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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28650579/reconstruction-using-a-perforator-free-flap-after-malignant-melanoma-resection-of-the-ankle-and-foot
#1
Young C Suh, Hyunsuk P Suh, Jong S Lee, Jee S Chang, Joon P Jp Hong
BACKGROUND: Surgical excision with adequate margin is the treatment of choice to provide best chance for survival. However, tumors located on distal lower extremity may require reconstruction to salvage the limb which may affect prognosis and quality of life. This retrospective study aimed to evaluate the effect of free flap on overall outcomes of patients with primary malignant melanoma located on the foot and ankle. METHODS: Patients with primary malignant melanoma on the leg and foot who required free flap coverage between August 2005 and January 2014 were evaluated...
June 26, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28641973/changes-in-hip-knee-and-ankle-coronal-alignments-after-total-hip-arthroplasty-with-transverse-femoral-shortening-osteotomy-for-unilateral-crowe-type-iv-developmental-dysplasia-of-the-hip
#2
Abdulhamit Misir, Turan B Kizkapan, Kadir I Yildiz, Mehmet A Kaygusuz, Yakup Alpay, Atakan Ezici
BACKGROUND: To investigate changes in lower extremity coronal alignment in patients with unilateral Crowe type IV developmental dysplasia of the hip who underwent total hip arthroplasty with transverse femoral shortening osteotomy. METHODS: We reviewed the preoperative and 1-year postoperative full-length lower extremity radiographs of 25 patients. Femoral offset (FO), mechanical hip-knee-ankle angle, anatomical axis, mechanical axis deviation (MAD), mechanical lateral proximal femoral angle, anatomical medial proximal femoral angle, mechanical lateral distal femoral angle, anatomical lateral distal femoral angle, knee joint line congruency angle, mechanical medial proximal tibial angle, mechanical lateral distal tibial angle, ankle joint line orientation angle, tibial plafond talus angle, extremity length, and pelvic obliquity were measured on both the operative and nonoperative sides...
June 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28623062/salvage-of-the-foot-for-recurrent-malignant-peripheral-nerve-sheath%C3%A2-tumor
#3
Meletis Rozis, Eustratios Papadelis, Andreas Mavrogenis, Spyridon Koufos, Vasilios Polyzois, Spyros Pneumaticos
Malignant peripheral nerve sheath tumors are rare soft tissue tumors accounting for 3% to 10% of all soft tissue tumors. They are strongly related to neurofibromatosis type 1, an autosomal dominant disease, and are characterized by aggressive biologic behavior, high local recurrence rates, and frequent metastases. Although the major nerves of the lower extremities are a common location of these tumors, scarce cases have been reported of malignant peripheral nerve sheath tumors involving the interdigital nerves of the foot...
June 13, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28616759/is-dual-semitendinosus-allograft-stronger-than-turndown-for-achilles-tendon-reconstruction-an-in-vitro-analysis
#4
Michael C Aynardi, Lara C Atwater, Roshan Melvani, Brent G Parks, Adrian G Paez, Stuart D Miller
BACKGROUND: Large Achilles tendon defects pose a treatment challenge. The standard treatment with a turndown flap requires a large extensile incision, puts the sural nerve at risk, and demands slow, careful rehabilitation. Dual allograft semitendinosus reconstruction is a new clinical alternative that has the theoretical advantages of a smaller incision, less dissection, and a stronger construct that may allow for faster rehabilitation. QUESTIONS/PURPOSES: In a cadaver biomechanical model, we compared the dual allograft semitendinosus reconstruction with the myofascial turndown in terms of (1) mechanical strength and resistance to deformation and (2) failure mechanisms in reconstruction of large segmental Achilles defects...
June 14, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28606434/the-relationships-between-surface-measurements-and%C3%A2-underlying-tendon-autograft-length-for-upper%C3%A2-extremity-reconstructive-surgery
#5
Michael T Milone, Mikael Starecki, Omri Ayalon, Michael W Aversano, Anthony Sapienza
PURPOSE: The availability of tendon grafts is an important consideration for successful upper extremity reconstructive surgery, including flexor or extensor tendon reconstructions, tendon transfers, and ligament reconstructions. Graft selection is based on availability, expendability, ease of harvest, and length. Given variations in patient height and extremity length, existing average values may provide suboptimal insight into actual tendon lengths available. The purpose of this study is, therefore, to pursue a method of estimating available donor tendon lengths based on easily measured anatomical surface landmarks...
June 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28606045/patient-impressions-of-possible-catastrophic-outcomes-after-diabetic-foot-ulceration
#6
Benjamin Vickers, Javier La Fontaine, Naohiro Shibuya, Daniel C Jupiter, Zachary Ashmore
BACKGROUND: Diabetes mellitus (DM) and its complications are well studied; patients with diabetes may suffer from neuropathy and vascular issues, and associated with these, lower extremity ulceration. Ulcers are often refractory to treatment, and can be difficult for both patients and clinicians to manage. Such complications may lead to amputations, which in turn are a risk factor for death. However, in certain situations amputation may be the only option available, and may be used as reconstructive surgery, restoring function...
