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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28327471/motion-compensation-in-extremity-cone-beam-ct-using-a-penalized-image-sharpness-criterion
#1
Alejandro Sisniega, Joseph Stayman, John Yorkston, Jeffrey Siewerdsen, Wojciech Zbijewski
Cone-beam CT (CBCT) for musculoskeletal imaging would benefit from a method to reduce the effects of involuntary patient motion. In particular, the continuing improvement in spatial resolution of CBCT may enable tasks such as quantitative assessment of bone microarchitecture (0.1 mm - 0.2 mm detail size), where even subtle, sub-mm motion blur might be detrimental. We propose a purely image based motion compensation method that requires no fiducials, tracking hardware or prior images. A statistical optimization algorithm (CMA-ES) is used to estimate a motion trajectory that optimizes an objective function consisting of an image sharpness criterion augmented by a regularization term that encourages smooth motion trajectories...
March 22, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28321479/novel-anatomical-reconstruction-of-distal-tibiofibular-ligaments-restores-syndesmotic-biomechanics
#2
Jian Che, Chunbao Li, Zhipeng Gao, Wei Qi, Binping Ji, Yujie Liu, Ming Han Lincoln Liow
PURPOSE: To date, there is a paucity of literature on syndesmotic reconstruction techniques that restore both anatomic stability and physiologic syndesmotic biomechanics. In this cadaveric study, (1) a novel syndesmotic reconstruction surgical technique using autogenous peroneus brevis tendon was described and (2) the biomechanical properties of the reconstruction was investigated. METHODS: Ten fresh-frozen lower extremities were used in this study. Reconstruction of the anterior and posterior, as well as the interosseous tibiofibular ligaments was performed with a halved peroneus brevis tendon...
March 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28319734/novel-mechanical-impact-simulator-designed-to-generate-clinically-relevant-anterior-cruciate-ligament-ruptures
#3
Nathaniel A Bates, Nathan D Schilaty, Christopher V Nagelli, Aaron J Krych, Timothy E Hewett
BACKGROUND: Over 250,000 anterior cruciate ligament ruptures occur each year; therefore, it is important to understand the underlying mechanisms of these injuries. The objective of the current investigation was to develop and analyze an impact test device that consistently produces anterior cruciate ligament failure in a clinically relevant manner. METHOD: A mechanical impact simulator was developed to simulate the ground reaction force impulse generated from landing in a physiologic and clinically relevant manner...
March 10, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28319440/markers-of-blood-coagulation-and-fibrinolysis-in-patients-with-early-and-delayed-microsurgical-reconstructions-in-the-lower-extremities
#4
Oliver Kloeters, Dalibor Vasilic, Pieter Hupkens, Dietmar Ulrich
BACKGROUND: In this study, markers of coagulation and fibrinolysis were assessed during early and delayed microsurgical reconstruction in patients with traumatic defects of their lower legs to analyse whether an imbalance of the hemostasis after trauma might predispose the development of vascular complications. METHODS: The prospective study included 70 patients. In 35 patients, surgery was performed within 72 hours after injury. In 35 other patients, delayed free flap transfer was performed between 14-21 days after trauma...
March 20, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28314214/gait-biomechanics-following-lower-extremity-trauma-amputation-vs-reconstruction
#5
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
https://www.readbyqxmd.com/read/28290752/mri-based-assessment-of-lower-extremity-muscle-volumes-in-patients-before-and-after-acl-reconstruction
#6
Grant E Norte, Katherine R Knaus, Chris Kuenze, Geoffrey G Handsfield, Craig H Meyer, Silvia S Blemker, Joseph M Hart
CONTEXT: Study of muscle volumes in patients after anterior cruciate ligament (ACL) injury and reconstruction (ACL-R) is largely limited to cross-sectional assessment of the thigh musculature, which may inadequately describe post-traumatic and post-surgical muscle function. No studies have prospectively examined the influence of ACL injury and reconstruction on lower extremity muscle volumes. OBJECTIVE: Assess magnetic resonance imaging (MRI) derived lower extremity muscle volumes, and quantify quadriceps strength and activation in patients following ACL injury and reconstruction...
