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Limb amputation

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https://www.readbyqxmd.com/read/28538287/cost-utility-analysis-of-reconstruction-compared-with-primary-amputation-for-patients-with-severe-lower-limb-trauma-in-colombia
#1
Mateo Ceballos, Carlos Oliver Valderrama, Luis Esteban Orozco, Laura Sánchez, Juan Pablo Valderrama, Luz Helena Lugo
BACKGROUND: To establish, from the health system perspective, the cost-utility relationship of limb reconstruction compared with primary amputation for patients over 32 years with grade IIIB and IIIC severe lower limb trauma in Colombia, S.A. METHODS: A Markov model was built including different short-term and long-term states that represent the main events that a patient could experience after a lower limb amputation or a reconstruction. A 42-year time horizon was considered for the base case...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28533599/the-effect-of-segmental-weight-of-prosthesis-on-hemodynamic-responses-and-energy-expenditure-of-lower-extremity-amputees
#2
Akmer Mutlu, Mohammad Dawood Kharooty, Yavuz Yakut
[Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme's amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint...
April 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28532464/neurorehabilitation-in-upper-limb-amputation-understanding-how-neurophysiological-changes-can-affect-functional-rehabilitation
#3
REVIEW
Lewis A Wheaton
BACKGROUND: Significant advances have been made in developing new prosthetic technologies with the goal of restoring function to persons that suffer partial or complete loss of the upper limb. Despite these technological advances, many challenges remain in understanding barriers in patient adoption of technology, and what critical factors should be of focus in prosthetics development from a motor control perspective. This points to a potential opportunity to improve our understanding of amputation using neurophysiology and plasticity, and integrate this knowledge into the development of prosthetics technology in novel ways...
May 22, 2017: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#4
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
May 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#5
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527728/the-patient-s-experience-of-amputation-due-to-peripheral-arterial-disease
#6
Eva Torbjörnsson, Carin Ottosson, Lena Blomgren, Lennart Boström, Ann-Mari Fagerdahl
It is not uncommon that patients with peripheral arterial disease (PAD) need to undergo a lower limb amputation, with or without previous revascularization attempts. Despite that, the patient's experience of the amputation has been scarcely studied. The aim of this qualitative study was to describe the patient's experience of amputation due to PAD. Thirteen interviews were conducted with vascular patients who had undergone a lower limb amputation at tibia, knee, or femoral level. Data were analyzed with content analysis...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527727/patient-outcomes-following-lower-leg-major-amputations-for-peripheral-arterial-disease-a-series-review
#7
Susan Monaro, Sandra West, Janice Gullick
INTRODUCTION: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). AIM: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. METHOD: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527350/bi-dimensional-variational-mode-decomposition-of-laser-speckle-contrast-imaging-data-a-clinical-approach-to-critical-limb-ischemia
#8
Anne Humeau-Heurtier, Pierre Abraham, Samir Henni
The number of patients suffering from peripheral arterial occlusive disease (PAOD) is growing worldwide. PAOD corresponds to an impairment of perfusion in the distal portion of some arteries that can generate critical limb ischemia. For some patients, the pathology leads to the necessity of amputation. PAOD may be diagnosed and studied with transcutaneous oxygen (tcpO2) measurements. However, the tcpO2 technique is a contact technique: probes have to be positioned on the limb, which may be impossible in case of ulcers and can lead to infection risks...
May 13, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28526051/functional-evaluation-for-patients-with-lower-extremity-sarcoma-application-of-the-chinese-version-of-musculoskeletal-tumor-society-scoring-system
#9
Leilei Xu, Xinhua Li, Zhou Wang, Jin Xiong, Shoufeng Wang
BACKGROUND: The Musculoskeletal Tumor Society (MSTS) scoring system is a disease-specific instrument to determine the physical and mental health for patients with extremity sarcoma. This study aims to investigate the reliability and validity of the Chinese version of the MSTS, and to evaluate functional outcomes of the surgical treatment of lower extremity sarcoma using the Chinese MSTS. METHODS: A cohort of 98 patients who had undergone surgery for lower extremity sarcoma were included...
May 19, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#10
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28523994/potential-biomolecules-and-current-treatment-technologies-for-diabetic-foot-ulcer-an-overview
#11
Zenith Khashim, Shila Samuel, Nallusamy Duraisamy, Kathiravan Krishnan
BACKGROUND: Diabetic foot ulceration remains a major challenge is one of the most expensive and a leading cause of major and minor among patients with a diabetic foot ulcer. Hence the purpose of this review emphases on potential molecular markers involved in diabetic ulcer physiology, the efficacy of different types of dressing materials, therapy and newer therapeutic approach like nanoparticles for the of diabetic foot ulcer. METHODS: We conducted a systematic literature reviews search by using Pubmed and other web search...