June 12, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28604551/the-periosteal-medial-femoral-condyle-free-flap-a-new-option-for-soft-tissue-reconstruction-of-the-distal-lower-extremity
#7
Noah H Saad, Matthew E Pontell, Brian S Winters, Joseph Daniel, Adam Saad
BACKGROUND: Small (<30 cm) soft tissue defects of the distal leg, foot, and ankle pose a complicated issue with regard to wound healing. Multiple flaps have been proposed for reconstruction of these wounds with varying levels of success. The medial femoral condyle flap is a free bone flap supplied by the descending geniculate artery. It is currently used in the treatment of fracture nonunion, infected bone defects, avascular necrosis, and osteoradionecrosis. This study proposes the use of the periosteal portion of the medial femoral condyle (PMFC) flap for soft tissue reconstruction of the distal leg, foot, and ankle...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28604548/pediatric-lower-extremity-lawn-mower-injuries-and-reconstruction-retrospective-10-year-review-at-a-level-1-trauma-center
#8
Leslie G Branch, John C Crantford, James T Thompson, Shruti C Tannan
INTRODUCTION: From 2004 to 2013, there were 9341 lawn mower injuries in children under 20 years old. The incidence of lawn mower injuries in children has not decreased since 1990 despite implementation of various different prevention strategies. In this report, the authors review the results of pediatric lawn mower-related lower-extremity injuries treated at a tertiary care referral center as well as review the overall literature. METHODS: A retrospective review was performed at a level 1 trauma center over a 10-year period (2005-2015)...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28598582/outcomes-of-intercalary-prosthetic-reconstruction-for-pathological-diaphyseal-femoral-fractures-secondary-to-metastatic-tumors
#9
Hong-Chao Huang, Yong-Cheng Hu, Deng-Xing Lun, Jun Miao, Feng Wang, Xiong-Gang Yang, Xin-Long Ma
OBJECTIVE: To evaluate the clinical outcomes and complications of segmental prosthetic reconstruction for pathological diaphyseal femoral fractures secondary to metastatic tumors. METHODS: Between 2011 and 2015, we retrospectively evaluated 16 patients (6 men and 10 women; 64.5 ± 11.4 years old at diagnosis) who underwent prosthetic reconstruction after segmental resection of diaphyseal femoral fractures due to metastatic lesions. Visual analog scale (VAS), functional outcomes, implant-related complications, and Mean postoperative Musculoskeletal Tumor Society (MSTS) score for each patient were collected...
June 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28574048/-assessment-of-severity-of-lesions-of-arterial-basins-in-patients-with-multifocal-atherosclerosis
#10
Zh G Sobirov, F Sh Bakhritdinov
The present study was aimed at working out a methodology combining clinical, haemodynamic, and functional parameters of lesions of arterial basins in patients presenting with concomitant lesions of the aortic arch branches and arteries of lower extremities. The authors retrospectively investigated the results of examining a total of 181 patients operated on for concomitant atherosclerotic lesions of the aortic arch branches, terminal portion of the abdominal aorta, and lower limb arteries. In patients subjected as the first stage to interventions on the aortic arch branches (Group 1), the index of severity of the lesion of the aortic arch branches (Cs) was higher than in those from Groups 2 and 3...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28562573/predictors-of-secondary-amputation-in-patients-with-grade-iiic-lower-limb-injuries-a-retrospective-analysis-of-35-patients
#11
Wenhao Song, DongSheng Zhou, Jinlei Dong
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28558939/the-humboldt-penguin-spheniscus-humboldti-rete-tibiotarsale-a-supreme-biological-heat-exchanger
#12
Shaked Kazas, Moran Benelly, Saar Golan
Humans are unable to survive low temperature environments without custom designed clothing and support systems. In contrast, certain penguin species inhabit extremely cold climates without losing substantial energy to self-heating (emperor penguins ambient temperature plummets to as low as -45°C). Penguins accomplish this task by relying on distinct anatomical, physiological and behavioral adaptations. One such adaptation is a blood vessel heat exchanger called the 'Rete Tibiotarsale' - an intermingled network of arteries and veins found in penguins' legs...
