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https://www.readbyqxmd.com/read/29349002/medial-patellofemoral-ligament-reconstruction-using-dual-patella-docking-technique
#1
Hassan Azimi, Oke Anakwenze
Medial patellofemoral ligament (MPFL) injuries are common in children and young adults. In patients with recurrent patellar dislocations with normal lower-extremity alignment, anatomic reconstruction of the MPFL has been shown to restore patellar stability. We describe a technique that creates an anatomic reconstruction using a dual docking technique into the patella. Our technique is simple and efficacious for reconstructing the MPFL without implant fixation in the patella, allowing a maximal bone-tendon interface for healing...
December 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29346148/vertical-profunda-artery-perforator-flap-for-plantar-foot-wound-closure-a-new-application
#2
Allyson R Alfonso, James L Mayo, Vishal K Sharma, Robert J Allen, Ernest S Chiu
BACKGROUND: Plantar foot reconstruction requires special consideration of both form and function. There are several fasciocutaneous flap options, each with indications and reservations. CASE STUDY: This case presents a new application of the vertical profunda artery perforator flap for definitive closure of a neuropathic foot ulcer in a young woman with spina bifida. The postoperative course was uneventful, and the flap survived completely. The surgical and donor sites were without wound recurrence at 5-month follow-up...
February 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29331289/titanium-scaffolding-an-innovative-modality-for-salvage-of-failed-first-ray-procedures
#3
Natalie Coriaty, Katherine Pettibone, Nicholas Todd, Shannon Rush, Ryan Carter, Colin Zdenek
Shortening of the first ray is a potential complication associated with first metatarsal procedures. Correction of this deformity conventionally has required the use of a tricortical bone graft to lengthen the bone. Graft complications, including donor site morbidity, poor graft stability, and graft resorption, have revealed a need for an alternative procedure. The present report shows that titanium cage scaffolding has lower extremity applications beyond its previous uses in the ankle and spine. Two patients underwent surgical correction for failed first ray procedures using a titanium cage apparatus with a calcaneal autograft and other biologic agents...
January 11, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29327547/-finite-element-analysis-on-the-effect-of-lateral-wedge-insole-intervention-on-the-contact-characteristics-of-the-subtalar-joint
#4
En-Chang Zhou, Ping Tang, Chuan-Ying Zhu, Shi-Ming Liu
OBJECTIVE: To establish a three-dimensional finite element model of the lower limb bones, and investigate the changes of the contact characteristics of the subtalar joint after using laterally wedge insole intervention. METHODS: Using the reverse modeling technology, the lower limb bones of normal adult volunteers was scanned by CT. Mimics 10.0 and Geomagic Studio 6.0 software were used to reconstruct the 3D morphology of bones and external soft tissue of the feet...
January 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29319351/amniotic-constriction-bands-secondary-deformities-and-their-treatments
#5
Benjamin T Drury, Ghazi M Rayan
BACKGROUND: The purpose of this study was to report the surgical treatment experience of patients with amniotic constriction bands (ACB) over a 35-year interval and detail consequential limb deformities with emphasis on hands and upper extremities, along with the nature and frequency of their surgical treatment methods. METHODS: Fifty-one patients were identified; 26 were males and 25 females. The total number of deformities was listed. The total number of operations, individual procedures, and operations plus procedures that were done for each patient and their frequency were recorded...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29318178/outcomes-after-dermal-allograft-reconstruction-of-chronic-or-subacute-pectoralis-major-tendon-ruptures
#6
Julie A Neumann, Christopher M Klein, Carola F van Eck, Hithem Rahmi, John M Itamura
Background: Avoiding delay in the surgical management of pectoralis major (PM) ruptures optimizes outcomes. However, this is not always possible, and when a tear becomes chronic or when a subacute tear has poor tissue quality, a graft can facilitate reconstruction. Purpose: The primary aim was to evaluate the clinical outcomes of PM reconstruction with dermal allograft augmentation for chronic tears or for subacute tears with poor tissue quality. A second aim was to determine patient and surgical factors affecting outcome...
January 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29316773/immediate-application-of-vacuum-assisted-closure-dressing-over-free-muscle-flaps-in-the-lower-extremity-does-not-compromise-flap-survival-and-results-in-decreased-flap-thickness
#7
Harvey Chim, Yasmina Zoghbi, Ajani George Nugent, Wrood Kassira, Morad Askari, Christopher John Salgado
Background: Free muscle flaps are a mainstay for reconstruction of distal third leg wounds and for large lower extremity wounds with exposed bone. However a major problem is the significant postoperative flap swelling, which may take months to resolve. We studied the efficacy and safety of immediate application of a vacuum assisted closure (VAC) dressing after a free muscle flap to the lower extremity. Methods: Over a 19 month period, all consecutive free muscle flaps for lower extremity reconstruction at a Level I trauma center were evaluated prospectively for postoperative flap thickness, complications and flap survival...
