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lower extremity reconstruction

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https://www.readbyqxmd.com/read/27910665/up-down-asymmetry-measurement-of-tungsten-distribution-in-large-helical-device-using-two-extreme-ultraviolet-euv-spectrometers
#1
Y Liu, S Morita, X L Huang, T Oishi, M Goto, H M Zhang
Two space-resolved extreme ultraviolet spectrometers working in wavelength ranges of 10-130 Å and 30-500 Å have been utilized to observe the full vertical profile of tungsten line emissions by simultaneously measuring upper- and lower-half plasmas of LHD, respectively. The radial profile of local emissivity is reconstructed from the measured vertical profile in the overlapped wavelength range of 30-130 Å and the up-down asymmetry is examined against the local emissivity profiles of WXXVIII in the unresolved transition array spectrum...
November 2016: Review of Scientific Instruments
https://www.readbyqxmd.com/read/27904225/the-inferior-medial-genicular-artery-and-its-vascularization-of-the-pes-anserinus-superficialis-a-cadaveric-study
#2
Lena Hirtler, Manuel Ederer, Mike Faber, Patrick Weninger
BACKGROUND: A common method for reconstruction of the anterior cruciate ligament (ACL) is it's replacement by a free avascular graft, using the gracilis and/or semitendinosus tendons. These grafts pass a vulnerable phase in the ligamentization-process during the 1(st) year after reconstruction. The aims of this study were first to evaluate the vascularization of the pes anserinus superficialis (PAS) by the inferior medial genicular artery (IMGA) and second to develop a pedunculated surgical technique for ACL reconstruction, to preserve a maximal amount of natural vascularization of the tendons inserting at the PAS...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27900196/muscle-function-is-associated-with-future-patient-reported-outcomes-in-young-adults-with-acl-injury
#3
Vala Flosadottir, Ewa M Roos, Eva Ageberg
BACKGROUND/AIM: Consequences of an anterior cruciate ligament (ACL) injury include worse patient-reported outcomes (PROs) and a decrease in activity level. Muscle function can be improved by targeted exercise. Our aims were to investigate cross-sectional and longitudinal associations among lower extremity muscle function and PROs after ACL injury. METHODS: Fifty-four participants (15 women, mean 30 years) with ACL injury or reconstruction, from the Knee Anterior Cruciate Ligament, Nonsurgical versus Surgical Treatment (KANON) trial (ISRCTN84752559), were assessed with hop performance, muscle power and postural orientation 3 years (SD 0...
2016: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/27895379/functional-outcomes-after-successful-lower-extremity-arterial-injuries-repair
#4
Ziad Sophie, Lekhraj Mal
The study was conducted to measure functional outcome of patients who had successful lower extremity arterial reconstruction after vascular injury at a tertiary care centre in Karachi over 5 years from January 2008 to December 2013. In this descriptive cohort study, the functional outcomes were assessed with lower extremity functional scale (LEFS). The mean age the 75 patients in the study was 32±11 years. Limb salvage was successful in 72(96%) cases. The most common injured artery was superficial femoral artery 30(40%) followed by popliteal artery 19(25%)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894155/increased-lower-extremity-venous-stasis-may-contribute-to-deep-venous-thrombosis-formation-after-microsurgical-breast-reconstruction-an-ultrasonographic-study
#5
Arash Momeni, Michael G Tecce, Michael A Lanni, Shagun Aggarwal, Christopher Pannucci, Stephen J Kovach, Suhail K Kanchwala, Liza C Wu, Joseph M Serletti
Background Despite guideline-compliant prophylaxis, an increased rate of deep venous thrombosis (DVT) formation has been reported following autologous versus implant-based breast reconstruction. We hypothesized that tight abdominal fascia closure might decrease lower extremity venous return and promote venous stasis. Methods An observational crossover study of patients who underwent autologous breast reconstruction using transverse rectus abdominis musculocutaneous/deep inferior epigastric artery perforator flaps was conducted...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27894154/perfusion-controlled-mobilization-after-lower-extremity-free-flaps-pushing-the-limits-of-time-and-intensity
#6
Ulf Dornseifer, Charlotte Kleeberger, Lukas Kargl, Markus Schönberger, Daniel Rohde, Milomir Ninkovic, Arndt Schilling
Background The current standard to gradually adapt the fragile perfusion in lower extremity free flaps to an upright posture is the dangling maneuver. This type of flap training neither fits the orthostatic target load of an upright posture, nor does it assist in mobilizing the patients effectively. In this study, we quantitatively analyzed training effects of an early and full mobilization on flap perfusion. Methods A total of 15 patients with gracilis flaps for distal lower extremity reconstruction were included...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27884329/saphenous-artery-based-flap-models-in-rats-new-flap-designs-for-experimental-studies
#7
Ersin Aksam, Berrak Aksam, Mustafa Erol Demirseren, Huban Sibel Orhun Yavuz
BACKGROUND: Experimental research using laboratory animals provides substantial data about reconstructive surgery. However, the literature does not include any experimental studies that have used flap models on the hind limbs of rats. To gain an understanding of the physiology of lower-extremity flaps and of flap failures, this study assessed the cutaneous perforators of the saphenous artery, and new flap models were designed for the hind limbs of rats. MATERIALS AND METHODS: The experiment was designed to include three stages and used 35 rats...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27866675/hemodynamics-of-patient-specific-aorta-pulmonary-shunt-configurations
#8
Senol Piskin, H Firat Altin, Okan Yildiz, Ihsan Bakir, Kerem Pekkan
Optimal hemodynamics in aorta-pulmonary shunt reconstruction is essential for improved post-operative recovery of the newborn congenital heart disease patient. However, prior to in vivo execution, the prediction of post-operative hemodynamics is extremely challenging due to the interplay of multiple confounding physiological factors. It is hypothesized that the post-operative performance of the surgical shunt can be predicted through computational blood flow simulations that consider patient size, shunt configuration, cardiac output and the complex three-dimensional disease anatomy...
