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Below knee amputation

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https://www.readbyqxmd.com/read/29340004/performance-and-kinematic-differences-in-putting-between-healthy-and-disabled-elite-golfers
#1
Tomáš Gryc, Petr Stastny, František Zahálka, Wojciech Smółka, Piotr Żmijewski, Artur Gołaś, Marek Zawartka, Tomáš Malý
Golfers with disability are limited in the execution of the full golf swing, but their performance in putting may be comparable because this stroke does not demand significant strength, balance and range of motion. Therefore, the aim of this study was to compare putting performance, kinetic and kinematic consistency between golfers with different disabilities and healthy athletes. The participants consisted of three disabled athletes (perinatal cerebral palsy, multiple sclerosis, below knee lower limb amputee) and three healthy golfers (age 34 ± 4...
December 2017: Journal of Human Kinetics
https://www.readbyqxmd.com/read/29301794/surgical-trauma-induces-overgrowth-in-lower-limb-gigantism-regulation-with-use-of-rapamycin-is-promising
#2
Rohan Sebastian Pinto, William David Harrison, Kenneth Graham, Durai Nayagam
We describe an unclassified overgrowth syndrome characterised by unregulated growth of dermal fibroblasts in the lower limbs of a 35-year-old woman. A PIK3CA gene mutation resulted in lower limb gigantism. Below the waist, she weighed 117 kg with each leg measuring over 100 cm in circumference. Her total adiposity was 50% accounted for by her legs mainly. Liposuction and surgical debulking were performed to reduce the size of the limbs but had exacerbated the overgrowth in her lower limbs. Systemic sepsis from an infected foot ulcer necessitated treatment by an above-knee amputation...
January 4, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29289948/association-of-anemia-with-outcomes-in-patients-undergoing-percutaneous-peripheral-vascular-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2-vic
#3
Nikhil V Ambulgekar, Scott F Grey, Howard S Rosman, Hussein Othman, Thomas P Davis, Timothy J Nypaver, Theodore Schreiber, Hiroshi Yamasaki, Thomas A Lalonde, Peter K Henke, Hitinder S Gurm, Rajendra H Mehta, P Michael Grossman
OBJECTIVES: To evaluate the clinical features and outcomes of patients with anemia undergoing percutaneous peripheral vascular intervention (PVI) in a contemporary registry. METHODS: We evaluated the differences in the clinical features and outcomes of patients with and without anemia undergoing PVI in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2 VIC) registry. Anemia was defined using World Health Organization criteria. RESULTS: Baseline anemia was present in 42...
January 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29284534/perineural-local-anaesthetic-catheter-after-major-lower-limb-amputation-trial-placement-study-protocol-for-a-randomised-controlled-pilot-study
#4
David C Bosanquet, Graeme K Ambler, Cherry-Ann Waldron, Emma Thomas-Jones, Lucy Brookes-Howell, Mark Kelson, Tim Pickles, Debbie Harris, Deborah Fitzsimmons, Neeraj Saxena, Christopher P Twine
BACKGROUND: Pain after major lower limb amputation for peripheral arterial disease (PAD) is a significant problem. A perineural catheter (PNC) can be placed adjacent to the major nerve at the time of amputation with a continuous local anaesthetic infusion given postoperatively to try and reduce pain. Although low-quality observational data suggest that PNC usage reduces postoperative opioid requirements, there are limited data regarding its effect on pain. The aim of PLACEMENT is to explore the feasibility of running an effectiveness trial to assess the impact of a PNC with continuous local anaesthetic infusion, inserted at the time of amputation, on short and medium-term postoperative outcomes...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29250834/comparison-of-drug-eluting-balloon-angioplasty-to-infrapopliteal-artery-critical-lesions-with-or-without-additional-pedal-artery-angioplasty-in-patients-with-diabetes-mellitus-and-critical-limb-ischemia
#5
Burak Teymen, Süleyman Aktürk
BACKGROUND: The purpose of this study is to investigate the feasibility and outcome of balloon angioplasty for the treatment of below the ankle (BTA) lesions in addition to below the knee (BTK) lesions in diabetic patients with critical limb ischemia (CLI). METHODS: Inclusion criteria are diabetes mellitus (DM), CLI (Rutherford class 4 or higher) and revascularized significant stenosis or occlusion of at least 1 below-the-knee vessel with incomplete or no pedal loop...
December 17, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29237360/endovascular-treatment-of-thromboangiitis-obliterans-buerger-s-disease
#6
Mohammad-Hadi S Modaghegh, Shahab Hafezi
PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included...