January 10, 2018: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/29310377/fat-grafting-for-resurfacing-an-exposed-implant-in-lower-extremity-a-case-report
#8
Yun-Nan Lin, Chieh-Han Chuang, Shih-Hao Huang, Shu-Hung Huang, Tsai-Ming Lin, I-Wen Lin, Sin-Daw Lin, Yur-Ren Kuo
RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29291279/january-2018-corrigendum
#9
(no author information available yet)
Corrections to an article published in the March 2013 issue of JOSPT: Xergia SA, Pappas E, Zampeli F, Georgiou S, Georgoulis AD. Asymmetries in functional hop tests, lower extremity kinematics, and isokinetic strength persist 6 to 9 months following anterior cruciate ligament reconstruction. J Orthop Sports Phys Ther 2018;48(1):52. doi:10.2519/jospt.2018.48.1.52.
January 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29279946/adaptive-statistical-iterative-reconstruction-use-for-radiation-dose-reduction-in-pediatric-lower-extremity-ct-impact-on-diagnostic-image-quality
#10
Amisha Shah, Mitchell Rees, Erica Kar, Kimberly Bolton, Vincent Lee, Ashok Panigrahy
BACKGROUND: For the past several years, increased levels of imaging radiation and cumulative radiation to children has been a significant concern. Although several measures have been taken to reduce radiation dose during computed tomography (CT) scan, the newer dose reduction software adaptive statistical iterative reconstruction (ASIR) has been an effective technique in reducing radiation dose. To our knowledge, no studies are published that assess the effect of ASIR on extremity CT scans in children...
December 26, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29275911/flap-reconstruction-does-not-increase-complication-rates-following-surgical-resection-of-extremity-soft-tissue-sarcoma
#11
Jelena Slump, Stefan O P Hofer, Peter C Ferguson, Jay S Wunder, Anthony M Griffin, Harald J Hoekstra, Esther Bastiaannet, Anne C O'Neill
BACKGROUND: Flap reconstruction plays an essential role in the surgical management of extremity soft tissue sarcoma (ESTS) for many patients. But flaps increase the duration and complexity of the surgery and their contribution to overall morbidity is unclear. This study directly compares the complication rates in patients with ESTS undergoing either flap reconstruction or primary wound closure and explores contributing factors. METHODS: Eight hundred and ninety-seven patients who underwent ESTS resection followed by primary closure (631) or flap reconstruction (266) were included in this study...
November 26, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29248126/management-of-the-infected-aortic-endograft
#12
REVIEW
Kamphol Laohapensang, Supapong Arworn, Saranat Orrapin, Termpong Reanpang, Saritphat Orrapin
Although the incidence of abdominal and thoracic aortic endograft infection is infrequent, ranging between 0.2% and 5%, stent-graft infection carries significant morbidity and mortality and exemplifies a formidable therapeutic challenge. The treatment goal is to eradicate the infectious process by endograft explantation, regional tissue debridement, and arterial reconstruction by either an extra-anatomic or in situ grafting procedure using autologous vein, cryopreserved allograft, or antibiotic-soaked prosthetic grafts...
June 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29240590/reverse-sural-adipofascial-flaps-with-acellular-dermal-matrix-and-negative-pressure-wound-therapy
#13
Matthew E Pontell, Noah Saad, Brian S Winters, Joseph N Daniel, Adam Saad
The reverse sural adipofascial flap (RSAF) is used to reconstruct challenging wounds of the foot and ankle. It offers several advantages over the traditional reverse sural flap, including less venous congestion. To complete the reconstruction, split-thickness skin grafting (STSG) may be done immediately or in a delayed fashion; however, both scenarios result in suboptimal take rates and prolonged healing. An acellular dermal matrix (ADM; Integra; Ethicon Inc, Somerville, New Jersey) and negative-pressure wound therapy (NPWT) combined with RSAF followed by delayed STSG may decrease wound healing time...
January 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29218283/early-reconstructions-of-complex-lower-extremity-battlefield-soft-tissue-wounds
#14
Ali Ebrahimi, Nasrin Nejadsarvari, Azin Ebrahimi, Hamid Reza Rasouli
BACKGROUND: Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS: This was a prospective case series study of battled field injured patients which was done in the Department of Plastic Surgery, Baqiyatallah University of Medical Sciences hospitals, Tehran, Iran between 2013-2015...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29208195/-treatment-principles-in-bone-reconstruction-and-limb-lengthening-of-the-lower-extremity
#15
Ulrik Kæhler Olesen, Tobias Nygaard, Søren V Kold, Adam Hede
Limb length discrepancies, axis deviations and bone loss on a congenital, traumatic or infectious basis are treated with restoration of axis and bone elongation. The intention is to improve gait and function, to relieve pain caused by imbalance in the musculoskeletal system and to prevent degenerative joint disease. Modern motorized intramedullary nails spare the patients for external fixators, and thus complications are being reduced. X-ray, CT-based planning and a thorough clinical examination is essential for a good result...