November 11, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27865319/circular-external-fixation-as-a-primary-or-adjunctive-therapy-for-the-podoplastic-approach-of-the-diabetic-charcot-foot
#9
REVIEW
Daniel J Short, Thomas Zgonis
Numerous techniques have been described for surgical management of the diabetic Charcot foot. External fixation has become a main surgical tool for the reconstructive foot and ankle surgeon when dealing with the ulcerated diabetic Charcot foot. In the presence of an open wound and/or osteomyelitis, staged reconstruction with circular external fixation becomes ideal for salvage of the diabetic lower extremity. Also, circular external fixation can provide simultaneous compression and stabilization, correct the underlying osseous or soft tissue deformities, and surgically offload the diabetic Charcot foot...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27865316/soft-tissue-reconstruction-pyramid-for-the-diabetic-charcot-foot
#10
REVIEW
Claire M Capobianco, Thomas Zgonis
Foot and ankle ulcerations in patients with diabetic Charcot neuroarthropathy (DCN) occur frequently and can be challenging to address surgically when conservative care fails. Patients with acute or chronic diabetic foot ulcers (DFU) are at continued risk for development of osteomyelitis, septic arthritis, gas gangrene, and potential lower extremity amputation. Concurrent vasculopathy and peripheral neuropathy as well as uncontrolled medical comorbidities complicate the treatment approach. In addition, pathomechanical forces left untreated may contribute to DFU recurrence in this patient population...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27862938/combined-percutaneous-trans-renal-and-trans-femoral-endovascular-recanalization-and-angioplastic-reconstruction-of-a-disrupted-transplant-renal-artery-stent-a-novel-salvage-technique
#11
Dustin J Carpenter, Sumit Mohan, Lloyd E Ratner, Peter Schlossberg
Renal artery stenosis (RAS) is the most common vascular complication following renal transplantation. Percutaneous endovascular transluminal angioplasty with stenting is the treatment of choice for clinically significant RAS. We present a case describing a novel combined trans-renal parenchyma and trans-femoral approach to repairing a disrupted transplant renal artery stent. Our patient's allograft RAS was initially managed by standard percutaneous approach, but during follow-up the stent became disrupted and crushed causing partial occlusion of the renal artery...
November 14, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27861256/nonmodifiable-risk-factors-for-anterior-cruciate-ligament-injury
#12
Meghan J Price, Maria Tuca, Frank A Cordasco, Daniel W Green
PURPOSE OF REVIEW: As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. RECENT FINDINGS: The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury...
November 16, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27861131/management-of-open-lower-extremity-wounds-with-concomitant-fracture-using-a-porcine-urinary-bladder-matrix
#13
Bruce A Kraemer, Scott E Geiger, Oliver A Deigni, John Tracy Watson
BACKGROUND: Open wounds of the distal third of the leg and foot with exposed bone, fractures, and hardware are challenging wounds for which to achieve stable coverage. The orthopedic advances in lower extremity fracture management over the last 30 years have allowed a rethinking of the standard operative approach to close these complex wounds. MATERIALS AND METHODS: The ability of extracellular matrix (ECM) products to facilitate constructive remodeling of a wound seemed a reasonable approach for treatment, especially in patients who are often poor surgical candidates for more advanced reconstructive procedures...
