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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#1
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#2
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28914827/-endovascular-surgery-for-critical-ischemia-of-lower-extremities-with-suppurative-necrotic-lesion-of-the-feet
#3
K V Lipatov, S V Permyakov, A G Asatryan, A V Borodin, V K Gostishchev
AIM: To improve treatment of patients with grade IV chronic ischemia of lower extremities via endovascular angioplasty combined with surgical methods for suppurative-necrotic lesions of the feet. MATERIAL AND METHODS: 51 patients with grade IV chronic ischemia of lower extremities underwent endovascular interventions (balloon angioplasty, stenting). A total of 23 stents were deployed in 16 patients including 12 stents in superficial and common femoral arteries, 5 in popliteal artery, 6 in iliac artery...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28887236/iatrogenic-major-venous-injury-is-associated-with-increased-morbidity-of-aortic-reconstruction
#4
Sachinder S Hans, Steven Vang, Gul Sachwani-Daswani
BACKGROUND: Major venous injury during open aortic reconstruction though uncommon often result in sudden and massive blood loss resulting in increased morbidity and mortality. This study details the etiology, management, and outcome of such injuries. METHODS: A retrospective review of 945 patients (1981-2017) undergoing aortic reconstruction from 2 mid-sized (350 bed teaching hospitals). Seven hundred twenty-three patients (76.5%) underwent open abdominal aortic aneurysm (AAA) repair/iliac aneurysm repair, 222 patients (23...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885203/vascular-malformations-of-upper-and-lower-extremity-from-radiological-interventional-therapy-to-surgical-soft-tissue-reconstruction-an-interdisciplinary-treatment
#5
M Ranieri, W Wohlgemuth, R Müller-Wille, L Prantl, A Kehrer, S Geis, S Klein, P Lamby, D Schiltz, W Uller, T Aung, J H Dolderer
This article presents our experience in managing peripheral vascular malformations over a 4-years period in a series of 46 patients treated in our Interdisciplinary Center of Vascular Anomalies at University of Regensburg. The patients presented vascular malformations of upper and lower extremity and were selected from our prospective vascular anomalies file archive from 2012 to 2016.The purpose of this study was to review combined embolotherapy, sclerotherapy (embolo/sclerotherapy), and surgical procedures (surgical excision and soft tissue reconstruction) to manage vascular malformations...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28882491/anatomic-and-high-resolution-computed-tomographic-angiography-study-of-the-lateral-femoral-condyle-flap-implications-for-surgical-dissection
#6
Mohamed Morsy, Yoo Joon Sur, Osman Akdag, Amr Eisa, Tarek A El-Gammal, Nirusha Lachman, Steven L Moran
BACKGROUND: The lateral femoral condyle (LFC) flap is a vascularized bone flap based on the superior lateral genicular artery (SLGA). Harvest technique for this flap has not yet been demonstrated. The purpose of this study was to better delineate the blood supply to the bone and skin of this flap to allow for a safe and effective harvest. MATERIALS AND METHODS: Twenty-three lower extremities were injected with latex or a mixture of latex and barium sulfate. The SLGA was identified and dissected, documenting the course, diameter, anatomical relations, length, and branches...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28873059/traction-assisted-internal-negative-pressure-wound-therapy-with-bridging-retention-sutures-to-facilitate-staged-closure-of-high-risk-wounds-under-tension
#7
Michael V DeFazio, James M Economides, Ersilia L Anghel, Ryan K Mathis, John R Barbour, Christopher E Attinger
BACKGROUND/OBJECTIVE: Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. MATERIALS AND METHODS: Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28862529/an-algorithmic-approach-to-rehabilitation-following-arthroscopic-surgery-for-arthrofibrosis-of-the-knee-a-case-series
#8
Brian J Eckenrode
BACKGROUND AND PURPOSE: Loss of knee range of motion (ROM) has been reported as the most common complication following anterior cruciate ligament reconstruction (ACLR). Arthrofibrosis of the knee, or specifically Cyclops syndrome, has been described as the formation of a scar tissue nodule adjacent to the tibial tunnel of the anterior cruciate ligament (ACL) graft. This lesion often results in loss of knee extension ROM, pain, and impaired function. CASE DESCRIPTIONS: Three consecutive patients were referred to physical therapy following arthroscopic knee surgery for lysis of adhesions of a Cyclops lesion from a previous ACLR...
