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https://www.readbyqxmd.com/read/29762280/long-term-outcomes-of-pedicled-gastrocnemius-flaps-in-total-knee-arthroplasty
#1
Matthew T Houdek, Eric R Wagner, Cody C Wyles, William S Harmsen, Arlen D Hanssen, Michael J Taunton, Steven L Moran
BACKGROUND: Deficient soft tissue following total knee arthroplasty (TKA) can jeopardize outcome. The gastrocnemius flap is an important means of providing coverage of a knee with deficient soft tissue. There is a paucity of long-term studies on the use of the gastrocnemius flap in the setting of TKA. The purpose of this study was to review the outcomes after the use of pedicled gastrocnemius flaps for coverage of a soft-tissue defect at the time of TKA. METHODS: Eighty-three patients in whom a gastrocnemius flap had been used to cover the site of a primary (n = 18) or revision (n = 65) TKA over a 25-year period were identified...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29753571/subway-related-trauma-an-urban-public-health-issue-with-a-high-case-fatality-rate
#2
Simon G Rodier, Charles J DiMaggio, Stephen Wall, Vasiliy Sim, Spiros G Frangos, Patricia Ayoung-Chee, Marko Bukur, Manish Tandon, S Rob Todd, Gary T Marshall
BACKGROUND: Between 1990 and 2003, there were 668 subway-related fatalities in New York City. However, subway-related trauma remains an understudied area of injury-related morbidity and mortality. OBJECTIVE: The objective of this study was to characterize the injuries and events leading up to the injuries of all patients admitted after subway-related trauma. METHODS: We conducted a retrospective case series of subway-related trauma at a Level I trauma center from 2001 to 2016...
May 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29701487/patient-preferences-for-diabetes-related-complications-in-taiwan
#3
Yi-Ju Lin, Chin-Yuan Wang, Ssu-Wei Cheng, Yu Ko
BACKGROUND: As the prevalence of diabetes mellitus (DM) continues to increase rapidly, there has been a rising need not only to assess the clinical outcomes but also the impact of DM on the health-related quality of life (HRQoL) of affected individuals. Most previous studies have found that having complications is strongly associated with decreased HRQoL in DM patients. As such, it is crucial to measure individuals' preferences for DM-related complications in order to assess the magnitude of complications' effect on overall HRQoL...
April 27, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29689575/investigating-patients-perception-of-microvascular-free-toe-flap-for-reconstruction-of-amputated-thumbs-a-guide-for-surgeons-during-informed-consent
#4
Johnny Ionut Efanov, Christopher Wong, Clarence Guilbault, Joseph Bou-Merhi, Patrick G Harris, Ali Izadpanah, Michel Alain Danino
BACKGROUND:  After thumb amputations, restoration of function and aesthetic can be accomplished with microvascular free toe flaps. However, many patients in clinical practice do not choose this reconstruction despite positive reported outcomes. This study aims to determine patients' perceptions with respect to free toe flaps to improve areas of informed consent. METHODS:  A retrospective survey was administered to patients with thumb amputations. Participants were required to complete a questionnaire about patient demographics, the Brief Michigan Hand Questionnaire (bMHQ), the standard gamble/time trade-off questionnaires for utility scores, and a questionnaire investigating potential reasons for electing not to undergo a free toe transfer...
April 24, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29653108/validation-of-the-narrowing-beam-walking-test-in-lower-limb-prosthesis-users
#5
Andrew Sawers, Brian Hafner
OBJECTIVE: To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. DESIGN: Cross-sectional study. SETTING: Research laboratory and prosthetics clinic. PARTICIPANTS: Forty unilateral transtibial and transfemoral prosthesis users. INTERVENTION: Not applicable. MAIN OUTCOME MEASURE(S): Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (i...
April 10, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29602580/effects-of-chronic-kidney-disease-on-clinical-outcomes-in-patients-with-peripheral-artery-disease-undergoing-endovascular-treatment-analysis-from-the-k-vis-ella-registry
#6
Hyung Oh Kim, Jae-Min Kim, Jong Shin Woo, Donghoon Choi, Young-Guk Ko, Chul-Min Ahn, Seung-Whan Lee, Jae-Hwan Lee, Seung-Hyuk Choi, Cheol Woong Yu, Pil-Ki Min, Chang-Hwan Yoon, In-Ho Chae, Sang-Rok Lee, Yoon Seok Koh, Weon Kim
OBJECTIVES: Chronic kidney disease (CKD) is a risk factor for peripheral artery disease (PAD), but the impact of CKD in PAD patients who received endovascular treatment (EVT) is not well studied. Aim of this study is to clarify the impact of CKD in patients with PAD in real EVT era. METHODS: Using the Korean Vascular Intervention Society (K-VIS) endovascular therapy in lower limb artery disease registry (ELLA) registry, we analyzed 3434 patients who underwent EVT...
