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Deep Fascia

Sergio Petroni, Paolo Capozzi, Rosa Parrilla, Gaetano Zinzanella, Luca Buzzonetti
PURPOSE: To evaluate the surgical outcome of a frontalis sling using deep temporal fascia in the treatment of severe congenital ptosis (SCP). METHODS: A retrospective, interventional case series was performed. The study involved 25 patients with SCP (>4 mm). All patients underwent frontalis sling surgery with deep temporal fascia between 2004 and 2012 with a follow-up period of 12 months at a minimum. Data regarding eyelid position, eyelid symmetry, cosmetic outcomes, and postoperative complications were evaluated...
October 16, 2018: Orbit
Min A Yoon, Choong Guen Chee, Hye Won Chung, Joon Seon Song, Jong Seok Lee, Wanlim Kim, Min Hee Lee, Sang Hoon Lee, Myung Jin Shin
OBJECTIVES: This study was conducted to evaluate the added value of diffusion-weighted imaging (DWI) to conventional magnetic resonance imaging (MRI) for predicting fascial involvement of soft tissue sarcomas located in close proximity to fascial boundaries. METHODS: This retrospective study included 29 patients with surgically resected soft tissue sarcomas located in proximity to deep fascia and with a curvilinear tail-like hyperintensity in the adjacent fascia on T2-weighted images...
October 15, 2018: European Radiology
Robert E Van Demark, Matthew C Anderson, Jeb T List, Meredith Hayes, Matthew Hayes, David Woodard
A 46-year-old female presented after 3 years of steadily increasing numbness in her hands bilaterally with worse symptoms in her right hand. She reported nighttime paresthesia and exacerbation of her symptoms while writing, typing, and driving. Tinel's and carpal tunnel compression test were positive bilaterally. During the right hand carpal tunnel release, a layer of synovium was present deep to the carpal ligament with a tendinous portion running midline longitudinally along the median nerve. This layer was an anomalous palmaris profundus (PP) tendon within the carpal tunnel, which inserted distally in the palmar fascia...
August 2018: Plastic and Reconstructive Surgery. Global Open
Anhad B S Sidhu, Sarah M Rosanowski, Alexandra M Davis, James F Griffith, Paul Robinson
OBJECTIVE: To quantitate the iatrogenic injury associated with deep plantar metatarsal fasciotomy performed with Metzenbaum scissors compared with a Y-shaped fasciotome. STUDY DESIGN: Experimental ex vivo surgical study. STUDY POPULATION: Cadaveric hind limbs (n = 20) from 10 sound thoroughbred racehorses. METHODS: A plantar metatarsal fasciotomy was performed, extending from the proximal extent of the deep metatarsal fascia, distally...
October 15, 2018: Veterinary Surgery: VS
Woo Jong Kim, Hong Seop Lee, Sung Hun Won, Yong Cheol Hong, Dhong Won Lee, Ji-Hye Lee, Chang Hyun Kim
RATIONALE: The Morel-Lavallée lesion (MLL) is a closed degloving injury developing when shear force acts between the muscle fascia and the subcutaneous layer. MLLs develop principally in the trochanteric area or the pelvis; lesions in the proximal calf are rare. Acute lesions can be treated conservatively, but chronic lesions are best treated surgically because of a high rate of recurrence. To the best of our knowledge, this is a rare case of successful treatment of an MLL in the proximal calf associated with tibio-fibular shaft fracture...
October 2018: Medicine (Baltimore)
Hironobu Ueshima, Hiroshi Otake
RATIONALE: The relief of selective hip pain may be difficult to attain. Therefore, a deep nerve block such as epidural anesthesia or lumbar plexus nerve block is required. However, deep nerve blocks may not be possible in patients with complications, including severe cardiovascular disease. PATIENTS CONCERNS: The patient in our report had coronary stents inserted previously and required continuous anticoagulant therapy owing to severe heart failure. DIAGNOSIS: Bipolar hip arthroplasty was required in our patient because of a fracture of the neck of femur on the left side...
October 2018: Medicine (Baltimore)
Xuekang Yang, Zhuoqun Fang, Mengdong Liu, Yue Zhang, Qiaohua Chen, Ke Tao, Juntao Han, Dahai Hu
BACKGROUND: This study introduces a technique for the reconstruction of deep toe defects in diabetic patients using a method that combines free vascularized fascia flap with skin grafting. METHODS: In this retrospective study, conducted between March 2010 and February 2016, 15 diabetic patients with deep toe ulcer received surgeries that combined free vascularized fascia flap with skin grafting, including nine anterolateral thigh fascia lata flaps and six superficial temporal fascia flaps...
