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Above knee amputation

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https://www.readbyqxmd.com/read/28966964/anterior-tibial-artery-perforator-plus-flaps-role-in-coverage-of-posttumor-excision-defects-around-the-knee-joint-and-upper-leg
#1
Harshvardhan Sahijwani, Vikas Warikoo, Abhijeet Ashok Salunke, Jaymin Shah, Preetish Bhavsar, Rahul Wagh, Subodh Pathak
OBJECTIVE: Posttumor excision defects can be very large, and many do require postoperative radiotherapy. It is therefore important to provide stable and durable wound coverage to provide ability to withstand radiotherapy as well as providing cover to vital structures. METHODS: Between July 2014 and June 2016, eight females and six male patients with defects around the knee were operated upon using a perforator plus flap from the anterior tibial artery perforator...
October 2017: Asia-Pacific Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28952363/identification-of-the-critical-level-of-implantation-of-an-osseointegrated-prosthesis-for-above-knee-amputees
#2
Elder Michael Andrango Castro, Svatava Konvickova, Matej Daniel, Zdenek Horak
The aim of our study was to identify potential critical levels of implantation of an osseointegrated prosthesis for above-knee amputees. The implant used was the OPRA system. It was inserted in the femur at four different amputation heights, characterized by their residual limb ratios (0.299, 0.44, 0.58 and 0.73). The stress and strain distribution was evaluated in the bone-implant system during walking, considering a body mass of 100 kg. Considerably high stimulus (11,489 με) in the tissue near the tip was found at the highest implantation level...
September 27, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#3
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28899563/treating-osteomyelitis-of-major-limb-amputations-with-a-modified-lautenbach-technique
#4
Juliet M Clutton, Oliver Donaldson, Anthony Perera, Rhidian Morgan-Jones
INTRODUCTION: Major lower limb amputation significantly increases the energy cost of walking for patients. Complications such as osteomyelitis may require further surgery, and can lead to shortening of the stump. In these cases, the aim should be to treat infection without shortening the limb further. We present a series of patients with established osteomyelitis of the amputation stump, managed using a modified Lautenbach technique. METHOD: Six patients with either above or below knee amputations, in the practice of a single orthopaedic surgeon, were studied...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#5
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by the level of amputation...
September 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885956/combat-casualties-and-severe-shock-risk-factors-for-death-at-role-3-military-facilities
#6
Michelle F Buehner, Brian J Eastridge, James K Aden, Joseph J DuBose, Lorne H Blackbourne, Ramon F Cestero
BACKGROUND: Although significant research has been conducted on combat casualties receiving blood products, there is limited data for the subpopulation presenting in shock. The purpose of this study was to evaluate combat casualties arriving to a role 3 facility with an initial systolic blood pressure (SBP) ≤ 90 in order to identify clinical characteristics and associations between presentation, transfusion therapy, and mortality outcomes. METHODS: The Department of Defense Trauma Registry was queried from 2001 to 2010 for trauma-related casualties who arrived at a role 3 combat surgical facility with a SBP ≤ 90...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28876598/spectrum-of-disease-and-outcome-of-primary-amputation-for-diabetic-foot-sepsis
#7
S Cheddie, C Manneh, H Zulu
BACKGROUND: Guillotine amputation for diabetic foot sepsis followed by an elective refashioning of the stump is regarded as standard practice. Primary amputation is associated with higher reamputation rates. METHOD: A prospective cohort study of 85 patients who underwent surgery for diabetic foot sepsis from 2014 to 2016 at Madadeni Provincial Hospital, KwaZulu-Natal was done. Ethical approval was granted. The Wagner classification (Wag) was used to classify disease severity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28865844/factors-affecting-lifespan-following-below-knee-amputation-in-diabetic-patients
#8
S Beyaz, Ü Ö Guler, G Ş Bagir
INTRODUCTION: Untreatable foot problems in diabetics may require lower extremity amputation, which has a high level of patient mortality. This high mortality rate is worse than most malignancies. The present study aimed to identify parameters that can be used to estimate survival in DM patients undergoing below-knee amputations for diabetic foot problems. MATERIALS AND METHODS: A total of 470 patients (299 males, 171 females) with a mean age of 64.32 years who underwent below-knee amputation for diabetic foot problems between 2004 and 2014 were enrolled in the study...
