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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28219139/-outcome-of-relaying-anterolateral-thigh-perforator-flap-in-resurfacing-the-donor-site-wound-following-free-anteromedial-thigh-perforator-flap-transfer-for-reconstruction-of-defect-after-oral-tumor-radical-resection
#1
D J Song, Z Li, X Zhou, Y X Zhang, X W Peng, B Zhou, C L Lyu, L C Yang, W Peng
Objective: To observe the outcome of relaying anterolateral thigh (ALT) perforator flap in resurfacing the donor site wound following free anteromedial thigh (AMT) perforator flap transfer for reconstruction of defect after oral tumor radical resection. Methods: From January 2013 to January 2016, 28 patients with oral tumor underwent radical resection in our hospital, leaving defects with size ranged from 6.5 cm×3.5 cm to 11.0 cm×7.5 cm which were reconstructed by free AMT perforator flaps with size ranged from 7...
February 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28216818/limb-salvage-with-microvascular-free-fibula-following-primary-bone-sarcoma-resection
#2
Sahasrabudhe Parag, Panchwagh Yogesh, Jesal Rathod, Panse Nikhil, Jadhav Amit
BACKGROUND: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. MATERIALS AND METHODS: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28216760/vanishing-bone-disease-of-chest-wall-and-spine-with-kyphoscoliosis-and-neurological-deficit-a-case-report-and-review-of-literature
#3
Sudhir Kumar Srivastava, Rishi Anil Aggarwal, Pradip Sharad Nemade, Sunil Krishna Bhoale
Vanishing bone disease is an extremely rare disorder of unknown etiology characterized by idiopathic osteolysis of bone. We describe a case of vanishing bone disease of chest wall and spine with kyphoscoliosis and neurological deficit. A 17-year-old male presented with gradually progressive deformity of back and dorsal compressive myelopathy with nonambulatory power in lower limbs. Radiographs revealed absent 4(th)-7(th) ribs on the right side with dorsal kyphoscoliosis and severe canal narrowing at the apex...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28214485/outcome-of-peripheral-venous-reconstructions-during-tumor-resection
#4
Philip Y Sun, Mark D Fleming, Kendall Stauffer, Manju Kalra, Gustavo Oderich, Thomas Bower, Peter Gloviczki, Randall R DeMartino
OBJECTIVE: Peripheral venous reconstruction surgery may be necessary for appropriate oncologic resection; however, the operative approach and surgical outcomes are not well described. We report our experience with these complex reconstructions to identify best practice. METHODS: We retrospectively reviewed all adult patients who underwent peripheral vein reconstruction for tumor resection at Mayo Clinic, Rochester (2000-2015). Patients were classified into three subgroups by the location: iliac (IL), lower extremity (LE), and upper extremity (UE)...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28203600/do-muscle-strength-deficits-of-the-uninvolved-hip-and-knee-exist-in-young-athletes-before-anterior-cruciate-ligament-reconstruction
#5
Joseph Hannon, Sharon Wang-Price, Shiho Goto, J Craig Garrison, James M Bothwell
BACKGROUND: Muscle strength of the involved limb is known to be decreased after injury. Comparison with the uninvolved limb has become standard of practice to measure progress and for calculation of limb symmetry indices (LSIs) to determine readiness to return to sport. However, some literature suggests strength changes in the uninvolved limb also are present after lower extremity injury. PURPOSE: To examine the uninvolved limb strength in a population of adolescent athletes after an anterior cruciate ligament (ACL) injury and compare strength values with those of the dominant limb in a healthy control group...