March 23, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29589494/intercalary-reconstruction-of-the-femur-after-tumour-resection
#7
D A Campanacci, F Totti, S Puccini, G Beltrami, G Scoccianti, L Delcroix, M Innocenti, R Capanna
Aims After intercalary resection of a bone tumour from the femur, reconstruction with a vascularized fibular graft (VFG) and massive allograft is considered a reliable method of treatment. However, little is known about the long-term outcome of this procedure. The aims of this study were to determine whether the morbidity of this procedure was comparable to that of other reconstructive techniques, if it was possible to achieve a satisfactory functional result, and whether biological reconstruction with a VFG and massive allograft could achieve a durable, long-lasting reconstruction...
March 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29580119/a-nationwide-cohort-study-of-the-role-of-chads-2-score-in-predicting-lower-extremity-amputation-and-death-among-patients-with-peripheral-arterial-occlusive-disease
#8
Wei-Syun Hu, Cheng-Li Lin
OBJECTIVES: The current study aimed to explore whether the CHADS2 score was predictive of lower extremity amputation (LEA) and death in people with peripheral arterial occlusive disease (PAOD). METHODS: This nationwide cohort came from Taiwan, with 16,888 PAOD patients, from 2000 through 2011, extracted from the Longitudinal Health Insurance Database 2000. Cox proportional hazard regression models were employed to identify the LEA and mortality risk according to CHADS2 score...
March 26, 2018: Aging Male: the Official Journal of the International Society for the Study of the Aging Male
https://www.readbyqxmd.com/read/29574036/prognostic-scoring-system-for-patients-undergoing-reconstructive-foot-and-ankle-surgery-for-charcot-neuroarthropathy-the-charcot-reconstruction-preoperative-prognostic-score
#9
David Rettedal, Alissa Parker, Adam Popchak, Patrick R Burns
Charcot neuroarthropathy is a destructive process that occurs in patients with peripheral neuropathy, often due to poorly controlled diabetes mellitus. Surgical reconstruction can be necessary to provide a plantigrade foot that is wound free. A risk of major amputation exists after a Charcot event and after attempted reconstruction. We retrospectively reviewed the data from 34 patients (36 reconstructions) who had undergone reconstructive surgery for Charcot neuroarthropathy. The mean patient age was 56.44 years...
May 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29567029/through-knee-amputation-is-a-feasible-alternative-to-above-knee-amputation
#10
Sungho Lim, Michael J Javorski, Pegge M Halandras, Bernadette Aulivola, Paul R Crisostomo
OBJECTIVE: Through-knee amputation (TKA) is a rare amputation performed in <2% of all major lower extremity amputations in the United States. Despite biomechanical benefits and improved rehabilitation compared with above-knee amputation (AKA), TKA has largely been abandoned by vascular surgeons because of concerns for poor wound healing. The purpose of this study was to evaluate surgical outcomes of TKA. METHODS: The American College of Surgeons National Surgical Quality Improvement Program between 2005 and 2012 was queried using Current Procedural Terminology codes indicating AKA and TKA...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29561340/validation-of-the-healthy-foot-screen-a-novel-assessment-tool-for-common-clinical-abnormalities
#11
Reneeka Persaud, Patricia M Coutts, Alisa Brandon, Luvneet Verma, James A Elliott, R Gary Sibbald
GENERAL PURPOSE: The purpose of this learning activity is to provide information about the Healthy Foot Screen, a new tool for assessment of common foot abnormalities. TARGET AUDIENCE: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:1...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29555530/negative-pressure-wound-therapy-versus-conventional-wound-dressings-in-treatment-of-open-fractures-a-systematic-review-and-meta-analysis
#12
REVIEW
Xi Liu, Hui Zhang, Shiqiang Cen, Fuguo Huang
BACKGROUND: Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings. METHODS: A systematic search was performed in Pubmed, Cochrane Library, Embase, and Google Scholar for the published relevant clinical studies...
March 16, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29535941/effectiveness-of-a-patient-education-module-on-diabetic-foot-care-in-outpatient-setting-an-open-label-randomized-controlled-study
#13
Hammadur Sk Rahaman, Viveka P Jyotsna, V Sreenivas, Anand Krishnan, Nikhil Tandon
Background: A large number of patients with diabetes mellitus are unaware of foot care and are at risk of developing foot ulcer and amputation. This increases healthcare burden due to preventable complication of diabetes. Aims: We conducted this study to assess the effectiveness of a foot care education module for diabetes developed by us. Materials and Methods: One hundred and twenty-seven patients with diabetes mellitus attending our outpatient were randomized into intervention ( n = 63) and control groups ( n = 64)...