May 18, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28520087/geographic-variation-and-risk-factors-for-systemic-and-limb-ischemic-events-in-patients-with-symptomatic-peripheral-artery-disease-insights-from-the-reach-registry
#12
Jérémie Abtan, Deepak L Bhatt, Yedid Elbez, Emmanuel Sorbets, Kim Eagle, Christopher M Reid, Iris Baumgartner, David Wu, Mary E Hanson, Hakima Hannachi, Puneet K Singhal, Philippe Gabriel Steg, Gregory Ducrocq
BACKGROUND: Patients with symptomatic peripheral artery disease (PAD) are at high risk of ischemic events. However, data about predictors of this risk are limited. HYPOTHESIS: We analyzed baseline characteristics and 4-year follow-up of patients enrolled in the international REduction of Atherothrombosis for Continued Health (REACH) Registry with symptomatic PAD and no history of stroke/transient ischemic attack to describe annual rates of recurrent ischemic events globally and geographically...
May 18, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28514130/-measuring-adherence-to-self-care-guidelines-for-patients-with-type-2-diabetes-with-diabetic-ulcers-admitted-to-the-orthopedic-rehabilitation-department-at-tel-hashomer-hospital-during-2012-2013
#13
Sigal Ezra, Itzhak Siev-Ner, Itzhak Zaidise
INTRODUCTION: Diabetic foot is a devastating complication of diabetes and represents the major cause of lower limb amputations in the western world in the 21st century. The World Health Organization predicts a dramatic increase in the number of diabetes patients over the next decade and by the year 2025, their number is expected to increase to 300 million. AIMS: Examine whether training leads to improving performance in the built-in self-care guidelines in patients with type 2 diabetes who were hospitalized with diabetic ulcers in the Orthopedic Rehabilitation Ward in Tel Hashomer between the years 2012-2013...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28513212/an-optical-fiber-based-smart-textile-smart-socks-to-manage-biomechanical-risk-factors-associated-with-diabetic-foot-amputation
#14
Bijan Najafi, Hooman Mohseni, Gurtej S Grewal, Talal K Talal, Robert A Menzies, David G Armstrong
OBJECTIVE: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). METHODS: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m(2)) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28511618/midterm-results-of-low-profile-stents-to-treat-atherosclerotic-iliac-artery-disease
#15
Nicola Troisi, Leonardo Ercolini, Emiliano Chisci, Piefrancesco Frosini, Enrico Barbanti, Stefano Michelagnoli
PURPOSE: To evaluate the safety and effectiveness of low-profile 4-F stents for the treatment of atherosclerotic iliac artery lesions. METHODS: Between January 2009 and December 2015, 63 patients (mean age 69.3 years; 42 men) received low-profile stents (Astron Pulsar or Pulsar-18) at the discretion of the operator to treat iliac artery occlusive disease. The majority of patients (40, 63.5%) had critical limb ischemia; 36 of 82 lesions were total occlusions. All procedures were performed with 4-F equipment...
June 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28509409/soft-tissue-reconstruction-and-salvage-of-infected-fixation-hardware-in-lower-extremity-trauma
#16
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/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#17
M Hari Krishna Reddy, B Sangeetha, M Aruna, V Sarat Chandra, Anil C Venkata Kumar, R Ram, V Sivakumar
There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508918/-local-anaesthesia-in-ruminants
#18
Karl Nuss, Andrea Schwarz, Simone Ringer
The use of local anaesthesia in ruminants allows many surgical procedures to be conducted free of pain, efficiently and inexpensively in the field. Local anaesthesia combined with sedation and immobilisation of the animal can replace general anaesthesia for many procedures (e. g. castration, claw amputation). The level of difficulty differs among various local anaesthetic techniques: local infiltration of tissue or anaesthesia of the cornual nerve are easily performed, whereas local anaesthesia of the eye, regional anaesthesia in limbs or anaesthesia for umbilical surgery are more difficult to carry out...
May 16, 2017: Tierärztliche Praxis. Ausgabe G, Grosstiere/Nutztiere
https://www.readbyqxmd.com/read/28507971/lethal-necrotizing-fasciitis-triggered-by-plaster-case-report-and-review-of-literature
#19
Mohit J Jain, Kinjal Mavani
INTRODUCTION: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster. CASE REPORT: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#20
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
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