November 2016: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/27851667/outcomes-after-primary-repair-and-staged-reconstruction-of-zone-i-and-ii-flexor-tendon-injuries-in-children
#14
Samantha L Piper, Lesley C Wheeler, Janith K Mills, Marybeth Ezaki, Scott N Oishi
BACKGROUND: Delayed diagnosis of flexor tendon injury in children is common, and consequent flexor sheath scarring may necessitate a 2-stage reconstruction. Previous studies show variable outcomes after 2-stage flexor reconstruction in children, especially those below 6 years old. We evaluated functional and subjective outcomes of primary repair and staged reconstruction of zone I and II tendon injuries in children under 6 years of age. METHODS: A retrospective chart review identified 12 digits in 10 patients who had undergone surgical treatment of a zone I or II flexor tendon injury...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27833885/congenital-arhinia-a-rare-case-report-and-review-of-literature
#15
Uttam Mondal, Rameshwar Prasad
Congenital absence of nose (Arhinia) is extremely rare. A male baby was born at term via uncomplicated vaginal delivery and presented with complete arhinia, bilateral microphthalmia, lower eyelid coloboma and feeding difficulty. Reconstructive surgery was postponed until preschool age. On follow up at 1 year of age baby is feeding liquid and semisolid food and growing well.
December 2016: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/27833281/one-plus-one-two-free-flaps-from-same-donor-thigh-for-simultaneous-coverage-of-two-different-defects
#16
Susmitha Bandi, Rayidi Venkata Koteswara Rao, Damalacheruvu Mukunda Reddy
INTRODUCTION: Primary microvascular reconstruction of multiple defects is challenging particularly if it has to be simultaneous. In trauma cases, harvesting two independent free flaps from different sites is very time-consuming and adds to morbidity. To eliminate these disadvantages, we sought to find out a reliable alternative method of harvesting two independent free flaps based on the descending branch of circumflex femoral artery, i.e., one anterolateral thigh (ALT) flap and one rectus femoris muscle flap...
May 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/27825631/versatility-and-flap-efficiency-of-pedicled-perforator-flaps-in-lower-extremity-reconstruction
#17
Jason K F Wong, Nidal Deek, Chung-Chen Hsu, Hsin-Yu Chen, Chih-Hung Lin, Cheng-Hung Lin
BACKGROUND: The use of pedicled perforator flaps provides an alternative to free tissue transfer for lower limb reconstruction. We use computer-aided image analysis to investigate the versatility of pedicled perforator flaps for the reconstruction of lower limb defects. PATIENTS AND METHODS: Between April 2007 and April 2011, a case series of 61 patients with wounds of the lower extremity from knee to ankle were reconstructed with pedicled perforator flaps. We performed 16 pedicled reverse-flow anterolateral thigh (RF-ALT) flaps, 8 pedicled medial sural artery perforator (MSAP) flaps, 26 pedicled peroneal artery perforator (PAP) flaps, and 11 pedicled posterior tibial artery perforator (PTAP) flaps...
October 5, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27790748/modified-approach-for-endoscopic-harvest-of-the-latissimus-dorsi-free-flap-with-co2-insufflation-and-standard-laparoscopic-equipment
#18
Juha Kiiski, Ilkka Kaartinen, Sannamari Kotaluoto, Hannu Kuokkanen
OBJECTIVE: The latissimus dorsi (LD) muscle flap is frequently used for free tissue transfer to reconstruct large defects of the extremities. As a free flap, the LD also can be harvested as a muscle-sparing flap (MS-LD), preserving the innervation and insertion of the remaining muscle. Conventional harvesting of the LD flap, however, results in a long scar on the lateral back. Harvesting using an endoscopic approach minimizes donor site morbidity. We present our modified endoscopic technique with CO2 insufflation and standard endoscopic instruments for harvesting the LD or MS-LD muscle flap...
October 28, 2016: Microsurgery
https://www.readbyqxmd.com/read/27783841/reconstruction-using-expandable-endoprostheses-for-skeletally-immature-patients-with-sarcoma
#19
Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27779978/patient-and-surgical-factors-contributing-to-perioperative-infection-in-complex-lower-extremity-trauma
#20
Karen E Burtt, Alexis D Rounds, Hyuma A Leland, Ram K Alluri, Ketan M Patel, Joseph N Carey
Infections in the traumatized lower extremity are a significant source of morbidity and expense. Outcomes after vascularized soft tissue reconstruction were analyzed to determine impact on infection rates. A retrospective review of a prospectively maintained database was performed, including 114 trauma patients requiring soft tissue reconstruction of lower extremity injuries at an urban Level I tertiary referral center from 2008 to 2015. Patient characteristics and perioperative outcomes were analyzed. After trauma, 39 (34...
October 2016: American Surgeon
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