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Lower extremity tendon transfer

Pablo Wagner, Cristian Ortiz, Omar Vela, Paul Arias, Diego Zanolli, Emilio Wagner
BACKGROUND: Tibialis posterior (TP) tendon transfer through the interosseous membrane is commonly performed in Charcot-Marie-Tooth disease. In order to avoid entrapment of this tendon, no clear recommendation relative to the interosseous membrane (IOM) incision size has been made. OBJECTIVE: Analyze the TP size at the transfer level and therefore determine the most adequate IOM window size to avoid muscle entrapment. METHODS: Eleven lower extremity magnetic resonances were analyzed...
September 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Iulia Tevanov, Dan M Enescu, Radu Bălănescu, G Sterian, Alexandru Ulici
Negative pressure wound therapy is a non-invasive treatment that uses under atmospheric pressure to increase blood supply to the wound, stimulating the formation of granulation tissue, angiogenesis, proliferation of fibroblasts and endothelial cells. Negative pressure therapy has also the ability to decrease the bacterial load, reduce swelling and decrease exudate while maintaining a moist environment that facilitates healing. Our patient, a 17 year old male, suffered major third and fourth-degree high voltage electrical burns on 60% of the body surface, in November 2011...
March 2016: Chirurgia
Jijun Liu, Haiping Zhang, Baorong He, Biao Wang, Xingbang Niu, Dingjun Hao
BACKGROUND: Intramedullary spinal tuberculoma combined with abscess has low incidence and could easily be misdiagnosed. Given the rarity of spinal intramedullary tuberculoma, there is no standardized treatment protocol for this condition. We reported the case of a 28-year-old male who was diagnosed with intramedullary tuberculoma combined with abscess and treated with antituberculosis therapy followed by surgery. CASE DESCRIPTION: A 28-year-old male was admitted to our hospital with lower back pain and lower limb sensory and motor dysfunction...
May 2016: World Neurosurgery
Chad Poage, Charles Roth, Brandon Scott
Peroneal nerve palsy is the most common entrapment neuropathy of the lower extremity. Numerous etiologies have been identified; however, compression remains the most common cause. Although injury to the nerve may occur anywhere along its course from the sciatic origin to the terminal branches in the foot and ankle, the most common site of compressive pathology is at the level of the fibular head. The most common presentation is acute complete or partial foot drop. Associated numbness in the foot or leg may be present, as well...
January 2016: Journal of the American Academy of Orthopaedic Surgeons
Michael P O'Malley, Ayoosh Pareek, Patrick Reardon, Aaron Krych, Michael J Stuart, Bruce A Levy
Tibiofemoral knee dislocations are typically a consequence of high-energy mechanisms, causing significant damage to the soft tissue and osseous structures of the knee. Concomitant neurovascular injuries such as popliteal artery and peroneal nerve injuries are also common and can have significant long-term consequences. The mechanism typically involves a traction injury to the peroneal nerve subsequent to an extreme varus moment applied to the knee. Complete nerve injuries typically hold a worse prognosis than incomplete palsies...
May 2016: Journal of Knee Surgery
Yasushi Sato, Kazuhiko Nakamura, Norio Yasui-Furukori
BACKGROUND: Serotonin syndrome is a rare but potentially fatal side effect of antidepressants that results from the effects of drug activity on both central and peripheral serotonergic receptors. CASE: A 78-year-old Japanese female with a 2-year history of major depressive disorder was treated with escitalopram (10 mg/d), risperidone (1 mg/d), and nitrazepam (5 mg/d). One month after beginning this drug regimen, she was transferred to the emergency department and immediately hospitalized due to suspicion of a urinary tract infection and dehydration...
2015: Neuropsychiatric Disease and Treatment
Jørgen Danielsen, Øyvind Sandbakk, Hans-Christer Holmberg, Gertjan Ettema
PURPOSE: This study aims to investigate fluctuations in total mechanical energy of the body (Ebody) in relation to external ergometer work (Werg) during the poling and recovery phases of simulated double-poling cross-country skiing. METHODS: Nine male cross-country skiers (mean ± SD age, 24 ± 5 yr; mean ± SD body mass, 81.7 ± 6.5 kg) performed 4-min submaximal tests at low-intensity, moderate-intensity, and high-intensity levels and a 3-min all-out test on a ski ergometer...
December 2015: Medicine and Science in Sports and Exercise
Jeannie Huh, Deanna M Boyette, Selene G Parekh, James A Nunley
BACKGROUND: Chronic ruptures of the tibialis anterior tendon are often associated with tendon retraction and poor-quality tissue, resulting in large segmental defects that make end-to-end repair impossible. Interpositional allograft reconstruction has previously been described as an operative option in these cases; however, there are no reports of the clinical outcomes of this technique in the literature. METHODS: Eleven patients with chronic tibialis anterior tendon ruptures underwent intercalary allograft recon-struction between 2006 and 2013...
October 2015: Foot & Ankle International
Valerie L Schade, Wayne Harsha, Caitlin Rodman, Thomas S Roukis
Septic peroneal tenosynovitis is a rare and significant challenge. A search of peer-reviewed published studies revealed only 5 case reports to guide treatment, none of which resulted in significant loss of both peroneal tendons necessitating reconstruction. No clear guidance is available regarding how to provide reliable reconstruction of both peroneal tendons after a significant loss secondary to septic tenosynovitis. In the present report, we describe the case of a young, active-duty soldier who underwent lateral ankle ligament reconstruction with a tendon allograft whose postoperative course was complicated by septic peroneal tenosynovitis resulting in significant loss of both peroneal tendons...