November 2018: Journal of Surgical Research
Mukund Gundanna, Kunal Shah
Background: Lateral lumbar interbody fusion (LLIF) has proved to be a safe tool in the armamentarium of spine surgeons for a variety of lumbar disorders. However, it has some complications related to specific approaches. Incisional hernia following abdominal surgery and anterior spinal surgery is commonly described; however, it is extremely rare following LLIF, with only 1 case reported in short postoperative period. In this report we present the first case of delayed presentation of true incisional hernia following a LLIF procedure and highlight its presentation, mechanism, possible preventive measures, and management...
April 2018: International Journal of Spine Surgery
Q Bettex, C Jaloux, M Abellan Lopez, D Casanova, B Bertrand, C Philandrianos
Breast reconstruction by abdominal flap has evolved to ensure minimal donor-site morbidity with the description of Deep Inferior Epigastric artery Perforator flap (DIEP flap). Being of the same thickness and the same surface, the Superficial Inferior Epigastric Artery flap (SIEA flap) does not require, for it harvesting, to open the abdominal fascia or to dissect through the muscles minimizing again donor-site sequelae. However, it is little used because of the variability of its vascularization and a higher failure rate than the DIEP in the literature...
September 27, 2018: Annales de Chirurgie Plastique et Esthétique
Sandeep Silawal, Karim Rayan Galal, Gundula Schulze-Tanzil
A rare unilateral variation of the first left lumbrical muscle was discovered in a female Caucasian cadaver dissected during a first year anatomy course at the Paracelsus Medical University - Nuremberg, Germany. The muscle possessed two venters with the first originating near the medial epicondyle of the humerus together with the intramuscular tendon of the superficial flexor digitorum tendon, and the second presenting as a regular first lumbrical muscle with radial palmar origin from first tendon of the deep flexor digitorum muscle...
September 25, 2018: Morphologie: Bulletin de L'Association des Anatomistes
M Atanasiu, A Paré, J D Kun-Darbois, D Goga, B Croisé
INTRODUCTION: Rhinoplasty is frequently performed worldwide, and patients and surgeons both expect good cosmetic results without any deformity recurrence. We report a rare case of mucous cyst occurred after post-traumatic rhinoseptoplasty. OBSERVATION: A 27-year old woman presented a median mass of the nose root 7 years after prior rhinoseptoplasty. Investigations showed a subcutaneous lesion of 10.5×24.5mm. The surgery consisted on an external rhinoplasty allowing cyst removal, bilateral osteotomies and reconstruction of the nasal dorsum by deep temporal fascia graft...
September 21, 2018: Annales de Chirurgie Plastique et Esthétique
Bahman Guyuron, Nazilla S Seyed Forootan, Kris Katira
BACKGROUND: Super-high superficial musculoaponeurotic system (SMAS) suspension and tailor tack plication are powerful facelift tools used in cases of primary facial rhytidectomy. TECHNIQUE: Thorough pre-operative patient screening and counseling are completed in an outpatient cosmetic surgery center. A super-high SMAS flap is developed by undermining and incising along a line extending from the tragus to lateral canthus and dissecting the SMAS sufficiently to induce movement of the lateral nose and the oral commissure with traction on the SMAS...
September 19, 2018: Aesthetic Plastic Surgery
M Severyns, R Nevière, D Resiere, T Andriamananaivo, L Decaestecker, H Mehdaoui, G A Odri, J L Rouvillain
Bothrops lanceolatus is an endemic Crotalidae species in Martinique, where approximately 30 cases of envenoming are managed yearly. Envenoming characteristics from Bothrops species include local tissue damage, systemic bleeding, and hemodynamic alterations. We hereby report a case of severe envenomation following B. lanceolatus snakebite to the right calf. Severe local manifestations developed progressively up to the lower limb despite adequate antivenom therapy. Systemic manifestations of venom also occurred, resulting in intensive care therapy...