August 30, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28831328/a-unique-application-of-negative-pressure-wound-therapy-used-to-facilitate-patient-engagement-in-the-amputation-recovery-process
#9
Jessica Wise, Alicia White, Daniel J Stinner, John R Fergason
Amputation rates during recent military conflicts were at an all-time high, but medical treatment of those amputations and attitudes of service members to get back to duty are also surging ahead. We present the cases of an active duty rescue C130 pilot with an above-the-knee amputation and a retired army sergeant with a below-the-knee amputation. Successful rehabilitation was augmented in both cases by using negative pressure incorporated in a custom prosthetic socket to accelerate incision closure, improve self-efficacy in wound care, and self-management, ultimately leading to faster recovery times, full engagement of the rehabilitation process, and return to active duty...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28819590/minimally-invasive-total-hip-replacement-in-an-ipsilateral-post-traumatic-above-knee-amputation-a-case-report
#10
Sanjeev Patnaik, Biswaranjan Nayak, Akshaya Kumar Sahoo, Nabin Kumar Sahu
INTRODUCTION: Total hip replacement (THR) is a highly successful operation in alleviating pain and improving the overall function of the hip, in end-stage arthritis of the hip, in otherwise fit patients. However, THR as a surgical option in post-traumatic hip arthritis with ipsilateral above-knee amputation is rarely reported. CASE REPORT: We are presenting a case report of a 30-year-old male, who had previously underwent an above-knee amputation due to road-traffic accident, presenting 24 h after the injury with segmental fracture femur and popliteal artery laceration, for which the limb could not be salvaged...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28759543/endovascular-repair-of-peripheral-arterial-disease-midterm-results-from-a-single-center
#11
Kemal Korkmaz, Hikmet Selcuk Gedik, Ali Baran Budak, Serdar Gunaydin, Kerim Cagli
OBJECTIVE: One thousand consecutive patients who underwent endovascular repair in an 8-year period were studied retrospectively to evaluate technical success, freedom from reinterventions, early clinical outcome, and risk factors for restenosis/occlusion. METHODS: Mean ± SD Rutherford class was 3.29 ± 0.8. A total of 755 patients have claudication, 423 from rest pain, and 569 from ischemic ulceration. RESULTS: A total of 552 men and 448 women (mean ± SD = 69...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28701675/pathology-of-neointimal-calcification-in-very-late-restenosis-after-bare-metal-stent-implantation-for-superficial-femoral-artery
#12
Hiroyuki Jinnouchi, Katsumi Inoue, Yoshimitsu Soga, Yusuke Tomoi, Yohei Kobayashi, Seiichi Hiramori, Shinichi Shirai, Kenji Ando
A 60-year-old man, who had claudication in his right limb due to total occlusion of the right superficial femoral artery, received bare metal stents. Although the bare metal stents in the superficial femoral artery did not show restenosis 5 years after stent implantation, angiography revealed significant in-stent restenosis when he developed right critical limb ischemia at 8 years post implantation. Ballooning for in-stent lesions did not result in full expansion. His right limb was amputated above the knee due to progressive limb ischemia...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28697694/midterm-outcomes-from-a-pilot-study-of-percutaneous-deep-vein-arterialization-for-the-treatment-of-no-option-critical-limb-ischemia
#13
Steven Kum, Yih Kai Tan, Michiel A Schreve, Roberto Ferraresi, Ramon L Varcoe, Andrej Schmidt, Dierk Scheinert, Jihad A Mustapha, Darryl M Lim, Derek Ho, Tjun Y Tang, Vlad-Adrian Alexandrescu, Pramook Mutirangura
PURPOSE: To report the initial clinical experience with percutaneous deep vein arterialization (PDVA) to treat critical limb ischemia (CLI) via the creation of an arteriovenous fistula. METHODS: Seven patients (median age 85 years; 5 women) with CLI and no traditional endovascular or surgical revascularization options (no-option CLI) were recruited in a pilot study to determine the safety of PDVA. All patients were diabetic; 4 had Rutherford category 6 ischemia...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28663654/successful-management-of-above-knee-amputation-with-combined-and-modified-nerve-blocks
#14
T Senthil Kumar, K Indu, S Parthasarathy
We report a successful management of a case of methicillin-resistant Staphylococcus aureus positive right lower limb cellulitis for above knee amputation under combined nerve blocks. The ongoing sepsis, thrombocytopenia, and severe respiratory infection with wheeze made us avoid both neuraxial block and general anesthesia and plan for a nerve block. We instituted a modified high inguinal femoral block along with sciatic and lateral femoral nerve blocks separately to successfully conduct the case. We decided to report as there were not as many cases as ours in the literature...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28630841/bipolar-hemiarthroplasty-in-a-patient-with-above-knee-amputation-surgical-technique