January 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28203505/bilateral-sciatic-neuropathy-after-an-autologous-breast-reconstruction-in-a-massive-weight-loss-patient
#6
Ramy Abdel-Naby, Michael Ablavsky, Aleksandr Shteynberg
Perioperative compression neuropathy is a known potential complication of prolonged surgical procedures. Sciatic postoperative neuropathy has rarely been reported. We present a 34-year-old woman who underwent right breast reconstruction with supercharged (venous anastomosis) transverse rectus abdominis flap and developed bilateral sciatic compression neuropathy. Her history was remarkable for sleeve gastrectomy 2 years earlier resulting in 105 pound weight loss 1 year before breast reconstruction. During the procedure, the patient was in the supine position for 8 hours and in the semirecumbent position for an additional 2 hours with the torso flexed at 30 degrees and knees flexed at approximately 45 degrees in addition to standard padding...
January 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28203023/-randomized-controlled-trial-to-superficial-femoral-artery-recanalization-for-lower-extremity-arteriosclerosis-obliterans
#7
J M Zhuang, X Li, T R Li, J Zhao, J Y Luan, C M Wang
OBJECTIVE: To evaluate the safety and effectiveness of neglecting superficial femoral artery (SFA) recanalization for chronic lower extremity arteriosclerosis obliterans (ASO). METHODS: Thirty-six cases treated for severe stenosis or occlusion of superficial femoral artery resulted from ASO were randomly divided into 2 groups. Twenty of them were treated by endovascular reconstruction of superficial femoral artery and the other 16 cases were not treated with their superficial femoral artery, but were only treated with the accompanied iliac and/or profunda femoral artery lesion...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28194713/use-of-compressive-osseointegration-endoprostheses-for-massive-bone-loss-from-tumor-and-failed-arthroplasty-a-viable-option-in-the-upper-extremity
#8
Krista A Goulding, Adam Schwartz, Steven J Hattrup, R Lor Randall, Donald Lee, Damian M Rispoli, Daniel M Lerman, Christopher Beauchamp
BACKGROUND: Endoprostheses using principles of compressive osseointegration have shown good survivorship in several studies involving the lower extremity; however, no series to our knowledge have documented the use of this technology in the management of massive bone loss in the upper limb. QUESTIONS/PURPOSES: (1) What proportion of upper extremity implants using compressive osseointegration fixation principles achieved durable short-term fixation, and what were the modes of failure? (2) What surgical complications resulted from reconstruction using this technique? METHODS: A multiinstitutional retrospective review identified nine patients (five women; four men) who underwent 13 endoprosthetic replacements between 2003 and 2014 using compressive osseointegration (Compliant(®) Pre-stress Device [CPS]; Biomet Inc, Warsaw, IN, USA) in the upper extremity, including two proximal humeri, two humeral diaphyses, seven distal humeri, and two proximal ulna...
February 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28188484/estimation-of-attachment-regions-of-hip-muscles-in-ct-image-using-muscle-attachment-probabilistic-atlas-constructed-from-measurements-in-eight-cadavers
#9
Norio Fukuda, Yoshito Otake, Masaki Takao, Futoshi Yokota, Takeshi Ogawa, Keisuke Uemura, Ryota Nakaya, Kazunori Tamura, Robert B Grupp, Amirhossein Farvardin, Mehran Armand, Nobuhiko Sugano, Yoshinobu Sato
PURPOSE: Patient-specific musculoskeletal biomechanical simulation is useful in preoperative surgical planning and postoperative assessment in orthopedic surgery and rehabilitation medicine. A difficulty in application of the patient-specific musculoskeletal modeling comes from the fact that the muscle attachment regions are typically invisible in CT and MRI. Our purpose is to develop a method for estimating patient-specific muscle attachment regions from 3D medical images and to validate with cadaver experiments...
February 10, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28188471/visualization-of-vascular-injuries-in-extremity-trauma
#10
Kwitae Chong, Chenfanfu Jiang, Daniel Ram, Anand Santhanam, Demetri Terzopoulos, Peyman Benharash, Erik Dutson, Joseph Teran, Jeff D Eldredge
A tandem of particle-based computational methods is adapted to simulate injury and hemorrhage in the human body. In order to ensure anatomical fidelity, a three-dimensional model of a targeted portion of the human body is reconstructed from a dense sequence of CT scans of an anonymized patient. Skin, bone and muscular tissue are distinguished in the imaging data and assigned with their respective material properties. An injury geometry is then generated by simulating the mechanics of a ballistic projectile passing through the anatomical model with the material point method...
