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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28804728/relationships-of-muscle-function-and-subjective-knee-function-in-patients-after-acl-reconstruction
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28767166/radiological-anatomy-of-the-perforators-of-the-gluteal-region-the-radiosome-based-anatomy
#6
Enrico Vigato, Eleonora De Antoni, Cesare Tiengo, Andrea Porzionato, Cinzia Tortorella, Maurizio Governa, Veronica Macchi, Raffaele De Caro
BACKGROUND: The superior (SGA) and the inferior gluteal artery (IGA) perforator flaps are widely used in pressure-sore repair and in breast reconstruction. The aim was to exhaustively depict the topographical anatomy of the whole system of perforators in the buttock. METHODS: Eighty lower-extremity computed tomographic angiography (CTA) of patients (20 males/20 females, mean age 61-years old, range 38-81) were considered. The source artery, location, type, and caliber of gluteal perforators were analyzed...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28765802/clinical-gait-analysis-on-a-patient-undergoing-surgical-correction-of-kyphosis-from-severe-ankylosing-spondylitis
#7
Ram Haddas, Theodore Belanger
BACKGROUND: Ankylosing spondylitis (AS) is a chronic inflammatory disease primarily affecting the axial skeleton, including the sacroiliac joints, costovertebral joints, and the spine. Patients with AS found to have an alter gait pattern. The purpose of this study was to investigate biomechanical alterations in gait after surgical correction in a patient with severe kyphosis from AS. METHODS: A case report in controlled laboratory study, a pretest-posttest design...
2017: International Journal of Spine Surgery
https://www.readbyqxmd.com/read/28746282/outcomes-of-muscle-brachialis-transfer-to-restore-finger-flexion-in-brachial-plexus-palsy
#8
Brent R DeGeorge, Hillary A Becker, John H Faryna, Robert J Spinner, Allen T Bishop, Alexander Y Shin
BACKGROUND: In adults with lower trunk brachial plexus injury, proximal nerve surgery for restoration of prehension demonstrates poor outcomes secondary to long distances required for nerve regeneration and time-dependent degradation of motor endplates. Options for reconstruction are limited to distal tendon or nerve transfers and free-functioning muscle transfers. In this article, the authors describe the long-term outcomes of brachialis muscle-to-flexor digitorum profundus transfer to restore prehension in patients with traumatic lower trunk brachial plexus injuries...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28746238/-sural-nerve-splitting-in-reverse-sural-artery-perforator-flap-anatomical-study-in-40-cadaver-legs
#9
Hyeonwoo Kim, Julong Hu, Hak Chang, Byung Jun Kim
BACKGROUND: The reverse sural artery perforator flap (RSAPF) has been widely used in reconstructions of the lower extremity. However, along with the high rate of flap necrosis, sural nerve (SN) injury is one of the most frequent complications. This cadaveric study investigated a simple SN preservation technique during RSAPF. METHODS: Anatomic dissection of the sural nerve was performed on 40 lower legs, from 20 cadavers, to investigate the pattern of SN distribution...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28746237/abdominoplasty-with-lymphatic-microsurgery-for-patients-with-secondary-lower-extremity-lymphedema
#10
Shinsuke Akita, Yoshihisa Yamaji, Hideki Tokumoto, Naoki Adachi, Yoshitaro Sasahara, Yoshitaka Kubota, Motone Kuriyama, Nobuyuki Mitsukawa
BACKGROUND: Patients with secondary lower extremity lymphedema (LEL) often develop suprapubic lymphedema. We developed a novel surgical method of shaping the lower abdomen and debulking suprapubic lymphedema with simultaneous reconstruction of lymphatic flow in case of LEL. METHODS: A skin incision in a fleur-de-lis pattern was performed for horizontal and vertical abdominal skin and fat resection. A caudal-based isosceles triangular flap was created on the central suprapubic region to reduce wound tension at the intersection of the horizontal and vertical incisions...
July 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28729748/on-flare-cme-characteristics-from-sun-to-earth-combining-remote-sensing-image-data-with-in-situ-measurements-supported-by-modeling
#11
Manuela Temmer, Julia K Thalmann, Karin Dissauer, Astrid M Veronig, Johannes Tschernitz, Jürgen Hinterreiter, Luciano Rodriguez
We analyze the well-observed flare and coronal mass ejection (CME) from 1 October 2011 (SOL2011-10-01T09:18) covering the complete chain of effects - from Sun to Earth - to better understand the dynamic evolution of the CME and its embedded magnetic field. We study in detail the solar surface and atmosphere associated with the flare and CME using the Solar Dynamics Observatory (SDO) and ground-based instruments. We also track the CME signature off-limb with combined extreme ultraviolet (EUV) and white-light data from the Solar Terrestrial Relations Observatory (STEREO)...