#15
Ramesh Perumal, Santhosh Ram Gaddam, J Vasudeva, J Dheenadhayalan, S Rajasekaran
INTRODUCTION: Femoral neck fractures are a common occurrence in lower limb amputees. Good post-operative results of hip hemiarthroplasty have been described in below-knee amputees. However, to our knowledge, very few such cases have been reported in above-knee amputees. CASE REPORT: We present a case of a 75-year-old male patient who underwent above-knee amputation of the right lower limb for severe crush injury right leg and a bipolar hemiarthroplasty for an ipsilateral fracture neck of femur sustained in the same road traffic accident...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28604466/unique-considerations-in-spinal-cord-stimulator-placement-in-pediatrics-a-case-report
#16
Eugene Kim, Giovanni Cucchiaro
Spinal cord stimulation can be a valuable treatment option in the management of neuropathic pain in select pediatric patients. We present a unique case of a 16-year-old girl with Klippel-Trenaunay-Weber syndrome and scoliosis who required the placement of a spinal cord stimulator (SCS) for severe sciatic nerve neuropathic pain after a right above-knee amputation. Several attempts at lead placement were required before successful pain coverage was achieved because of late recognition of significant vertebral body rotation...
August 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28590380/surgical-treatment-for-hemophilic-pseudotumor-twenty-three-cases-with-an-average-follow-up-of-5-years
#17
Jiliang Zhai, Xisheng Weng, Baozhong Zhang, Yong Liu, Peng Gao, Yan-Yan Bian
BACKGROUND: Hemophilic pseudotumor (HPT) is a rare disease with many challenges. Only a few reports on surgical treatment for HPT have been published. METHODS: The cases of 23 patients with HPT who had surgical treatment from July 1996 to December 2014 were retrospectively reviewed. Demographic data, blood loss and transfusion during surgery, outcomes, and complications after surgery were analyzed. RESULTS: Eleven patients underwent HPT resection; 4 underwent HPT excision, allograft transplantation, and absorbable screw fixation; 3 had HPT resection and metallic internal fixation; 2 had HPT resection, autogenous fibular grafting, and absorbable screw fixation; 2 underwent curettage and bone-grafting; and 1 patient received above-the-knee amputation...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28587576/risk-factors-for-wound-complications-and-30-day-mortality-after-major-lower-limb-amputations-in-patients-with-peripheral-arterial-disease
#18
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa
Purpose Risk factors for wound complications or 30-day mortality after major amputation in patients with peripheral arterial disease remain unclear. We investigated the outcomes of major amputation in patients with peripheral arterial disease. Methods Patients who underwent major amputation from 2008 to 2015 were retrospectively analyzed. The main outcome measures were risk factors for wound complications and 30-day mortality after major lower limb amputations. Major amputation was defined as above-knee amputation or below-knee amputation...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28578133/extraintestinal-clostridium-difficile-infection-due-to-a-ribotype-different-from-that-isolated-from-the-feces-of-the-patient-a-case-report
#19
Yoshihiro Onada, Shiro Endo, Takahisa Umemoto, Tomomichi Kajino, Yoshiharu Amasaki, Akira Furusaki
Extraintestinal infections due to Clostridium difficile are uncommon. When such infections occur, extraintestinal C. difficile isolates are usually identical to fecal isolates. We present a rare case of a large postoperative abscess caused by C. difficile infection, in which different C. difficile strains were isolated from the abscess and from feces of the patient. An 82-year-old woman with cutaneous polyarteritis nodosa developed pain, skin ulcers, and extensive necrosis of the right leg. Above-knee amputation was performed without stopping antiplatelet therapy, leading to postoperative hematoma...
May 31, 2017: Anaerobe
https://www.readbyqxmd.com/read/28567161/serial-femoral-fractures-in-an-amputation-stump-a-case-report
#20
M Nannaparaju, K Annavaram, R Anwar, W S Khan, J Hambidge
We report a case of an above-knee amputee who underwent dynamic hip screw fixation for a proximal femoral fracture and then open reduction and internal fixation a few years later for a further femoral fracture in the same stump. The patient had a good outcome. We aim to discuss the challenges in decision making, surgical technique and potential complications for the patient.
2017: Open Orthopaedics Journal
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