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lower extremity reconstruction

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https://www.readbyqxmd.com/read/28432762/microvascular-replantation-of-head-and-neck-amputated-parts-a-systematic-review
#1
REVIEW
Johnny I Efanov, Ixchel J Montoya, Ke N Huang, Charles Guertin, Patrick G Harris, Joseph Bou-Merhi, Alain M Danino
BACKGROUND: As opposed to upper and lower extremity amputations representing a considerable volume of admissions, the prowess of microsurgeons is seldom solicited in complex cases of head and neck replantation. Our aim was to determine the rate of successful replantation of craniofacial parts in a systematic review of the literature. METHODS: We performed a systematic review of English literature using PubMed/MEDLINE for every replantation of a head and neck parts...
April 22, 2017: Microsurgery
https://www.readbyqxmd.com/read/28425251/evaluation-of-plantar-pressure-distributions-in-patients-with-anteriorcruciate-ligament-deficiency-preoperative-and-postoperative-changes
#2
Engin Çetin, Mehmet Ali Deveci, Murat Songür, Hamza Özer, Sacit Turanli
BACKGROUND/AIM: Anterior cruciate ligament (ACL) deficiency results in several kinematic changes in the lower extremities. The aim of this study is to define the plantar pressure parameters in ACL-deficient patients and to show the effect of ACL reconstruction on dynamic plantar pressure. MATERIALS AND METHODS: Forty patients with unilateral ACL rupture and 40 healthy controls were included in this study. Dynamic plantar pressures of both groups were recorded by the EMED SF-2 system during level walking...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28423061/muscle-contributions-to-medial-tibiofemoral-compartment-contact-loading-following-acl-reconstruction-using-semitendinosus-and-gracilis-tendon-grafts
#3
Jason M Konrath, David J Saxby, Bryce A Killen, Claudio Pizzolato, Christopher J Vertullo, Rod S Barrett, David G Lloyd
BACKGROUND: The muscle-tendon properties of the semitendinosus (ST) and gracilis (GR) are substantially altered following tendon harvest for the purpose of anterior cruciate ligament reconstruction (ACLR). This study adopted a musculoskeletal modelling approach to determine how the changes to the ST and GR muscle-tendon properties alter their contribution to medial compartment contact loading within the tibiofemoral joint in post ACLR patients, and the extent to which other muscles compensate under the same external loading conditions during walking, running and sidestep cutting...
2017: PloS One
https://www.readbyqxmd.com/read/28408083/masquelet-technique-versus-ilizarov-bone-transport-for-reconstruction-of-lower-extremity-bone-defects-following-posttraumatic-osteomyelitis
#4
Kai Tong, Ziyi Zhong, Yulan Peng, Chuangxin Lin, Shenglu Cao, YunPing Yang, Gang Wang
OBJECTIVE: This study was to compare the effectiveness of Masquelet technique versus Ilizarov bone transport in the treatment of lower extremity bone defects following posttraumatic osteomyelitis. PATIENTS AND METHODS: We retrospectively reviewed 39 patients who had been treated at our department for lower extremity bone defects following posttraumatic osteomyelitis. They were 30 males and 9 females with a mean age of 39.18 (range, 12-63 years). The infected bone defects involved 26 tibias and 13 femurs...
April 4, 2017: Injury
https://www.readbyqxmd.com/read/28407317/reconstruction-of-quadriceps-function-with-composite-free-tissue-transfers-following-sarcoma-resection
#5
Kempland C Walley, Erin M Taylor, Megan Anderson, Santiago Lozano-Calderon, Matthew L Iorio
BACKGROUND AND OBJECTIVES Wide margin resection of a soft tissue sarcoma (STS) may require extensive removal of quadriceps muscle with or without the knee extensor mechanism. The objective of this study is to present present the use of a combined functional muscle transfer and soft tissue coverage through the use of chimeric anterolateral thigh flaps. METHODS: Patients were retrospectively reviewed who underwent deep STS resection of the anterior compartment of the thigh with functional reconstruction of knee extension using a contralateral free anterolateral thigh (ALT) flap...