February 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29214670/recanalization-of-native-superficial-femoral-artery-chronic-total-occlusion-after-failed-femoropopliteal-bypass-in-patients-with-critical-limb-ischemia
#7
Zhenjiang Li, Rui Feng, Feng Qin, Zhiqing Zhao, Liangxi Yuan, Yiming Li, Junjun Liu, Jiaxuan Feng, Jian Zhou, Junmin Bao, Zaiping Jing
OBJECTIVES: This study aimed to examine the outcomes of endovascular recanalization for native superficial femoral artery (SFA) chronic total occlusion (CTO) in patients with critical limb ischemia (CLI) after femoropopliteal bypass failure with limited surgical revascularization options. BACKGROUND: Endovascular recanalization of native artery occlusions has been recently used as a new alternative for threatened limbs after bypass graft occlusion. The feasibility and efficacy has not been widely reported...
December 6, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29189099/creative-prosthetic-foot-selection-enables-successful-ambulation-in-stiletto-high-heels
#8
Elizabeth Russell Esposito, Delbert H Lipe, Christopher A Rábago
BACKGROUND: Walking in high heels presents biomechanical challenges, yet they remain part of many women's attire. However, women with a lower limb amputation are limited in available footwear options. Case description and methods: This case study is in response to one patient's assertion that she walked better and more symmetrically in heels than flat shoes with her below-knee prosthesis. She underwent gait analysis in athletic shoes and 10-cm stiletto high heels worn with a pediatric running foot to determine if these claims could be substantiated through biomechanical measures...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29184493/step-to-step-ankle-inversion-eversion-torque-modulation-can-reduce-effort-associated-with-balance
#9
Myunghee Kim, Steven H Collins
Below-knee amputation is associated with higher energy expenditure during walking, partially due to difficulty maintaining balance. We previously found that once-per-step push-off work control can reduce balance-related effort, both in simulation and in experiments with human participants. Simulations also suggested that changing ankle inversion/eversion torque on each step, in response to changes in body state, could assist with balance. In this study, we investigated the effects of ankle inversion/eversion torque modulation on balance-related effort among amputees (N = 5) using a multi-actuated ankle-foot prosthesis emulator...
2017: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/29167568/elite-long-jumpers-with-below-the-knee-prostheses-approach-the-board-slower-but-take-off-more-effectively-than-non-amputee-athletes
#10
Steffen Willwacher, Johannes Funken, Kai Heinrich, Ralf Müller, Hiroaki Hobara, Alena M Grabowski, Gert-Peter Brüggemann, Wolfgang Potthast
The use of technological aids to improve sport performance ('techno doping') and inclusion of Paralympic athletes in Olympic events are matters of ongoing debate. Recently, a long jumper with a below the knee amputation (BKA) achieved jump distances similar to world-class athletes without amputations, using a carbon fibre running-specific prosthesis (RSP). We show that athletes with BKA utilize a different, more effective take-off technique in the long jump, which provided the best athlete with BKA a performance advantage of at least 0...
November 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29154697/rate-of-subtalar-joint-arthrodesis-after-retrograde-tibiotalocalcaneal-arthrodesis-with-intramedullary-nail-fixation-evaluation-of-the-rain-database
#11
Michael Dujela, Christopher F Hyer, Gregory C Berlet
BACKGROUND: Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail. METHODS: A chart and radiographic review was performed. TTC fusions performed in patients with osteoarthritis, posttraumatic arthritis, or deformity correction with retrograde nail fixation were included...
November 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#12
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29142485/unexpected-inflammation-in-the-sympathetic-ganglia-in-thromboangiitis-obliterans
#13
Mahdi Farzadnia, Hassan Ravari, Mitra Masoudian, Narges Valizadeh, Bahare Fazeli
The aim of this study was to inspect more closely the microscopic and molecular sympathetic ganglia histology in thromboangiitis obliterans (TAO). The paraffin block and frozen RNAlater-treated tissue of the lumbar sympathetic ganglia of 19 TAO Caucasian male patients were evaluated. The gene expression of cluster of differentiation 4 (CD4) and cluster of differentiation 8 (CD8) markers in the frozen RNAlater-treated sympathetic ganglia tissues were evaluated by real-time polymerase chain reaction. Unexpectedly, lymphocyte infiltration was observed in all of the histological sections, ranging from scattered to moderate lymphocyte infiltration...