March 14, 2017: Journal of Sport Rehabilitation
https://www.readbyqxmd.com/read/28285013/use-of-revascularized-artery-as-a-recipient-in-microvascular-reconstruction-of-the-lower-leg-an-analysis-of-62-consecutive-free-flap-transfers
#7
Hyung Min Hahn, Yeon Seong Jeong, You Sun Hong, Je Hwan Won, Sang Hyun Lim, Jinoo Kim, Myong Chul Park, Dong Ha Park, Il Jae Lee
BACKGROUND: This study aimed to demonstrate the safety and reliability of combined preoperative angioplasty and free flap transfer in patients with peripheral arterial occlusive disease (PAOD) by analyzing the surgical outcomes. METHODS: Between October 2011 and October 2015, patients who had undergone lower extremity angiography and subsequent free flap transfer were retrospectively reviewed. Data collected included demographics, perioperative data, and postoperative outcomes...
February 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28282673/five-strand-versus-four-strand-hamstring-tendon-graft-technique-for-anterior-cruciate-ligament-reconstruction-a-biomechanical-comparison
#8
Eric R Vaillant, Brent G Parks, Lyn M Camire, Richard Y Hinton
The aim of this article is to compare diameter and stiffness, displacement, and strain in a five-strand versus four-strand hamstring graft for anterior cruciate ligament reconstruction. Eight matched pairs of lower extremities underwent four-strand or five-strand hamstring graft reconstruction. Diameter was significantly higher in the five-strand versus the four-strand construct (p = 0.002). No significant difference was found between the groups in construct displacement or stiffness. Significantly higher strain was observed in the inner limb versus the outer limb in the four-strand construct (p = 0...
March 10, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28280670/a-comprehensive-approach-to-lower-extremity-free-tissue-transfer
#9
Lee L Q Pu
BACKGROUND: The purpose of this study was to introduce a comprehensive approach to lower extremity free-tissue transfer and report the clinical outcome that has been achieved with this approach. METHODS: The comprehensive approach developed by the author includes patient selection, flap selection, selection of the recipient vessels, flap dissection, flap preparation, microvascular anastomosis, flap inset, immediate postoperative care, intermediate postoperative care, and further follow-up care...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28260602/recovery-after-abdominal-wall-reconstruction
#10
REVIEW
Kristian Kiim Jensen
Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28259572/vascular-surgery-an-essential-hospital-resource-in-modern-health-care
#11
Miguel F Manzur, Sung Wan Ham, Ramsey Elsayed, Sherwin Abdoli, Trevor Simcox, Sukgu Han, Vincent Rowe, Fred A Weaver
OBJECTIVE: In modern health care, vascular surgeons frequently serve as a unique resource to other surgical specialties for vascular exposure, repair, reconstruction, or control. These services occur both in planned and unplanned clinical settings. We analyzed the frequency, outcomes, and value of vascular services in this setting to other surgical specialties and the hospital. METHODS: Intraoperative planned and unplanned vascular surgery operative consultations were reviewed over a 3-year period (2013-2016)...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28255387/reverse-sural-flap-for-ankle-and-heel-soft-tissues-reconstruction
#12
R N Ciofu, D G Zamfirescu, S A Popescu, I Lascar
Introduction: The potential of the medial calf integument, as donor site for a free flap based on musculocutaneous branches of the medial sural artery, was first identified by Taylor and Daniel, following cadaver investigation. In 1981, Pontén described the fasciocutaneous sural flap as a reconstructive option for soft tissue loss of the lower extremity, particularly around the knee. Two years later, Donski and Fogdestram presented the distally based fasciocutaneous flap from the sural region followed by Montegut and Allen who considered the sural artery perforator flap as a viable alternative for the gastrocnemius myocutaneous flap...