November 20, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29205902/therapeutic-options-and-postoperative-wound-complications-after-extremity-soft-tissue-sarcoma-resection-and-postoperative-external-beam-radiotherapy
#16
Mohamed H Abouarab, Iman L Salem, Magdy M Degheidy, Dominic Henn, Christoph Hirche, Ahmad Eweida, Matthias Uhl, Ulrich Kneser, Thomas Kremer
Soft tissue sarcomas occur most commonly in the lower and upper extremities. The standard treatment is limb salvage surgery combined with radiotherapy. Postoperative radiotherapy is associated with wound complications. This systematic review aims to summarise the available evidence and review the literature of the last 10 years regarding postoperative wound complications in patients who had limb salvage surgical excision followed by direct closure vs flap coverage together with postoperative radiotherapy and to define the optimal timeframe for adjuvant radiotherapy after soft tissue sarcomas resection and flap reconstruction...
December 5, 2017: International Wound Journal
https://www.readbyqxmd.com/read/29199268/a-rare-case-of-giant-basal-cell-carcinoma-of-the-abdominal-wall-excision-and-immediate-reconstruction-with-a-pedicled-deep-inferior-epigastric-artery-perforator-diep-flap
#17
Sara Di Lorenzo, Giovanni Zabbia, Bartolo Corradino, Massimiliano Tripoli, Roberto Pirrello, Adriana Cordova
BACKGROUND Basal cell carcinoma (BCC) greater than 5 cm in diameter is called giant basal cell carcinoma (GBCC), or super giant basal cell carcinoma if it has a diameter larger than 20 cm. Giant BCC only accounts for 0.5% of BCCs and super giant BCC is exceedingly rare. On account of their rarity, there are no established guidelines for GBCC treatment. CASE REPORT We describe a peculiar case of an 82-year-old woman with a GBCC carcinoma of the lower abdominal wall. The tumor was surgically removed with ipsilateral inguinal lymph nodes and the abdominal wall was reconstructed immediately with a pedicled deep inferior epigastric artery perforator (DIEP) flap...
December 4, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29194743/optimizing-venous-outflow-in-reconstruction-of-gustilo-iiib-lower-extremity-traumas-with-soft-tissue-free-flap-coverage-are-two-veins-better-than-one
#18
John T Stranix, Z-Hye Lee, Lavinia Anzai, Adam Jacoby, Tomer Avraham, Pierre B Saadeh, Jamie P Levine, Vishal D Thanik
PURPOSE: The dependent nature of the lower extremity predisposes to venous congestion, especially following significant trauma. The benefit of a second venous anastomosis, however, remains unclear in lower extremity trauma free flap reconstruction. This study investigated the effect of an additional venous anastomosis on flap outcomes in lower extremity trauma reconstruction. METHODS: Retrospective review between 1979 and 2016 identified 361 soft tissue flaps performed for Gustilo IIIB/C coverage meeting inclusion criteria...
November 30, 2017: Microsurgery
https://www.readbyqxmd.com/read/29192363/quantitative-and-visual-assessments-toward-potential-sub-msv-or-ultrafast-fdg-pet-using-high-sensitivity-tof-pet-in-pet-mri
#19
Spencer C Behr, Emma Bahroos, Randall A Hawkins, Lorenzo Nardo, Vahid Ravanfar, Emily V Capbarat, Youngho Seo
PURPOSE: Newer high-performance time-of-flight (TOF) positron emission tomography (PET) systems have the capability to preserve diagnostic image quality with low count density, while maintaining a high raw photon detection sensitivity that would allow for a reduction in injected dose or rapid data acquisition. To assess this, we performed quantitative and visual assessments of the PET images acquired using a highly sensitive (23.3 cps/kBq) large field of view (25-cm axial) silicon photomultiplier (SiPM)-based TOF PET (400-ps timing resolution) integrated with 3 T-MRI in comparison to PET images acquired on non-TOF PET/x-ray computed tomography (CT) systems...
November 30, 2017: Molecular Imaging and Biology: MIB: the Official Publication of the Academy of Molecular Imaging
https://www.readbyqxmd.com/read/29184750/long-term-patency-of-twisted-vascular-pedicles-in-perforator-based-propeller-flaps
#20
Rafael G Jakubietz, Aljoscha Nickel, Iva Neshkova, Karsten Schmidt, Fabian Gilbert, Rainer H Meffert, Michael G Jakubietz
Background: Propeller flaps require torsion of the vascular pedicle of up to 180 degrees. Contrary to free flaps, where the relevance of an intact vascular pedicle has been documented, little is known regarding twisted pedicles of propeller flaps. As secondary surgeries requiring undermining of the flap are common in the extremities, knowledge regarding the necessity to protect the pedicle is relevant. The aim of this study was a long-term evaluation of the patency of vascular pedicle of propeller flaps...
October 2017: Plastic and Reconstructive Surgery. Global Open
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