April 13, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28403000/the-combined-use-of-a-neurocutaneous-flap-and-the-ilizarov-technique-for-reconstruction-of-large-soft-tissue-defects-and-bone-loss-in-the-tibia
#6
Jia Xu, Wan-Run Zhong, Liang Cheng, Chun-Yang Wang, Gen Wen, Pei Han, Yi-Min Chai
BACKGROUND: Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS: We retrospectively reviewed 18 consecutive patients with trauma-related soft tissue defects and bone loss. The size of the soft tissue defect ranges from 8 × 9 cm to 14 × 18 cm...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28401281/ct-angiography-and-3d-imaging-in-aortoiliac-occlusive-disease-collateral-pathways-in-leriche-syndrome
#7
REVIEW
Sameer Ahmed, Siva P Raman, Elliot K Fishman
Collateral pathways in aortoiliac occlusive disease are essential for arterial blood flow to the abdomen, pelvis, and lower extremities. These pathways can be broadly divided into systemic-systemic, visceral-visceral, and systemic-visceral collateral networks. MDCT angiography is the most commonly used modality for the diagnostic evaluation of patients with aortoiliac occlusive disease, allowing excellent evaluation of stenotic arterial segments, as well as beautifully illustrating resulting collateral pathways (particularly when utilizing 3D reconstruction techniques)...
April 11, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28399024/immediate-reconstruction-for-plantar-melanoma-a-paradigm-shift
#8
Hunter Oliver-Allen, Merisa Piper, Carolyn Vaughn, Hani Sbitany
INTRODUCTION: Plantar melanoma tumors are traditionally treated with wide local excision based on depth of invasion, followed by delayed reconstruction once negative surgical margins are confirmed. However, delayed reconstruction requires care for an open wound, a prolonged treatment course, and the need for an additional surgery. Immediate reconstruction has been shown to be oncologically safe in head and neck melanoma, but little is described in the literature regarding immediate reconstruction in plantar melanoma...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28382276/prosthetic-grafting-and-arteriovenous-fistula-for-the-surgical-management-of-a-common-femoral-vein-injury-using-a-staged-approach
#9
Kuk Hui Son, So Young Lee, Jin Mo Kang, Chang Hu Choi, Kook Yang Park, Chul Hyun Park
A 27-year-old female patient was referred due to an edematous left lower extremity. Both saphenous veins had been ablated with an endovenous laser procedure used to treat varicose veins. Venography revealed that the left common femoral vein had been divided and that thrombosis was present at the site of division. No veins were available around the thighs. The patient was treated using a staged procedure. During the first stage, a ringed polytetrafluoroethylene graft was used to repair the common femoral vein, and an arteriovenous fistula was constructed from the femoral artery to the graft using a short segment of cephalic vein to increase graft patency...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28378316/domino-reconstruction-of-the-portal-vein-using-the-external-iliac-vein-and-an-eptfe-graft-in-pancreatic-surgery
#10
Masato Yoshioka, Hiroshi Uchinami, Go Watanabe, Masatake Iida, Yasuhiko Nakagawa, Hideaki Miyazawa, Makoto Yoshida, Yuzo Yamamoto
BACKGROUND: In the portal vein resection of long distance, an interposition by autologous vein is mandatory. External iliac vein (EIV) has been used, but harvesting the EIV is associated with severe venous congestion of the affected lower extremity. We have reconstructed the EIV using a ringed expanded polytetrafluoroethylene (ePTFE) graft. METHODS: Thirteen patients underwent this surgery. The right EIV was used for reconstructing the portal vein, and the retrieved portion of EIV was interposed by the ePTFE graft...
April 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28363228/super-thin-and-suprafascial-anterolateral-thigh-perforator-flaps-for-extremity-reconstruction
#11
Akhil K Seth, Matthew L Iorio
Background The anterolateral thigh (ALT) flap remains a workhorse for soft tissue reconstruction. However, the traditional ALT flap is often too bulky for resurfacing shallow, distal extremity defects, prohibiting adequate function, or well-fitted orthotics. This study evaluates extremity reconstruction using ALT flaps elevated in the suprafascial or super-thin plane. Methods Retrospective review of ALT free flap reconstruction from October 2014 to July 2016 was performed. Suprafascial and super-thin flaps were those elevated just above the crural fascia and within the superficial scarpal plane, respectively...