December 2017: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/29138198/norwegian-trends-in-numbers-of-lower-extremity-revascularisations-and-amputations-including-regional-trends-in-endovascular-treatments-for-peripheral-arterial-disease-a-retrospective-cross-sectional-registry-study-from-2001-to-2014
#14
Kjersti Wendt, Ronny Kristiansen, Kirsten Krohg-Sørensen, Fredrik Alexander Gregersen, Erik Fosse
OBJECTIVE: The numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important. METHODS: This retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29133607/cardiovascular-outcomes-and-risks-after-initiation-of-a-sodium-glucose-co-transporter-2-inhibitor-results-from-the-easel-population-based-cohort-study
#15
Jacob A Udell, Zhong Yuan, Toni Rush, Nicholas M Sicignano, Michael Galitz, Norman Rosenthal
Background : Clinical trials have shown cardiovascular benefits and potential risks from sodium glucose co-transporter 2 inhibitors (SGLT2i). Trials may have limited ability to address individual endpoints or safety concerns. Methods : We performed a population-based cohort study among type 2 diabetes patients with established cardiovascular disease newly initiated on antihyperglycemic agents (AHAs) within the US Department of Defense Military Health System between 4/1/2013 and 12/31/2016. Incidence rates, hazard ratios (HRs), and 95% confidence intervals (CIs) for time to first composite endpoint of all-cause mortality (ACM) and hospitalization for heart failure (HHF) event, major adverse cardiovascular events (MACE; defined as ACM, nonfatal myocardial infarction, and nonfatal stroke), and individual endpoints were evaluated using conditional Cox models comparing new SGLT2i users with other AHAs...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29129314/tibiotalocalcaneal-arthrodesis-with-the-hindfoot-arthrodesis-nail-a%C3%A2-prospective-consecutive-series-from-a-single-institution
#16
Bing Howe Lee, Christopher Fang, Remesh Kunnasegaran, Gowreeson Thevendran
Tibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure. We report a series of 20 patients who underwent TTCA using an intramedullary nail. Of the 20 patients, 7 (35%) had diabetes mellitus. The patient experiences and outcomes were analyzed. Their mean age was 61.1 (range 39 to 78) years. The minimum follow-up period was 13 (mean 28, range 13 to 49) months. Surgical indications included diabetic Charcot arthropathy in 7 (35%), hindfoot osteoarthritis in 10 (50%), and severe equinovarus deformity in 3 (15%)...
November 9, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29124073/first-necrotizing-fasciitis-caused-by-haemophilus-influenza-serotype-a
#17
Giang T Quach, Jared Frisby, Kurt Kralovich, Mustafa Bohra
Necrotizing fasciitis (NF) is an infrequently encountered skin infection that has high morbidity and mortality, even with prompt medical and surgical intervention. We describe the case of a 67-year-old male presenting with significant NF in his left lower extremity, despite aggressive surgical intervention, and included multiple surgical debridements, ACell Matrix, split-thickness, and negative wound VAC therapy. Ultimately, this patient required a below the knee amputation. This is the first documented case of Haemophilus influenza type a causing NF...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29121845/improving-outcomes-for-lower-extremity-amputations-using-intraoperative-fluorescent-angiography-to-predict-flap-viability
#18
Andrew E Yang, Charles A Hartranft, Alisha Reiss, Charles R Holden
OBJECTIVES: Nearly 25% of vascular surgery patients operated on for peripheral vascular disease are readmitted within 30 days. Development of adjuncts to minimize wound complications remains an area of great interest. Here, we present our experience with intraoperative fluorescent angiography (IFA) as a tool to predict skin flap viability following lower extremity amputations (LEAs). METHODS: Experience with IFA using indocyanine green (ICG) dye was reviewed retrospectively at a single institution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29104110/pseudomyogenic-hemangioendothelioma-of-skin-bone-and-soft-tissue-a-clinicopathological-immunohistochemical-and-fluorescence-in-situ-hybridization-study
#19
Dinesh Pradhan, Karen Schoedel, Richard L McGough, Sarangarajan Ranganathan, Uma N M Rao
Pseudomyogenic hemangioendothelioma (PHE) is an uncommon neoplasm with propensity for local recurrence. The tumor mimics epithelioid hemangioendothelioma and epithelioid sarcoma, representing a possible diagnostic pitfall. We investigated the clinicopathological, immunohistochemical and fluorescence in situ hybridization features of PHEs. Eight cases of PHE were retrieved from our pathology archives. The clinical and outcome information was available in six patients. In six cases the tumors were located in the lower limb while the upper limb was involved in two cases...
November 2, 2017: Human Pathology
https://www.readbyqxmd.com/read/29101423/risk-of-lower-limb-amputation-in-a-national-prevalent-cohort-of-patients-with-diabetes
#20
Jason K Gurney, James Stanley, Steve York, Dieter Rosenbaum, Diana Sarfati
AIMS/HYPOTHESIS: Lower limb amputation is a serious complication of diabetes mellitus. Understanding how amputation risk differs by population subgroups is crucial in terms of directing preventive strategies. In this study, we describe those factors that impact amputation risk in the entire prevalent diabetic population of New Zealand. METHODS: A national prevalent cohort of 217,207 individuals with diabetes in 2010 were followed up until the end of 2013 for lower limb amputations, and 2014 for mortality...
November 3, 2017: Diabetologia
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