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Above knee amputation

P X Kuan, P W Tan, A T Jobli, A R Norsila
INTRODUCTION: Differences in systolic blood pressure reading between arms are common but could signal trouble if the discrepancy is significant. Early detection of aortic dissection could invariably determine patient's survivability. Hence, a high index of suspicion with prompt diagnostic imaging is vital for accurate diagnosis. CASE PRESENTATION: A previously healthy 35-year-old lady was referred from district hospital for hypertensive cardiomyopathy complicated by acute pulmonary oedema...
August 2016: Medical Journal of Malaysia
Nina S Nnamani, Judson C Janak, Steven J Hudak, Jessica C Rivera, Eluned A Lewis, Douglas W Soderdahl, Jean A Orman
BACKGROUND: In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. MATERIALS AND METHODS: The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF...
November 2016: Journal of Trauma and Acute Care Surgery
Eric Klingelhoefer, Hendrik Bergert, Stephan Kersting, Stefan Ludwig, Norbert Weiss, Frank Schönleben, Robert Grützmann, Gabor Gäbel
BACKGROUND: Peripheral arterial disease (PAD) is one of the most underestimated diseases because of its high prevalence and unfavorable prognosis. Many PAD patients without suitable autologous veins or options for endovascular treatment receive prosthetic above-knee femoropopliteal bypass (PAKB). Until now predictors of prosthetic bypass failure and of increased amputation risk remain indistinct. This study aimed to identify predictive factors associated with better bypass patency and limb salvage to achieve a more favorable outcome after PAKB reconstruction...
August 2016: Journal of Vascular Surgery
Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
October 14, 2016: Journal of Vascular Surgery
Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
September 28, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Hongmei Wang, Michelle Stern
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Vovanti Jones, Ankur Verma, Ray Lee
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Ahmed Kayssi, Steven Dilkas, Derry L Dance, Charles de Mestral, Thomas L Forbes, Graham Roche-Nagle
BACKGROUND: The heterogeneity of medical complications that lead to amputation has resulted in a diverse patient population with differing rehabilitation needs; however, the rehabilitation trends for patients with lower extremity amputations across Canada have not been studied previously. OBJECTIVE: To describe trends in rehabilitation after lower extremity amputations and the factors affecting rehabilitation length of stay in Canada. DESIGN: Retrospective cohort analysis...
September 21, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Mansher Singh, Hehuan Li, Kristo Nuutila, K C Collins, Jennifer Wall, Robert Riviello, Michael J Weaver, Matthew J Carty, Julian Pribaz, Simon G Talbot
Concurrent injuries to multiple extremities present unique challenges to the reconstructive surgeon. The primary goal in such scenarios is to optimize functional outcomes. The goal of this article is to present an overview of various techniques necessary to provide sufficient soft tissue and preserve amputation limb lengths and function. The concept of innovative techniques for maximizing limb savage and function is presented using an index patient with multiple extremity third- and fourth-degree burn injuries resulting in nonsalvageable lower extremities and severe left-hand wounds...
September 9, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
Kaitlyn Bernhard, Kenneth Morgan, Dustin Kruse, Paul A Stone
Marjolin's ulcer is a rare and aggressive cutaneous malignancy arising from previously traumatized skin, most commonly at the site of previous burns. We present a unique case of Marjolin's ulceration secondary to an orthopedic injury and a nonburn history of trauma. The patient had been involved in a motorcycle accident >20 years earlier. For 17 months, the patient had refused to acknowledge the severity of his disease state. He had refused the standard of care and opted for local wound care only until a minor fall caused a pathologic fracture, leading to an above the knee amputation...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jaiben George, Jared M Newman, Joseph W Caravella, Alison K Klika, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Above knee amputation (AKA) is a rare, but serious, complication of total knee arthroplasty with relatively poor functional outcomes. The purpose of this study was to identify the factors predicting ambulatory status after AKA for periprosthetic joint infection of the knee and to elucidate the effects of this procedure on general health outcomes. METHODS: Patients who underwent AKA after an infected total knee arthroplasty between 2009 and 2014 at a single institution (n = 53) were retrospectively reviewed...
August 10, 2016: Journal of Arthroplasty
Maher Fattoum, Stefan Kennel, Peter Knez, Thomas Schmitz-Rixen, Hazem Khout, Matthias H Tenholt
OBJECTIVE: This study was conducted to determine whether it was feasible to increase the diameter of smaller great saphenous veins (GSVs) in preparation for possible bypass and whether such a conditioned conduit could be used with reasonable patency. METHODS: Twenty-five patients (26 cases: 24 peripheral arterial occlusive disease, 2 popliteal aneurysms) with GSV diameters between 2 and 3 mm underwent in situ GSV valvulotomy and were observed for 3 months. After GSV dilation to >3 mm for below-knee revascularization and >3...