2017: Solar Physics
https://www.readbyqxmd.com/read/28718319/medical-modeling-for-precision-ulna-reconstruction-using-a-microvascular-fibula-free-flap
#12
Michael Alperovich, Jonathan M Bekisz, Vishal D Thanik
BACKGROUND: Despite the growing use of medical modeling in other surgical specialties, its utilization in extremity reconstruction has remained limited. METHODS: We present the application of medical modeling for ulna reconstruction using a microvascular fibula free flap. RESULTS: Following a motor vehicle accident, the patient suffered segmental loss of the right radius and ulna with concomitant forearm soft tissue and muscle loss. Using medical modeling, imaging from the unaffected contralateral forearm and lower extremity was used to plan a reconstruction that restored the anatomic length and orientation of the ulna...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716695/the-nugget-design-a-modified-segmental-gracilis-free-flap-for-small-sized-defect-reconstruction-on-the-lower-extremity
#13
M Tremp, C M Oranges, W J Wang, R Wettstein, Y X Zhang, D J Schaefer, D F Kalbermatten
BACKGROUND: Little attention has been given to the segmental free gracilis muscle flap supplied by secondary proximal pedicles. We introduce a technical refinement for small-sized three-dimensional defect reconstruction on the foot. METHODS: Between November 2013 and August 2016, three patients with a mean age of 66 years (range 47-70 years) were included. A segmental gracilis free flap supplied by the most proximal secondary pedicle was harvested according to a modified "nugget design" to treat small-sized defects on the lower extremity requiring dead space reconstruction...
July 8, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28716470/early-or-delayed-reconstruction-in-multi-ligament-knee-injuries-a-systematic-review-and-meta-analysis
#14
REVIEW
Erik Hohmann, Vaida Glatt, Kevin Tetsworth
BACKGROUND: Whether early or delayed surgical intervention in patients with multi-ligament injuries results in better outcomes, is of current and controversial debate. PURPOSE: The purpose of this study was to perform a meta-analysis comparing early versus late surgical treatment of multi-ligament knee injuries. METHODS: We performed a systematic review of Medline, Embase, Scopus, and Google Scholar to identify relevant studies in the English and German literature...
July 14, 2017: Knee
https://www.readbyqxmd.com/read/28712488/staged-reconstruction-of-diaphyseal-fractures-with-segmental-defects-surgical-and-patient-reported-outcomes
#15
S D Zoller, L A Cao, R A Smith, W Sheppard, E L Lord, C D Hamad, J H Ghodasra, C Lee, D Jeffcoat
INTRODUCTION: Two-stage limb reconstruction is an option for patients with critical size segmental bone defects following acute trauma or non-union. Reconstruction is technically demanding and associated with a high complication rate. Current protocols for limb reconstruction have well-documented challenges, and no study has reported on patient outcomes using a validated questionnaire. In this study, we aimed to examine the clinical and patient-centered outcomes following our surgical protocol for two-stage limb reconstruction following critical size segmental defects...
June 23, 2017: Injury
https://www.readbyqxmd.com/read/28706258/transverse-coherence-limited-coherent-diffraction-imaging-using-a-molybdenum-soft-x-ray-laser-pumped-at-moderate-pump-energies
#16
M Zürch, R Jung, C Späth, J Tümmler, A Guggenmos, D Attwood, U Kleineberg, H Stiel, C Spielmann
Coherent diffraction imaging (CDI) in the extreme ultraviolet has become an important tool for nanoscale investigations. Laser-driven high harmonic generation (HHG) sources allow for lab scale applications such as cancer cell classification and phase-resolved surface studies. HHG sources exhibit excellent coherence but limited photon flux due poor conversion efficiency. In contrast, table-top soft X-ray lasers (SXRL) feature excellent temporal coherence and extraordinary high flux at limited transverse coherence...
July 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#17
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28698831/effectiveness-of-reverse-sural-artery-flap-in-the-management-of-wheel-spoke-injuries-of-the-heel
#18
Hafiz U Farooq, Rizwan Ishtiaq, Shabana Mehr, Sadia Ayub, Umer H Chaudhry, Anam Ashraf
OBJECTIVE: Soft tissue injuries at the level of lower extremities, plantar, and dorsal foot pose a surgical challenge for reconstructive surgeons. This kind of injury commonly occurs when lower limbs get stuck in between the spokes of the wheel. Reverse sural artery flap has been proven to be an effective option to cover such defects. The aim of this study is to analyze the demographic variables of affected individuals, technical aspects of reverse sural artery flap, quantify the effectiveness of reverse sural artery flap among various treatment options available, and to study the outcome of injury...
June 10, 2017: Curēus
https://www.readbyqxmd.com/read/28678124/an-in-vivo-simulation-of-isometry-of-the-anterolateral-aspect-of-the-healthy-knee
#19
Willem A Kernkamp, Samuel K Van de Velde, Tsung-Yuan Tsai, Ewoud R A van Arkel, Peter D Asnis, Rob G H H Nelissen, Robert F LaPrade, Bertram Zarins, Guoan Li
BACKGROUND: To assess the isometry of theoretical lateral extra-articular reconstruction (LER), we evaluated theoretical grafts attached to various points on the lateral femoral condylar area and to either Gerdy's tubercle or the anatomic attachment site of the anterolateral ligament to the tibia. METHODS: In 18 subjects, healthy knees with no history of either injury or surgery involving the lower extremity were studied. The subjects performed a sit-to-stand motion (from approximately 90° of flexion to full extension), and each knee was studied using magnetic resonance and dual fluoroscopic imaging techniques...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28673602/platelet-rich-plasma-as-a-minimally-invasive-approach-to-uterine-prolapse
#20
E L Chrysanthopoulou, V Pergialiotis, D Perrea, S Κourkoulis, C Verikokos, S K Doumouchtsis
Pelvic organ prolapse (POP) is a major health problem that affects many women with potentially severe physical and psychological impact as well as impact on their daily activities, and quality of life. Several surgical techniques have been proposed for the treatment of POP. The FDA has published documents that refer to concerns about the use of synthetic meshes for the treatment of prolapse, in view of the severe complications that may occur. These led to hesitancy in use of these meshes and partial increase in use of other biological grafts such as allografts and xenografts...
July 2017: Medical Hypotheses
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