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Below knee amputation

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https://www.readbyqxmd.com/read/28633785/the-lisfranc-amputation-a-more-reliable-level-of-amputation-with-proper-intraoperative-tendon-balancing
#1
Christopher J Greene, Christopher Bibbo
Traditional transmetatarsal amputations are a reliable level of amputation. However, amputations at the Lisfranc level have met with limited success owing to improper biomechanics resulting from tendon imbalance, ultimately leading to foot deformity positions and an unstable soft tissue envelope with ensuing skin breakdown, infection, and below-the-knee amputation. We describe proper tendon rebalancing that results in improved biomechanics and a more reliable and stable amputation at the more proximal Lisfranc level...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633150/hexapod-frame-stacked-transport-for-tibial-infected-nonunions-with-bone-loss-analysis-of-use-of-adjunctive-stability
#2
Joshua K Napora, Douglas S Weinberg, Blake A Eagle, Bram R Kaufman, John K Sontich
OBJECTIVES: The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN: Retrospective cohort study. SETTING: Level 1 trauma center. PATIENTS/PARTICIPANTS: Seventy-five patients with infected posttraumatic nonunions of the tibia. INTERVENTION: Resection of nonunion with application of stacked hexapod frame for bone transport...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28630841/bipolar-hemiarthroplasty-in-a-patient-with-above-knee-amputation-surgical-technique
#3
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/28630763/malignant-tumours-of-the-foot-and-ankle
#4
E Mascard, N Gaspar, L Brugières, C Glorion, S Pannier, A Gomez-Brouchet
Most of tumours of the foot are tumour-like (synovial cyst, foreign body reactions and epidermal inclusion cyst) or benign conditions (tenosynovial giant cells tumours, planta fibromatosis). Malignant tumours of the soft-tissue and skeleton are very rare in the foot and their diagnosis is often delayed with referral to specialised teams after initial inappropriate procedures or unplanned excisions. The adverse effect of these misdiagnosed tumours is the increasing rate of amputation or local recurrences in the involved patients...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28600024/efficacy-of-cilostazol-for-below-the-knee-artery-disease-after-balloon-angioplasty-in-patients-with-severe-limb-ischemia-cabbage-trial
#5
Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Yasutaka Yamauchi, Keisuke Hirano, Masashi Fukunaga, Kan Zen, Kenji Suzuki, Yoshiaki Shintani, Yusuke Miyashita, Taketsugu Tsuchiya, Terutoshi Yamaoka, Kenji Ando
BACKGROUND: Optimal medical therapy after endovascular therapy in patients with critical limb ischemia (CLI) remains unclear. Therefore, we investigated whether cilostazol reduce restenosis after balloon angioplasty for infrapopliteal lesions in CLI patietns. METHODS: This study was performed as a multicenter prospective randomized open-label blinded-endpoint study with independent angiographic core lab adjudication. Sixty patients were eligible and 53 patients were enrolled and allocated...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28589052/safe-and-effective-reduction-technique-for-intertrochanteric-fracture-with-ipsilateral-below-knee-amputated-limb
#6
Hironori Ochi, Tomonori Baba, Takahiro Hamanaka, Yu Ozaki, Taiji Watari, Yasuhiro Homma, Mikio Matsumoto, Kazuo Kaneko
The positioning of the patient on the fracture table is critical for the successful reduction and operative fixation of intertrochanteric hip fractures. However, this manipulation is challenging with patients who have undergone amputations of their legs. A 97-year-old man presented to the emergency department with symptom of right hip pain following a mechanical fall. He had a below-knee amputation on his right leg following a traffic accident as a 19-year-old and had a below-knee patellar tendon bearing prosthesis fitted to his lower limb for mobility...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28587797/comparison-of-long-term-outcomes-of-heparin-bonded-polytetrafluoroethylene-and-autologous-vein-below-knee-femoropopliteal-bypasses-in-patients-with-critical-limb-ischaemia
#7
C Uhl, C Grosch, C Hock, I Töpel, M Steinbauer
OBJECTIVE/BACKGROUND: Endovascular first is the preferred therapy approach to critical limb ischaemia (CLI). However, in spite of new endovascular techniques, bypass surgery still plays an important role, especially in patients with complex anatomy in whom endovascular therapy is not considered feasible, or has failed. The goal of this study was to analyse the outcomes of prosthetic or autologous vein for femoropopliteal (P3) bypasses performed under the abovementioned conditions. METHODS: A retrospective analysis of patients who underwent a femoropopliteal (P3) bypass for CLI (March 2007-December 2015) was conducted...