January 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/28253946/-periprosthetic-infection-of-the-knee-megaprosthesis-following-a-resection-of-malignant-tumours-around-the-knee
#13
J Včelák, Z Matějovský, I Kofránek, R Kubeš, J Lesenský
PURPOSE OF THE STUDY The study presents the monocentric retrospective study of a group of patients with malignant tumours around the knee, treated by a wide resection and a reconstruction with megaprosthesis due to infectious complications. Provided is a detailed analysis of each operative treatment due to the manifestation and process of periprostethic infection of the knee megaprosthesis and the use of external fixator during a two-stage revision. MATERIAL AND METHODS Between 01/1993 and 12/2013, a total of 67 cemented megaprostheses were assessed, with a detailed analysis of 12 patients with periprosthetic infection...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28252544/applying-the-keystone-design-perforator-island-flap-concept-in-a-variety-of-anatomic-locations-a-review-of-60-consecutive-cases-by-a-single-surgeon
#14
Michael Alan Lanni, Emily Van Kouwenberg, Alan Yan, Kristen M Rezak, Ashit Patel
BACKGROUND: The keystone design perforator island flap has been gaining popularity for reconstruction of cutaneous defects. Published experience of this technique in North America is limited predominantly to the trunk and extremities; our study aims to demonstrate expanding applications. METHODS: Retrospective chart review was conducted on all patients who underwent keystone flap reconstruction by a single surgeon. Outcomes of interest were wound healing complications (WHC) and surgical site infections (SSI)...
March 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28249314/dual-energy-cta-in-patients-with-symptomatic-peripheral-arterial-occlusive-disease-study-of-diagnostic-accuracy-and-impeding-factors
#15
Thorsten Klink, Theresa Wilhelm, Christine Roth, Johannes T Heverhagen
Purpose The purpose of this study was to assess the diagnostic performance of dual-energy CT angiography (DE-CTA) in patients with symptomatic peripheral artery occlusive disease (PAOD) and to identify factors that impede its diagnostic accuracy. Materials and Methods Dual-source DE-CTA scans of the lower extremities of 94 patients were retrospectively compared to the diagnostic reference standard, digital subtraction angiography (DSA). Two independent observers assessed PAOD incidence, image quality, artifacts, and diagnostic accuracy of DE-CTA in 1014 arterial segments on axial, combined 80/140 kVp reconstructions and on 3 D maximum intensity projections (MIP) after automated bone and plaque removal...
March 1, 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28249115/lateral-ge-diffusion-during-oxidation-of-si-sige-fins
#16
William M Brewer, Yan Xin, Chris Hatem, David R Diercks, Van Q Truong, Kevin S Jones
This paper reports on the unusual diffusion behavior of Ge during oxidation of a multilayer Si/SiGe fin. It is observed that oxidation surprisingly results in the formation of vertically stacked Si nanowires encapsulated in defect free epitaxial strained SixGe1-x. High angle annular dark field scanning transmission electron microscopy (HAADF-STEM) shows that extremely enhanced diffusion of Ge occurs along the vertical Si/SiO2 oxidizing interface and is responsible for the encapsulation process. Further oxidation fully encapsulates the Si layers in defect free single crystal SixGe1-x (x up to 0...
March 1, 2017: Nano Letters
https://www.readbyqxmd.com/read/28236921/targeting-the-most-important-complications-in-vascular-surgery
#17
Kyla M Bennett, K Craig Kent, Jessica Schumacher, Caprice C Greenberg, John E Scarborough
OBJECTIVE: This study was conducted to identify the most clinically relevant and costly perioperative complications occurring in vascular surgery patients. METHODS: The analysis included patients in the 2012 to 2014 National Surgical Quality Improvement Program database undergoing one of four high-risk vascular procedures. The procedures-aortic reconstruction, lower extremity bypass, lower extremity amputation, and carotid endarterectomy (CEA)-were selected because they have been established as high risk in the literature, rendering them natural targets for quality improvement initiatives...
March 2017: Journal of Vascular Surgery
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
#18
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
#19
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
#20
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
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