February 11, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28182531/relationships-of-functional-tests-following-acl-reconstruction-exploratory-factor-analyses-of-the-lower-extremity-assessment-protocol
#11
Melissa DiFabio, Lindsay V Slater, Grant Norte, John Goetschius, Joseph M Hart, Jay Hertel
CONTEXT: After ACL reconstruction (ACLR), deficits are often assessed using a variety of functional tests, which can be time consuming. It is unknown whether these tests provide redundant or unique information. OBJECTIVE: To explore relationships between components of a battery of functional tests, the Lower Extremity Assessment Protocol (LEAP), to aid in developing the most informative, concise battery of tests for evaluating ACLR patients. DESIGN: Descriptive, cross-sectional...
February 9, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28181915/interlayer-vacancy-defects-in-aa-stacked-bilayer-graphene-density-functional-theory-predictions
#12
Amanda Vuong, Tom Trevethan, Christopher Latham, Chris Ewels, Doğan Erbahar, Patrick Briddon, Mark Rayson, Malcolm Heggie
AA-stacked graphite and closely related structures, where carbon atoms are located in registry in adjacent graphene layers, are a feature of graphitic systems including twisted and folded bilayer graphene, and turbostratic graphite. We present the results of <i>ab initio</i> density functional theory calculations performed to investigate the complexes that are formed from the binding of vacancy defects across neighbouring layers in AA-stacked bilayers. As with AB stacking, the carbon atoms surrounding lattice vacancies can form interlayer structures with sp<sup>2</sup> bonding that are lower in energy than in-plane reconstructions...
February 9, 2017: Journal of Physics. Condensed Matter: An Institute of Physics Journal
https://www.readbyqxmd.com/read/28174445/treadmill-training-with-partial-body-weight-support-after-anterior-cruciate-ligament-reconstruction-a-randomized-controlled-trial
#13
Yuan Luo, Weizhong Shen, Zhong Jiang, Jiao Sha
[Purpose] To compare the effects of treadmill training with partial body weight support (TTPBWS) and conventional physical therapy (PT) on subjects with anterior cruciate ligament reconstructions. [Subjects and Methods] A total of 40 subjects were randomly allocated to either a treatment group or a control group. Subjects received either treadmill training with partial body weight support (treatment group) or conventional physical therapy (control group). The circumferences of the lower extremities, Holden classifications, 10-meter walking times and the International Knee Documentation Committee (IKDC) scores were compared at 12 and 24 weeks post-operation...
December 2016: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28151866/acute-arterial-embolism-of-left-lower-extremity-caused-by-paradoxical-embolism-in-ebstein-s-anomaly-a-case-report
#14
Jun-Sheng Li, Jie Ma, Zi-Xing Yan, Dong-Ming Cheng, Liang Chang, Hai-Chun Zhang, Jiang-Yan Liu
INTRODUCTION: Ebstein's anomaly is a benign and stable congenital heart disease for asymptomatic patients. Despite a low incidence of Ebstein's anomaly (EA), patients' quality of life can be badly affected by EA without positive surgical intervention. Especially EA is associated with other congenital heart disease, such as the atrial septal defect, patent foramen ovale, and arterial embolism exclude other reasons, it is often considered to be the consequence of paradoxical embolism, and surgical intervention must be conducted...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28125537/the-lymphatic-response-to-injury-with-soft-tissue-reconstruction-in-high-energy-open-tibial-fractures-of-the-lower-extremity
#15
Malou C van Zanten, Raakhi M Mistry, Hiroo Suami, Andrew Campbell-Lloyd, James P Finkemeyer, Neil B Piller, Yugesh Caplash
BACKGROUND: Severe compound tibial fractures are associated with extensive soft-tissue damage, resulting in disruption of lymphatic pathways that leave the patient at risk of developing chronic lymphedema. There are limited data on lymphatic response following lower limb trauma. Indocyanine green fluorescence lymphography is a novel, real-time imaging technique for superficial lymphatic mapping. The authors used this technique to image the superficial lymphatic vessels of the lower limbs in patients with severe compound tibial fracture...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28121893/complications-and-long-term-outcomes-of-free-fibula-reconstruction-following-resection-of-a-malignant-tumor-in-the-extremities