September 1, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28861738/a-surgical-case-of-radiotherapy-induced-esophageal-perforation-accompanying-pyogenic-spondylodiscitis-a-case-report
#9
Shuntaro Yoshimura, Kazuhiko Mori, Koichiro Kawasaki, Asami Tanabe, Susumu Aikou, Koichi Yagi, Masato Nishida, Hiroharu Yamashita, Sachiyo Nomura, Masayoshi Fukushima, Hideomi Yamashita, Yasuhiro Yamauchi, Yasuyuki Seto
BACKGROUND: Stereotactic body radiotherapy has been a treatment choice for lung cancer, especially in medically inoperable patients. However, the acute and late toxicity to adjacent organs have been reported as an uncommon but severe adverse effect. CASE PRESENTATION: A 65-year-old male was presented with his back pain and pyrexia. He had been followed up for non-small-cell lung cancer, which was treated by the stereotactic body radiotherapy 4 years prior to the current visit...
August 31, 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28861203/differences-between-the-upper-extremity-and-the-lower-extremity-in-reconstruction-using-an-anterolateral-thigh-perforator-flap
#10
Sang Hyun Lee, Jeung Tak Suh, Tae Young Ahn, Sung Min Hong, Hyo Yeol Lee
BACKGROUND: While reconstruction of soft tissue defects is the common purpose, surgical reconstructions of upper extremities and lower extremities have different goals in terms of functional and aesthetic outcomes. The purpose of the current study was to compare and analyze differences between reconstructions of upper extremities and lower extremities using an anterolateral thigh (ALT) flap. METHODS: We analyzed 74 patients who underwent reconstructions of upper extremities and lower extremities using an ALT flap from October 2006 to August 2012 (upper extremities, 45 cases; lower extremities, 29 cases)...
September 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28858400/evaluation-of-389-patients-following-free-flap-lower-extremity-reconstruction-with-respect-to-secondary-refinement-procedures
#11
Dimitra Kotsougiani, Juliana Platte, Amir K Bigdeli, Bernd Hoener, Thomas Kremer, Ulrich Kneser, Leila Harhaus
INTRODUCTION: Primary functional and aesthetic results after free-flap salvage of lower extremities are occasionally suboptimal. The objective of this study was to identify predictors for secondary refinement procedures such as liposuction, dermolipectomy, or direct excision. In addition, patient-reported long-term satisfaction with the final reconstructive result was analyzed. PATIENTS AND METHODS: All patients undergoing free-flap lower extremity salvage between January 2011 and July 2015 were included in a comparative study...
August 31, 2017: Microsurgery
https://www.readbyqxmd.com/read/28857452/quantum-molecular-resonance-technology-in-hard-to-heal-extremity-wounds-histological-and-clinical-results
#12
Marco Fraccalvieri, Marco Salomone, Claudia Di Santo, Erind Ruka, Umberto Morozzo, Stefano Bruschi
Chronic wounds are commonly associated with high morbidity rates due to the patient's need of frequent dressing changes and repeated visits to the outpatient wound clinic. Furthermore, chronic wounds are often characterised by severe pain, which can cause significant disability to the patient. New technologies aim to develop an optimal device to reduce discomfort of the patient and to heal wounds. The device Rexon-age® is introduced for the first time in wound healing, and preliminary data on clinical and histological results are shown...
