients with each diagnosis based on the ICD-10 code. We then analyzed differences in the demographic and clinical characteristics between the diagnostic groups to identify factors influencing the duration of hospital stay...
March 20, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28316167/-influences-of-high-voltage-electrical-burns-on-microcirculation-perfusion-on-serosal-surface-of-small-intestine-of-rats-and-the-interventional-effects-of-pentoxifylline
#18
Q F Zhang, S J Xu, L M Liang, J K Feng, Y F Xu, L L Tu
Objective: To investigate influences of high-voltage electrical burns on microcirculation perfusion on serosal surface of small intestine of rats and the interventional effects of pentoxifylline (PTX). Methods: Totally 180 SD rats were divided into sham injury group, simple electrical burn group, and treatment group according to the random number table, with 60 rats in each group. The electrical current was applied to the outside proximal part of left forelimb of rats and exited from the outside proximal part of right hind limb of rats...
March 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28315725/vibration-training-after-chronic-spinal-cord-injury-evidence-for-persistent-segmental-plasticity
#19
Chu-Ling Yen, Colleen L McHenry, Michael A Petrie, Shauna Dudley-Javoroski, Richard K Shields
H-reflex paired-pulse depression is gradually lost within the first year post-SCI, a process believed to reflect reorganization of segmental interneurons after the loss of normal descending (cortical) inhibition. This reorganization co-varies in time with the development of involuntary spasms and spasticity. The purpose of this study is to determine whether long-term vibration training may initiate the return of H-reflex paired-pulse depression in individuals with chronic, complete SCI. Five men with SCI received twice-weekly vibration training (30Hz, 0...
March 15, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#20
Elizabeth Russell Esposito, Daniel J Stinner, John R Fergason, Jason M Wilken
BACKGROUND: Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. PURPOSE: To compare gait biomechanics after lower limb reconstruction and transtibial amputation. METHODS: Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length...
February 21, 2017: Gait & Posture
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