September 2016: Journal of Vascular Surgery
T Bisdas, G Torsello, A Stachmann, R T Grundmann
AIM: On the basis of the CRITISCH registry outcomes in patients with critical limb ischemia (CLI) undergoing lower extremity bypass surgery were analyzed according to the site of distal anastomosis and type of bypass material. PATIENTS AND METHODS: A total of 284 patients with lower extremity bypasses consisting of 75 patients with bypasses above the knee (group 1), 80 with bypasses below the knee (group 2) and 129 crural or pedal bypasses (group 3) were included in the study...
2016: Gefässchirurgie: Zeitschrift Für Vaskuläre und Endovaskuläre Chirurgie
K Nagasaki, H Obara, K Tanaka, K Koyano, A Asamia, Y Kitagawa
OBJECTIVE: We retrospectively assessed the effectiveness of peripheral nerve crushing (Smithwick operation) in relieving intractable chronic pain associated with foot ulcers caused by diabetes mellitus (DM) or atherosclerosis. METHOD: From April 2009 to April 2012, patients underwent peripheral nerve crushing in the leg affected by foot ulceration. The cause of ulceration was either DM alone, atherosclerosis alone, or both DM and atherosclerosis. Because sensation in the foot is associated with five nerves: the tibial, deep peroneal, superficial peroneal, sural, and saphenous, one or more of these nerves were crushed over a length of 1...
August 2016: Journal of Wound Care
D H B Ubayawansa, W Y M Abeysekera, M M A J Kumara
OBJECTIVE: To determine the epidemiology and conditions frequently seen in major lower extremity amputation. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Teaching Hospital Karapitiya, Sri Lanka, from October 2013 to September 2014. METHODOLOGY: Major lower limb amputations were identified according to ICD-10 criteria. Data was retrospectively collected. Type of the amputation, indication for the amputation, gender and age of the patients, and mortality were noted...
July 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Antal Renner, Annamária Szentirmai, Andrea Sántha, Tamás Viola, Ferenc Gyárfás, András Melly, Péter Varga, Tibor Retteghy
In this article, we report successful treatment of serious complications of replantation after traumatic mid-third femoral amputation. To the best of our knowledge, no similar case has been reported in the literature. A 38-year-old healthy male sustained a mid-third right traumatic femoral amputation. We performed replantation. Oliguria and anuria occurred and were treated successfully with hemofiltration and hemodialysis. Six years later, patient walked wearing orthopedic shoes and also protective sensibility recovered on the limb...
August 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Gaetano Caruso, Emanuele Gerace, Vincenzo Lorusso, Rosario Cultrera, Loredana Moretti, Leo Massari
BACKGROUND: Chronic osteomyelitis is a challenging problem, and malignant transformation is a rare occurrence. We report a case of a patient with squamous cell carcinoma arising from an osteomyelitic hotbed and discuss through a literature review the etiopathogenesis, diagnosis, and treatment of this lesion. CASE PRESENTATION: A 69-year-old Italian man had sustained an exposed tibial fracture 40 years ago during a road accident, for which he had undergone various surgical osteosynthesis treatments with multiple antibiotic therapies...
2016: Journal of Medical Case Reports
Markus Parkkinen, Rami Madanat, Jan Lindahl, Tatu J Mäkinen
BACKGROUND: The risk factors are unclear for deep surgical site infection after plate fixation of proximal tibial fractures. The objective of this study was to identify the patient and surgical procedure-related risk factors for infection using established criteria for deep surgical site infection. METHODS: A total of 655 proximal tibial fractures were treated with open reduction and plate fixation at our center between 2004 and 2013. We identified 34 patients with deep surgical site infection...
August 3, 2016: Journal of Bone and Joint Surgery. American Volume
Bjoern D Suckow, Karina A Newhall, Kimon Bekelis, Adrienne E Faerber, Daniel J Gottlieb, Jonathan S Skinner, David H Stone, Philip P Goodney
BACKGROUND: Major (above-knee or below-knee) amputation is a complication of diabetes and is seen more common among black and Hispanic patients. While amputation rates have declined for patients with diabetes in the last decade, it remains unknown if these improvements have equitably extended across racial groups and if measures of diabetic care, such as hemoglobin A1c testing, are associated with these improvements. We set out to characterize secular changes in amputation rates among black, Hispanic, and white patients, and to determine associations between hemoglobin A1c testing and amputation risk...
October 2016: Annals of Vascular Surgery
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