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Above knee amputation

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https://www.readbyqxmd.com/read/27926681/influence-of-immediate-and-delayed-lower-limb-amputation-compared-with-lower-limb-salvage-on-functional-and-mental-health-outcomes-post-rehabilitation-in-the-u-k-military
#1
Peter Ladlow, Rhodri Phillip, Russell Coppack, John Etherington, James Bilzon, M Polly McGuigan, Alexander N Bennett
BACKGROUND: Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. METHODS: This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#2
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27823759/are-antibiotic-nails-effective-in-the-treatment-of-infected-tibial-fractures
#3
Rachel M Reilly, Thomas Robertson, Robert V O'Toole, Theodore T Manson
BACKGROUND: Antibiotic-impregnated cement nails are used to treat postoperative deep infections after primary intramedullary nail insertion for the treatment of tibial fractures. Few data exist regarding the efficacy of this treatment strategy. We hypothesized that such treatment with antibiotic nails results in a high rate of infection clearance at intermediate follow-up. METHODS: We conducted a retrospective review at our Level I trauma center. Patients who received intramedullary nails to stabilize tibial fractures (from 2000 to 2011) and subsequently required antibiotic nails to treat deep postoperative infection (n=55) were considered for study inclusion...
December 2016: Injury
https://www.readbyqxmd.com/read/27783841/reconstruction-using-expandable-endoprostheses-for-skeletally-immature-patients-with-sarcoma
#4
Alexander P Decilveo, Bartlomiej W Szczech, Jacob Topfer, James C Wittig
Expandable endoprostheses have become an acceptable modality to address the issue of limb-length inequality in limb-sparing procedures for skeletally immature patients afflicted with lower extremity bone sarcomas. This study retrospectively analyzed postoperative outcomes and complications for 7 patients (8 limbs) who underwent minimally invasive or noninvasive reconstruction during a 12-year period. Musculoskeletal Tumor Society (MSTS) scores and complication rates were reported. Mean functional outcome (MSTS scores) at final follow-up was 93...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27770122/discrepancy-in-blood-pressure-between-the-left-and-right-arms-importance-of-clinical-diagnosis-and-role-of-radiological-imaging
#5
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
https://www.readbyqxmd.com/read/27768657/genitourinary-injuries-and-extremity-amputation-in-operations-enduring-freedom-and-iraqi-freedom-early-findings-from-the-trauma-outcomes-and-urogenital-health-tough-project
#6
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
https://www.readbyqxmd.com/read/27763266/predictive-factors-for-better-bypass-patency-and-limb-salvage-after-prosthetic-above-knee-bypass-reconstruction
#7
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
https://www.readbyqxmd.com/read/27751735/a-multi-institutional-experience-in-adventitial-cystic-disease
#8
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
https://www.readbyqxmd.com/read/27703940/salvage-of-a-below-knee-amputation-utilizing-rotationplasty-principles-in-a-patient-with-chronic-tibial-osteomyelitis
#9
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
https://www.readbyqxmd.com/read/27685013/knee-rotationplasty-motion-of-the-body-centre-of-mass-during-walking
#10
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
https://www.readbyqxmd.com/read/27673160/poster-409-tackling-pain-after-above-knee-amputation-what-are-our-options-a-case-report
#11
Hongmei Wang, Michelle Stern
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27672961/poster-198-residual-limb-pain-precipitating-autonomic-dysreflexia-in-a-traumatic-spinal-cord-injury-patient-with-peripheral-artery-disease-and-right-above-the-knee-amputation-a-case-report
#12
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
https://www.readbyqxmd.com/read/27664402/rehabilitation-trends-after-lower-extremity-amputations-in-canada
#13
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
https://www.readbyqxmd.com/read/27617405/innovative-techniques-for-maximizing-limb-salvage-and-function
#14
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
https://www.readbyqxmd.com/read/27600488/rare-presentation-of-a-marjolin-s-ulcer-secondary-to-a-post-traumatic-injury
#15
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
https://www.readbyqxmd.com/read/27597430/predicting-functional-outcomes-after-above-knee-amputation-for-infected-total-knee-arthroplasty
#16
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
https://www.readbyqxmd.com/read/27565601/lower-extremity-arterial-revascularization-using-conditioned-small-diameter-great-saphenous-vein
#17
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
https://www.readbyqxmd.com/read/27551877/results-of-peripheral-bypass-surgery-in-patients-with-critical-limb-ischemia-critisch-registry
#18
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
https://www.readbyqxmd.com/read/27523659/peripheral-nerve-crushing-to-relieve-chronic-pain-in-diabetic-and-ischaemic-foot-ulcers
#19
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
https://www.readbyqxmd.com/read/27504557/major-lower-limb-amputations-experience-of-a-tertiary-care-hospital-in-sri-lanka
#20
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
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