September 17, 2018: American Journal of Tropical Medicine and Hygiene
Miroslav L Djordjevic
The current management of female to male (FTM) gender confirmation surgery is based on the advances in neo phalloplasty, perioperative care and the knowledge of the female genital anatomy, as well as the changes that occur to this anatomy with preoperative hormonal changes in transgender population. Reconstruction of the neophallus is one of the most difficult elements in surgical treatment of female transsexuals. While there is a variety of available surgical techniques, their results are not equally acceptable to all patients...
August 2018: Translational Andrology and Urology
Christopher N Johnson, Alice S Ha, Eleanor Chen, Darin Davidson
Lipomatous soft-tissue tumors are the most common neoplasms encountered by physicians. They range from benign lipomas to high-grade liposarcomas. Unplanned excisions of sarcomas are commonly due to the presumptive diagnosis of lipoma and can be avoided by understanding their diagnostic magnetic resonance imaging appearance. Magnetic resonance images should be obtained for all soft-tissue masses that are deep to fascia or those >5 cm in subcutaneous tissue. Atypical lipomatous tumors present as large deep fatty masses and have a propensity for local recurrence and a small risk of malignant transformation...
September 5, 2018: Journal of the American Academy of Orthopaedic Surgeons
Daniel P Butler, Agata M Plonczak, Dimitris Reissis, Francis P Henry, Judith E Hunter, Simon H Wood, Navid Jallali
Deep inferior epigastric artery perforator (DIEP) flap has become the gold standard in autologous breast reconstruction. Attention is now being focused on the impact of DIEP flap harvest technique on abdominal hernia rates. The aim of this study was to evaluate DIEP abdominal wall morbidity in relation to flap harvest and fascial closure technique. A retrospective analysis of patients undergoing DIEP flap breast reconstruction between 2012 and 2016 was performed. Post-operative evaluation of the abdominal wall integrity was performed by an operating consultant...
September 4, 2018: Journal of Plastic Surgery and Hand Surgery
Łukasz Olewnik, Bartosz Gonera, Konrad Kurtys, Michał Podgórski, Michał Polguj, Marcin Sibiński, Mirosław Topol
INTRODUCTION: The anterolateral ligament (ALL) is a potential stabilizer of the knee and cooperates with the anterior cruciate ligament (ACL). It originates on the lateral epicondyle of the femur, to which it is mainly posterior and proximal; insertion is posterior to Gerdy's tubercle. Its anatomical characteristics vary. Recent publications have focused on morphological variations concerning mainly the femoral and tibial attachments, and on morphometric measurements. Histological and cystochemical examinations have also been performed...
August 25, 2018: Clinical Anatomy
Christian von Rüden, Richard Kühl, Christoph J Erichsen, Stephen L Kates, Sven Hungerer, Mario Morgenstern
Skin and soft tissue infections include the skin as well as fascia, muscles, ligaments, tendons, synovial membranes, fat, blood vessels, nerves, and fibrous tissues. They range from superficial infections to deep infections with a necrotizing clinical course. These infections can promptly progress with severe systemic complications, requiring rapid management, and proper surgical and medical treatment. This manuscript provides recommendations based on current practice guidelines for diagnosis and treatment of surgically relevant skin and soft tissue infections in adults...
August 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Paul J Choi, Chidinma Nwaogbe, Joe Iwanaga, Georgi P Georgiev, Rod J Oskouian, R Shane Tubbs
Introduction A reoperation for a cubital tunnel syndrome is not uncommon. Patients often complain of sensorimotor symptoms in the ulnar nerve distribution after their primary surgery. The documented etiologies for such a phenomenon include a "new" kinking of the distal ulnar nerve and a "new" compression of the ulnar nerve by the fascial septum in between or tendinous bands over the muscles of the forearm. The deep fascial plane along which the ulnar nerve travels in the forearm has had scant attention...
June 19, 2018: Curēus
Young Chul Suh, Joon Pio Hong, Hyunsuk Peter Suh
According to early studies on the superficial circumflex iliac artery perforator flap, there are two major types of perforators that are presumed to originate from the superficial circumflex iliac artery: the medial perforator with a direct cutaneous vessel (superficial branch) - located relatively medially on the flap, and the lateral perforator, traveling laterally beneath the deep fascia and often with an intramuscular pathway penetrating the deep fascia on the lateral aspect (deep branch) of the flap. Although there are well described studies on the anatomy of the arterial vasculature, design and elevation of the flap are different issues, as there are always some potential for anatomical variations, such as pedicle anatomy, location of lymph nodes, and thickness of superficial fascia...
August 2018: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
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