August 30, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28856360/postpartum-treatment-of-metastatic-recurrent-giant-cell-tumor-of-capitate-bone-of-wrist
#13
Robert L Satcher, Vinod Ravi, Wei-Lien Wang, Scott Oates
Giant cell tumors (GCTs) are aggressive benign lesions that occur in the bone epiphysis. They are most often found in the long bones of the lower extremities. Wrist bone involvement is rare, capitate bone involvement exceedingly rare. Treatment in the wrist usually consists of excision, local adjuvant treatment, and cementing and/or bone grafting. GCTs also metastasize to the lungs; pulmonary lesions are excised and systemic therapy provided. We present the case of a 19-year-old woman with GCT of the capitate bone...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#14
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28809684/combination-of-sharing-matrix-and-image-encryption-for-lossless-k-n-secret-image-sharing
#15
Long Bao, Shuang Yi, Yicong Zhou
This paper first introduces a (k, n)-sharing matrix S(k,n) and its generation algorithm. Mathematical analysis is provided to show its potential for secret image sharing. Combining sharing matrix with image encryption, we further propose a lossless (k, n)-secret image sharing scheme (SMIE-SIS). The chaotic image encryption is extremely sensitive to ciphertext. Little change in the ciphertext will lead to failure of noise-like decrypted results even with right key. Thus, even though sharing matrix will recover part of ciphertext information when less than k secret shares are combined, its missing information will result in a wrong key and a noise-like decryption result, keeping the secret from leakage...
August 10, 2017: IEEE Transactions on Image Processing: a Publication of the IEEE Signal Processing Society
https://www.readbyqxmd.com/read/28804728/relationships-of-muscle-function-and-subjective-knee-function-in-patients-after-acl-reconstruction
#16
Stephan Bodkin, John Goetschius, Jay Hertel, Joe Hart
BACKGROUND: After anterior cruciate ligament reconstruction (ACLR), relationships between objective measures of muscle function and patient-reported outcomes may change over time. Examining these measures at different time frames after surgery may help develop individualized approaches to improve post-ALCR analysis. PURPOSE: To examine the associations between subjective knee function and lower-extremity muscle function in individual patients at various time points after ACLR...
July 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28800252/progressive-changes-in-walking-kinematics-and-kinetics-after-anterior-cruciate-ligament-injury-and-reconstruction-a-review-and-meta-analysis
#17
Lindsay V Slater, Joseph M Hart, Adam R Kelly, Christopher M Kuenze
CONTEXT:   Anterior cruciate ligament (ACL) injury and ACL reconstruction (ACLR) result in persistent alterations in lower extremity movement patterns. The progression of lower extremity biomechanics from the time of injury has not been described. OBJECTIVE:   To compare the 3-dimensional (3D) lower extremity kinematics and kinetics of walking among individuals with ACL deficiency (ACLD), individuals with ACLR, and healthy control participants from 3 to 64 months after ACLR...
August 11, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28777285/3d-modeling-of-lower-extremities-with-biplanar-radiographs-reliability-of-measures-on-subsequent-examinations
#18
David E Westberry, Ashley M Carpenter
BACKGROUND: Biplanar radiography with 3-dimensional (3D) modeling (EOS) provides a comprehensive assessment of lower limb alignment in an upright weight-bearing position with less radiation than conventional radiography. A study was performed to assess the consistency and reliability of 2 lower extremity 3D biplanar radiograph models created at least 1 year apart in a pediatric population. METHODS: All patients who had 2 lower extremity radiographic evaluations with EOS performed at visits a minimum of 1 year apart were reviewed...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28768575/short-term-results-of-the-management-of-severe-bone-defects-in-primary-tka-with-cement-and-k-wires
#19
Muhammet Sadik Bilgen, Gokay Eken, Nejat Guney
OBJECTIVE: The aim of this study was to evaluate the results of cement and kirschner wire augmentation in the management of bone defects in primary TKA. METHODS: Twenty-four patients (10 male, 14 female; mean age: 66 years) with uncontained unilateral medial tibial articular bone defect who underwent TKA between 2010 and 2014 were included in this study. The average follow up time was 33.7 months. Patients were divided to two groups according to the size of the bone defect (Group 1: <20 mm, Group 2: >20 mm)...
July 30, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28767176/sequential-chimeric-medial-femoral-condyle-and-anterolateral-thigh-flow-through-flaps-for-one-stage-reconstructions-of-composite-bone-and-soft-tissue-defects-report-of-three-cases
#20
Dominic Henn, Mohamed H Abouarab, Christoph Hirche, Jochen F Hernekamp, Volker J Schmidt, Ulrich Kneser, Thomas Kremer
Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients...
August 2, 2017: Microsurgery
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