#16
Matthew T Houdek, Eric R Wagner, Allen T Bishop, Alexander Y Shin, Peter S Rose, Franklin H Sim, Steven L Moran
BACKGROUND: To achieve limb salvage and provide the patient with a functional extremity, vascularized free fibula transfer has become the workhorse for segmental bony reconstruction. Because of various host factors, there has been a high complication rate following oncologic reconstruction. The authors reviewed the experience of their institution with the use of free fibula reconstruction following an oncologic resection in the extremities. METHODS: The authors reviewed 56 cases of free fibula transfer performed for limb salvage following oncologic resection from 1994 through 2013...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28118229/hospital-transfer-of-open-tibial-fractures-requiring-microsurgical-reconstruction-negatively-impacts-clinical-outcomes
#17
Christopher S Crowe, Anna Luan, Gordon K Lee
INTRODUCTION: Open tibial fractures are orthopedic emergencies that may present with severe soft tissue damage. Free tissue transfer is often required when local tissues are insufficient and patients may require hospital transfer to tertiary care centers for this purpose. Although the negative impact of inter-facility transfer has been well demonstrated in trauma patients, less is known regarding transfers for lower extremity injury patients. This study investigates differences in outcomes based on transfer status after open tibial fracture...
January 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28112431/the-proximal-superficial-femoral-artery-perforator-flap-anatomic-study-and-clinical-cases
#18
Imran Ratanshi, Colin W McInnes, Avinash Islur
BACKGROUND: The upper thigh has provided multiple new soft tissue free flaps in recent decades, including the anterolateral thigh, anteromedial thigh, transverse upper gracilis, the profunda artery perforator, and superficial circumflex iliac perforator flaps. The purpose of this study is to describe a new, reliable free flap option in the upper thigh: the proximal superficial femoral artery perforator (p-SFAP) flap. METHODS: A cadaveric dissection study was performed to confirm clinical landmarks and evaluate pedicle characteristics...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28112411/medial-sural-artery-as-a-salvage-recipient-vessel-for-complex-post-traumatic-microvascular-lower-limb-reconstruction
#19
Amresh Baliarsing, Shivprasad Date, Pedro Ciudad
BACKGROUND: Complex lower extremity trauma still poses a formidable challenge for micro vascular reconstruction. The extensive surrounding zone of trauma can make it difficult to find a suitable recipient pedicle for anastomosis. A need was felt for exploration of newer recipient vessels in lower extremity which could be harnessed for reliable and tension free micro anastomosis. The purpose of the present report is to highlight the possibility of using medial sural artery for safe micro vascular anastomosis in selected scenarios like vessel depleted extremity...
January 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28096384/holocene-enso-related-cyclic-storms-recorded-by-magnetic-minerals-in-speleothems-of-central-china
#20
Zongmin Zhu, Joshua M Feinberg, Shucheng Xie, Mark D Bourne, Chunju Huang, Chaoyong Hu, Hai Cheng
Extreme hydrologic events such as storms and floods have the potential to severely impact modern human society. However, the frequency of storms and their underlying mechanisms are limited by a paucity of suitable proxies, especially in inland areas. Here we present a record of speleothem magnetic minerals to reconstruct paleoprecipitation, including storms, in the eastern Asian monsoon area over the last 8.6 ky. The geophysical parameter IRMsoft-flux represents the flux of soil-derived magnetic minerals preserved in stalagmite HS4, which we correlate with rainfall amount and intensity...
January 31, 2017: Proceedings of the National Academy of Sciences of the United States of America
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