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Below knee amputation

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/29095750/the-use-of-regional-or-neuraxial-anesthesia-for-below-knee-amputations-may-reduce-the-need-for-perioperative-blood-transfusions
#12
Obaid Malik, Ethan Y Brovman, Richard D Urman
BACKGROUND AND OBJECTIVES: Amputations of the lower extremity remain a common procedure in a high-risk population. Perioperative morbidity and mortality reach as high as 14.1% in below-knee amputations. We aimed to determine whether regional, or neuraxial, anesthesia, when compared with general anesthesia (GA), would be associated with reduced perioperative morbidity and mortality. METHODS: We queried the American College of Surgeons National Surgical Quality Improvement Program data set...
November 1, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29092990/multiple-limb-salvage-attempts-for-diabetic-foot-infections-is-it-worth-it
#13
C C Hong, J H Tan, S H Lim, A Nather
AIMS: Limb salvage for diabetic foot infections often require multiple procedures. Some patients will eventually end up with below knee amputation (BKA) when all limb salvage attempts fail. We seek to study the patients' ability to return to normal life, functional status, prosthesis usage and perspectives on multiple limb salvage procedures that culminated in BKA to review if they would undertake a similar path if their situation was repeated. PATIENTS AND METHODS: A total of 41 patients who underwent BKA between July 2011 and June 2013 were reviewed...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29079006/risk-factors-for-unplanned-readmission-and-stump-complications-after-major-lower-extremity-amputation
#14
John Phair, Charles DeCarlo, Larry Scher, Issam Koleilat, Saadat Shariff, Evan C Lipsitz, Karan Garg
OBJECTIVE: The unplanned 30-day readmission rate is a marker of quality of patient care across many disciplines. Data regarding risk factors for unplanned readmission after major lower extremity amputation (LEA) are limited. We evaluated predictors of readmission at our institution after major LEA. METHODS: We conducted a retrospective review of all patients undergoing above-knee amputation (AKA) or below-knee amputation (BKA) between November 2009 and November 2014...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29077505/rate-of-and-factors-associated-with-ambulation-after-unilateral-major-lower-limb-amputation-at-an-urban-us-tertiary-care-hospital-with-a-multidisciplinary-limb-salvage-team
#15
Laura E Sansosti, Amanda Crowell, Eric T Choi, Andrew J Meyr
BACKGROUND: One relatively universal functional goal after major lower-limb amputation is ambulation in a prosthesis. This retrospective, observational investigation sought to 1) determine what percentage of patients successfully walked in a prosthesis within 1 year after major limb amputation and 2) assess which patient factors might be associated with ambulation at an urban US tertiary-care hospital. METHODS: A retrospective medical record review was performed to identify consecutive patients undergoing major lower-limb amputation...
September 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29069141/intra-arterial-fibrinolysis-for-the-management-of-acute-ischemia-on-a-below-knee-amputation-stump-case-report
#16
Breno Boueri Affonso, Joaquim Maurício da Motta Leal, Rafael Noronha Cavalcante, Priscila Mina Falsarella, Francisco Leonardo Galastri, Rodolfo Souza Cardoso, Felipe Nasser
Preservation of the knee joint has enormous advantages in terms of mobility and rehabilitation of an amputee. Any cause of breakdown requiring revision to an above-knee amputation is a major setback because it reduces the patient's rehabilitative potential. We report a case of intra-arterial thrombolysis use to save a below-knee amputation stump with acute ischemia. A 56-year-old man who sought the emergency department with 1-day history of acute pain on his right below-knee stump. The angiography confirmed popliteal artery occlusion...
October 23, 2017: Einstein
https://www.readbyqxmd.com/read/29063607/spinal-or-general-anaesthesia-for-lower-limb-amputation-in-peripheral-artery-disease-a-retrospective-cohort-study
#17
M Niskakangas, S Dahlbacka, J Liisanantti, M Vakkala, T Kaakinen
BACKGROUND: The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post-operative analgesic requirements in patients undergoing major limb amputation for lower-limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high-risk patients despite abnormal coagulation profile or use of anticoagulation. METHODS: The study was a retrospective cohort study...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29062347/major-limb-amputations-in-a-tertiary-hospital-in-north-western-nigeria
#18
Chikwendu Nwosu, Misbau O Babalola, Muhammad H Ibrahim, Siyaka I Suleiman
BACKGROUND: Amputation is the removal of whole or part of a limb, often as a life saving measure. It is a mutilating surgical procedure altering the body image and producing severe functional deficit. It is a common orthopedic surgical procedure performed worldwide. AIMS AND OBJECTIVES: The aim of this study was to determine the pattern and indications for amputation in Federal Medical Centre, Birnin Kebbi, Kebbi State, Nigeria; between January 2008 and December 2014, in a bid to proffer preventive measures...
June 2017: African Health Sciences
https://www.readbyqxmd.com/read/29033684/fluorine-18-2-fluoro-2-deoxy-d-glucose-positron-emission-tomography-computed-tomography-masquerading-as-a-case-of-sporadic-malignant-peripheral-nerve-sheath-tumor-of-lower-extremity-presenting-as-massive-lower-limb-edema
#19
Deepa Singh, Rajender Kumar, Ashim Das, Subhash C Varma, Bhagwant R Mittal
Malignant peripheral nerve sheath tumors (MPNSTs) are rare neuroectodermal tumors resulting from the malignant transformation of benign plexiform neurofibromas. The sporadic form of these tumors is rare than familial variants (seen in neurofibromatosis Type 1) and making the diagnosis difficult. We are presenting a case of 40--year-old female with the complaint of progressive swelling of lower limb with initial suspicion of lymphedema and underwent lymphoscintigraphy, magnetic resonance imaging, and finally fluorine-18-2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography scans were done to rule out mitotic etiology and extent of the disease...
October 2017: World Journal of Nuclear Medicine
https://www.readbyqxmd.com/read/28978899/subarachnoid-block-induced-deafferentation-pain-successfully-treated-with-pentazocine
#20
Hiroaki Kishikawa, Zen'ichiro Wajima, Toshiro Shitara, Toru Shimizu, Hitoshi Adachi, Atsuhiro Sakamoto
Deafferentation pain induced by subarachnoid block (SAB) is rare, but it can appear in the form of recurrent phantom lower limb pain, new acute-onset stump pain in amputees, lower limb pain in patients with tabes dorsalis, and neuropathic pain. We have previously reported that thiopental is an effective treatment for deafferentation pain induced by therapeutic SAB applied to treat neuropathic pain of central origin. Here, we report the case of an amputee who developed new stump pain in his lower limb immediately after subarachnoid tetracaine was administered prior to appendectomy...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
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