January 2018: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29518503/early-outcomes-following-endovascular-open-surgical-and-hybrid-revascularization-for-lower-extremity-acute-limb-ischemia
#14
Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
BACKGROUND: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization (HyR) in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare the outcomes of endovascular, open surgical, and HyR for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or HyR for ALI deemed at high risk of limb loss if not treated within 24 hr (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29483763/evaluation-of-experience-with-lower-extremity-arterial-injuries-at-an-urban-trauma-center
#15
Christopher Tanga, Randall Franz, Joshua Hill, Michael Lieber, John Galante
Lower extremity arterial injuries (LEAIs) can be complicated injuries resulting in limb loss and death. Patients with LEAI often have multiple injuries increasing the risk for morbidity and mortality. We sought to evaluate the incidence and management of LEAI and to define associations between injuries and outcomes. We performed a retrospective review of LEAI at an urban level-1 trauma center from April 2005 to April 2015. Chi-square tests were used to compare independent groups with respect to mortality and amputation...
March 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29481944/prior-endovascular-intervention-is-not-detrimental-to-pedal-bypasses-for-ischemic-wounds
#16
Abhisekh Mohapatra, Mikayla N Lowenkamp, Jon C Henry, Aureline Boitet, Efthimios D Avgerinos, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
BACKGROUND: Endovascular strategies are often preferred for revascularization of ischemic foot wounds secondary to infrapopliteal disease because of the less invasive technique and faster recovery. Bypass is typically reserved for failures or lesions not amenable to balloon angioplasty. However, the effects of an endovascular-first approach on subsequent bypass grafts are largely unknown. This study evaluates the effects of prior endovascular tibial interventions (PTIs) on successive bypasses to pedal targets...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29480890/is-total-femur-replacement-a-reliable-treatment-option-for-patients-with-metastatic-carcinoma-of-the-femur
#17
Florian Sevelda, Wenzel Waldstein, Joannis Panotopoulos, Alexandra Kaider, Philipp Theodor Funovics, Reinhard Windhager
BACKGROUND: The majority of metastatic bone lesions to the femoral bone can be treated without surgery or with minimally invasive intramedullary nailing. In rare patients with extensive metastatic disease to the femur, total femur replacement may be the only surgical alternative to amputation; however, little is known about this approach. QUESTIONS/PURPOSES: In a highly selected small group of patients with metastatic carcinoma of the femur, we asked: (1) What was the patient survivorship after this treatment? (2) What was the implant survivorship free from all-cause revision and amputation, and what complications were associated with this treatment? (3) What functional outcomes were achieved by patients after total femur replacement for this indication? METHODS: Eleven patients (three men, eight women) with a mean age of 64 years (range, 41-78 years) received total femur replacements between 1986 and 2016; none were lost to followup...
May 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29452439/assessment-of-function-after-free-tissue-transfer-to-the-lower-extremity-for-chronic-wounds-using-the-lower-extremity-functional-scale
#18
Reuben A Falola, Chrisovalantis Lakhiani, Jocelyn Green, Siya Patil, Brandon Jackson, Rachel Bratescu, Ersilia Anghel, John S Steinberg, Paul J Kim, Christopher E Attinger, Karen K Evans
BACKGROUND:  Free tissue transfer is one option for preservation of form and function in the native limb, in the setting of soft tissue paucity. However, the data on patient functionality after microvascular intervention is inconsistently reported. The Lower Extremity Function Scale (LEFS) measures patient-reported difficulty in carrying out 20 physical activities, on a Likert scale, the sum of which correlates with descriptive functional stages of 1-5. We assess limb functionality in this cohort of microvascular patients using the LEFS survey...
February 16, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29443850/does-an-algorithmic-approach-to-using-brachytherapy-and-external-beam-radiation-result-in-good-function-local-control-rates-and-low-morbidity-in-patients-with-extremity-soft-tissue-sarcoma
#19
Jason Klein, Alex Ghasem, Samuel Huntley, Nathan Donaldson, Martin Keisch, Sheila Conway
BACKGROUND: High-dose-rate brachytherapy (HDR-BT) and external-beam radiation therapy (EBRT) are two modalities used in the treatment of soft tissue sarcoma. Previous work at our institution showed early complications and outcomes for patients treated with HDR-BT, EBRT, or a combination of both radiation therapy modalities. As the general indications for each of these approaches to radiation therapy differ, it is important to evaluate the use of each in an algorithmic way, reflecting how they are used in contemporary practice at sites that use these treatments...
March 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29421428/cryopreserved-homografts-in-infected-infrainguinal-fields-are-associated-with-frequent-reinterventions-and-poor-amputation-free-survival
#20
S Keisin Wang, Ashley R Gutwein, Natalie A Drucker, Michael P Murphy, Andres Fajardo, Michael C Dalsing, Raghu L Motaganahalli, Gary W Lemmon
BACKGROUND: Single-length saphenous vein continues to be the conduit of choice in infected-field critical limb ischemia. However, half of these individuals have inadequate vein secondary to previous use or chronic venous disease. We reviewed our outcomes of infected-field infrainguinal bypasses performed with cryopreserved homografts (CHs), a widely accepted alternative to autogenous vein in this setting. METHODS: This is a retrospective, institutional descriptive analysis of infected-field infrainguinal revascularizations between 2012 and 2015...
February 5, 2018: Annals of Vascular Surgery
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