March 31, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28361285/evaluation-of-lower-limb-kinetics-during-gait-sprint-and-hop-tests-before-and-after-anterior-cruciate-ligament-reconstruction
#12
Joaquín Moya-Angeler, Javier Vaquero, Francisco Forriol
BACKGROUND: The purpose of this study was to evaluate the functional status prior to and at different times after anterior cruciate ligament reconstruction (ACLR), and to analyze the changes in the kinetic patterns of the involved and uninvolved lower limb during gait, sprint and three hop tests. MATERIALS AND METHODS: Seventy-four male patients with an ACL injury were included in the study. All patients performed a standardized kinetic protocol including gait, sprint and three hop tests (single-leg hop, drop vertical jump and vertical jump tests), preoperatively and at 3, 6, and 12 months after ACLR with a semitendinosus gracilis tendon autograft...
March 30, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28344600/staged-reconstruction-brachytherapy-has-lower-overall-cost-in-recurrent-soft-tissue-sarcoma
#13
Arash O Naghavi, Ricardo J Gonzalez, Jacob G Scott, Youngchul Kim, Yazan A Abuodeh, Tobin J Strom, Michelle Echevarria, John E Mullinax, Kamran A Ahmed, Louis B Harrison, Daniel C Fernandez
PURPOSE: Adjuvant brachytherapy (AB) with immediate (IR) and staged reconstruction (SR) are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS). Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective. MATERIAL AND METHODS: A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone...
February 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/28341505/secondary-aortoenteric-erosion-followed-by-recurrent-lower-extremity-abscesses
#14
Shigeshi Ono, Yoshitomo Samejima, Susumu Watada, Toshihiro Kakefuda
A secondary aortoenteric fistula (SAEF) is a relatively rare complication of aortoiliac reconstructive surgery, often involving relatively fixed duodenal 3(rd) portion and a vascular anastomosis. We observed a 52-year-old man with a recurrent right lower leg abscess following the erosion between ipsilateral bifurcated prosthetic graft limb and non-fixed jejunum. In situ graft-sparing surgical treatment with aggressive debridement was successfully performed. A SAEF may occur even at a non-vascular anastomosis site, or in non-fixed small bowel, and may become a source of a septic embolus...
March 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28340663/compound-or-specially-designed-flaps-in-the-lower-extremities
#15
REVIEW
Bruno Battiston, Davide Ciclamini, Jin Bo Tang
Novel and combined tissue transfers from the lower extremity provide new tools to combat soft tissue defects of the hand, foot, and ankle, or fracture nonunion. Flaps can be designed for special purposes, such as providing a gliding bed for a grafted or repaired tendon or for thumb or finger reconstruction. Propeller flaps can cover soft tissue defects of the leg and foot. In repairing severe bone and soft tissue defects of the lower extremity, combined approaches, including external fixators, one-stage vascularized bone grafting, and skin or muscle flap coverage of the traumatized leg and foot, have become popular...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28340662/vascularized-small-bone-transfers-for-fracture-nonunion-and-bony-defects
#16
REVIEW
Ai Dong Deng, Marco Innocenti, Rohit Arora, Markus Gabl, Jin Bo Tang
Vascularized small-bone grafting is an efficient and often necessary surgical approach for nonunion or necrosis of several bones in particular sites of the body, including scaphoid, lunate, distal ulna, and clavicle. The medial femoral condyle is an excellent graft source that can be used in treating scaphoid, ulna, clavicle, or lower-extremity bone defects, including nonunion. Vascularized bone grafting to the small bones, particularly involving reconstruction of damaged cartilage surfaces, should enhance subchondral vascular supply and help prevent cartilage regeneration...
April 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28327471/motion-compensation-in-extremity-cone-beam-ct-using-a-penalized-image-sharpness-criterion
#17
A Sisniega, J W Stayman, J Yorkston, J H Siewerdsen, W 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...
May 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28321479/novel-anatomical-reconstruction-of-distal-tibiofibular-ligaments-restores-syndesmotic-biomechanics
#18
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
#19
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
#20
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
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