June 3, 2017: European Journal of Vascular and Endovascular Surgery
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
#8
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/28541016/pedal-arch-patency-and-not-direct-angiosome-revascularization-predicts-outcomes-of-endovascular-interventions-in-diabetic-patients-with-critical-limb-ischemia
#9
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
BACKGROUND: Aim of this study was to evaluate the impact of pedal arch status and direct-angiosome revascularization (DAR) on clinical outcomes in diabetic patients with foot wounds undergoing endovascular revascularization. METHODS: Between January 2014 and June 2015 93 diabetic patients with foot wounds underwent endovascular revascularization of at least one below-the-knee vessel. Patients were divided into three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA) and absent pedal arch (APA)...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#10
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527727/patient-outcomes-following-lower-leg-major-amputations-for-peripheral-arterial-disease-a-series-review
#11
Susan Monaro, Sandra West, Janice Gullick
INTRODUCTION: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). AIM: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. METHOD: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#12
M Hari Krishna Reddy, B Sangeetha, M Aruna, V Sarat Chandra, Anil C Venkata Kumar, R Ram, V Sivakumar
There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28507971/lethal-necrotizing-fasciitis-triggered-by-plaster-case-report-and-review-of-literature
#13
Mohit J Jain, Kinjal Mavani
INTRODUCTION: Plasters have been frequently associated with known complications such as infection, and compartment syndrome or deep vein thrombosis. However, life-threatening complication of necrotizing fasciitis (NF) has not been frequently attributed to plaster. CASE REPORT: We had a case of a 62-year male developing a lethal NF triggered by a below knee plaster for undisplaced fracture medial malleolus after twisting injury. He had no history suggestive of diabetes, renal impairment, and predisposing allergic factors or any comorbidity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28507956/an-unusual-case-of-giant-cell-tumor-of-first-metatarsal-a-rare-case-report-and-review-of-literature
#14
Kumar Prashant, Tulsi Das Bhattacharyya, Herman Frank, Prema Ram
INTRODUCTION: Giant cell tumor (GCT) or osteoclastoma is an osteolytic, mostly benign but locally aggressive tumor occurring in young adults at the epiphysis. Area of predilection is mainly long bones (85-90%). 4% of GCT are also found in iliac bone, spine and only 2% in hand (of which GCT phalanges are more common than metacarpal). GCT of metatarsal is a very rare occurrence with very few cases being reported so far. We report a case of GCT 1(st) metatarsal in a 40-year-old male which is a very rare entity...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#15
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28476929/the-case-of-the-mysterious-vanishing-spleen-autosplenectomy-complicating-pneumococcal-sepsis
#16
Georgina Moritz, Megan Jenkins, Dushyant Shetty, Julie Blundell
A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion. This was unexpected as an ultrasound in intensive care 10 weeks previously had demonstrated a normal spleen...
May 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28456813/early-thrombosuction-and-tirofiban-use-in-knee-and-below-knee-arterial-thrombosis
#17
Ulas Bildirici, Umut Celikyurt, Sadan Yavuz, Emir Dervis, Qurban Adina, Dilek Ural
BACKGROUND Acute limb ischemia (ALI) is a clinical entity with a high rate of morbidity and mortality. Despite advances and variety of its management, there is still no criterion standard treatment. The goal of this study was to evaluate the effect of tirofiban use on the early and 6-month prognosis of patients with knee and below-knee arterial thrombosis who were treated with percutaneous thrombosuction (PT) within 24 h. MATERIAL AND METHODS Data of consecutive ALI patients who were diagnosed with popliteal and infra-popliteal arterial thrombosis and underwent PT procedure within 24 h between January 2010 and September 2015 were evaluated retrospectively...
April 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28447855/the-arterial-anatomy-of-the-deltoid-ligament-a-cadaveric-study
#18
Jacob A Haynes, Michelle Gosselin, Brian Cusworth, Jeremy McCormick, Jeffery Johnson, Sandra Klein
BACKGROUND: There is an increasing interest in the operative treatment of deltoid ligament disruption in the setting of chronic ankle instability. Understanding the vascular anatomy of the deltoid complex is beneficial when considering operative procedures on the medial ankle and may provide insight into factors that lead to chronic deltoid insufficiency and ankle instability. METHODS: Thirty-two pairs of cadaveric specimens (64 total legs) were amputated below the knee, and the tibialis anterior, tibialis posterior, and peroneal arteries were injected with India ink and Ward's blue latex...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28431865/statin-use-and-other-factors-associated-with-mortality-after-major-lower-extremity-amputation
#19
Charles DeCarlo, Larry Scher, Saadat Shariff, John Phair, Evan Lipsitz, Karan Garg
OBJECTIVE: Above-knee amputations (AKAs) and below-knee amputations (BKAs) are associated with high postoperative mortality rates. In this study, we examined factors associated with 30-day, 90-day, and 1-year mortality in patients who underwent a major lower extremity amputation. METHODS: We queried a prospectively collected institutional database for all patients who underwent AKA or BKA with primary or secondary closure, during a 5-year period, between November 2009 and November 2014...
April 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28421855/midterm-outcomes-after-infrapopliteal-interventions-in-patients-with-critical-limb-ischemia-based-on-the-tasc-ii-classification-of-below-the-knee-arteries
#20
Gagan D Singh, Ellen K Brinza, Justin Hildebrand, Stephen W Waldo, T Raymond Foley, John R Laird, Ehrin J Armstrong
PURPOSE: To analyze the relationship between the new TransAtlantic Inter-Society Consensus (TASC II) infrapopliteal classification and limb outcomes among patients with critical limb ischemia (CLI). METHODS: A single-center retrospective study was performed on 166 consecutive CLI patients (mean age 71 years; 113 men) undergoing endovascular treatment of 244 infrapopliteal lesions from 2006 to 2013. Patient, procedural, angiographic, and limb outcomes were compared for the new TASC A/B vs C/D classification for infrapopliteal lesions...
April 1, 2017: Journal of Endovascular Therapy
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