July 2017: Journal of Thermal Biology
https://www.readbyqxmd.com/read/28538374/a-systematic-review-of-the-keystone-design-perforator-island-flap-in-lower-extremity-defects
#13
REVIEW
Jiuzuo Huang, Nanze Yu, Xiao Long, Xiaojun Wang
BACKGROUND: The keystone design perforator island flap is useful for the reconstruction of lower extremity defects. We performed a systematic review with the objective of identifying complication rates associated with using the keystone design perforator island flap to treat such defects. METHODS: The MEDLINE, PubMed Central, Embase, and Cochrane databases were searched from January 2003 to August 2016 for articles describing keystone design perforator island flaps in lower extremities...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28536801/induced-membrane-technique-using-beta-tricalcium-phosphate-for-reconstruction-of-femoral-and-tibial-segmental-bone-loss-due-to-infection-technical-tips-and-preliminary-clinical-results
#14
Gen Sasaki, Yoshinobu Watanabe, Wataru Miyamoto, Youichi Yasui, Shota Morimoto, Hirotaka Kawano
PURPOSE: This study aimed to provide preliminary evidence regarding effectiveness of grafting beta-tricalcium phosphate (β-TCP) combined with a cancellous autograft for treating nonunion of long bones in the lower extremity due to infection by evaluating clinical and radiological outcomes. METHODS: We retrospectively reviewed the clinical and radiological results in seven patients (six men, one woman; median age 39 years) treated by the induced membrane technique for nonunion of the femur or tibia due to infection...
May 24, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28536044/free-tissue-transfer-for-necrotizing-fasciitis-reconstruction-a-case-series
#15
Justin Peter Gawaziuk, Tianyi Liu, Leif Sigurdson, Edward Buchel, Thomas Edward Jo Hayakawa, Sarah Shiga, Sarvesh Logsetty
BACKGROUND: Necrotizing fasciitis (NF) is a life-threatening infection requiring extensive debridement that may necessitate amputation. Free tissue transfer (FTT) is an option for reconstruction in difficult cases. Currently, only case reports have described FTT in the setting of NF, and comprehensive evidence on flap outcomes is lacking. The present study characterizes outcomes in patients with FTT following NF. METHODS: All patients admitted with NF between January 1, 2005 and December 31, 2011 to our level 1 burns/trauma referral center were retrospectively reviewed...
May 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28527883/endovascular-iliocaval-stent-reconstruction-for-inferior-vena-cava-filter-associated-iliocaval-thrombosis-approach-technical-success-safety-and-two-year-outcomes-in-120-patients
#16
Jeffrey Forris Beecham Chick, Alexandria Jo, J Matthew Meadows, Steven D Abramowitz, Minhaj S Khaja, Kyle J Cooper, David M Williams
PURPOSE: To report technical success, outcomes, and patency of iliocaval stent reconstruction for inferior vena cava (IVC) filter-bearing iliocaval thrombosis. MATERIALS AND METHODS: A total of 120 patients with 123 IVC filters and symptomatic iliocaval thrombosis underwent stent reconstruction. Mean patient age was 55 years (range, 19-88 y). Filters included 70 (57%) retrievable and 53 (43%) permanent filters. Symptoms included lower extremity swelling or pain (n = 93), ulcers (n = 8), phlegmasia (n = 7), back pain (n = 5), shortness of breath (n = 4), worsening renal function (n = 2), and stenosis identified during translumbar catheter placement (n = 1)...
May 18, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28526560/limb-flexion-induced-axial-compression-and-bending-in-human-femoropopliteal-artery-segments
#17
William Poulson, Alexey Kamenskiy, Andreas Seas, Paul Deegan, Carol Lomneth, Jason MacTaggart
BACKGROUND: High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities...
May 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#18
Hyuma A Leland, Alexis D Rounds, Karen E Burtt, Daniel J Gould, Geoffrey S Marecek, Ram K Alluri, Ketan M Patel, Joseph N Carey
BACKGROUND: Tibial fracture management may be complicated by infection of internal fixation hardware (iIFH) resulting in increased morbidity and amputation rate. When iIFH removal is not possible, salvage of the lower extremity is attempted through debridement, antibiotics, and vascularized soft tissue coverage. This study investigates lower extremity salvage with retention of iIFH. METHODS: Demographics, outcomes, and bacterial speciation in patients with tibial fractures at a level 1 trauma center from 2007 to 2014 were reviewed...
May 16, 2017: Microsurgery
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#19
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507858/reconstructing-discontinuous-facial-defects-with-simultaneous-ulnar-perforator-free-flaps
#20
Carissa M Thomas, Mofiyinfolu Sokoya, Frederic W-B Deleyiannis
Multiple, simultaneous skin cancers of the face are common. This is the first description of reconstructing discontinuous facial defects (i.e., separate sites of the face) with simultaneous ulnar perforator flaps. The distinct innovations of this multiple flap design are the ability to restrict the harvest site to one extremity, to obtain vein and arterial grafts from the same extremity, and to create multiple flaps with minimal hirsutism and bulk. We present a case of a 57-year-old male with multiple basal cell carcinomas who underwent wide local excisions of the right upper lip and cheek and of the left lower eyelid and infraorbital cheek...
April 2017: Plastic and Reconstructive Surgery. Global Open
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