March 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sheng-Li Huang, Hua-Guang Qi, Jing-Jie Liu, Ya-Juan Huang, Li Xiang
OBJECTIVE: Since little has been reported about Guillain-Barré syndrome (GBS) after spine surgery, we sought to determine some of the clinical features and the management of the condition. METHODS: A total of 4 cases of GBS after spine surgery were included. The medical charts of the patients were reviewed to obtain demographic and clinical details. All the patients underwent neurologic and electrophysiologic examinations and were followed up after surgery. RESULTS: The onset of symptoms about GBS was 2-7 days after the operation...
September 2015: World Neurosurgery
Shuro Kogawa, Atsushi Nakajima, Syuhei Kobashi, Makoto Samukawa, Susumu Kusunoki
A 67-year-old man noticed paresthesia in both legs in July 2011. Three days later, he was found on a street where he was unable to stand up. On admission, the deep sensation in both legs was severely disturbed, but their muscle strength remained normal. Cranial nerves and autonomic functions were normal. The deep tendon reflexes were diminished in both legs. Magnetic resonance imaging of the spine was normal. Motor nerve conduction studies revealed normal conduction velocity, amplitude, and F-wave latency. However, sensory nerve conduction studies revealed severe reduction of amplitude in the upper and lower extremities...
2015: Rinshō Shinkeigaku, Clinical Neurology
Troy J Boffeli, Jessica A Tabatt
Charcot-Marie-Tooth disease is a neuromuscular disorder that commonly results in a predictable pattern of progressive bilateral lower extremity weakness, numbness, contracture, and deformity, including drop foot, loss of ankle eversion strength, dislocated hammertoes, and severe cavus foot deformity. Late stage reconstructive surgery will be often necessary if the deformity becomes unbraceable or when neuropathic ulcers have developed. Reconstructive surgery for Charcot-Marie-Tooth deformity is generally extensive and sometimes staged...
July 2015: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jing Peng
An 18-year old female was admitted to a psychiatric hospital with an initial episode of mania. Treated with routine dosages of lithium bicarbonate, her symptoms resolved after two weeks; she was discharged on a dosage of 250mg lithium bid. Five days after discharge she was taken to the emergency department of a general hospital with loss of appetite and disturbed consciousness. The general hospital physicians were unable to diagnose the problem so she was transferred back to the psychiatric hospital. At that time she had a lithium blood level of 0...
April 2014: Shanghai Archives of Psychiatry
Hakan Tayfun, Orakdöğen Metin, Somay Hakan, Berkman Zafer, Aker Fügen Vardar
Brown tumor (BT), also known as osteoclastoma, may appear in the context of primary and secondary hyperparathyroidism. Spinal cord compression due to the BT is extremely rare. We present here an unusual case of BT involving thoracal spine and mandible. A 26-year-old woman, who had been on hemodialysis for chronic renal failure for over 6 years, got admitted with dorsal pain and progressive weakness in her lower extremities and gait disturbances. Neurological examination revealed spastic paraparesis and symmetrically hyperactive tendon reflex in the lower extremities...
January 2014: Asian Journal of Neurosurgery
Alpo Vuorio, Matti J Tikkanen, Petri T Kovanen
Familial hypercholesterolemia (FH) is an autosomal dominant disease caused by mutations in the low-density lipoprotein (LDL)-receptor gene (LDLR). Patients with homozygous FH (hoFH) have inherited a mutated LDLR gene from both parents, and therefore all their LDL-receptors are incapable of functioning normally. In hoFH, serum LDL levels often exceed 13 mmol/L and tendon and cutaneous xanthomata appear early (under 10 years of age). If untreated, this extremely severe form of hypercholesterolemia may cause death in childhood or in early adulthood...
2014: Vascular Health and Risk Management
Toshinori Kurashige, Kensuke Kawabata, Seiichi Suzuki
Checkrein deformity is a relatively rare condition caused by hypotrophy or adhesion of a tendon after a lower leg injury. The occurrence of this condition due to the dysfunction of the extensor hallucis longus (EHL) is extremely rare. Only a few related case reports have been published, and Z-lengthening of the EHL tendon was performed for almost all patients. We report a case of checkrein deformity due to EHL hypotrophy. The patient was involved in a traffic accident 7 years ago. He sustained left tibial and fibular closed diaphyseal fractures and underwent minimally invasive plate osteosynthesis...
June 2014: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Yung Ki Lee, Keun Yung Park, Youn Taek Koo, Rong Min Baek, Chan Yeong Heo, Seok Chan Eun, Tae Seung Lee, Kyoung Min Lee, Baek Kyu Kim
BACKGROUND: The limb-threatening large soft tissue defects that occur on the feet of type 2 diabetic patients have complex causes and are less likely to be corrected by free flap reconstruction compared to those in non-diabetic patients. We retrospectively analysed factors affecting the success of free flap transfer for necrotising soft tissue defects of the lower extremities in patients with type 2 diabetes. METHODS: This study included 33 diabetic patients whose feet were treated with free flap transfers...
May 2014: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Ghada El Euch-Fayache, Yosr Bouhlal, Rim Amouri, Moncef Feki, Fayçal Hentati
Ataxia with vitamin E deficiency is an autosomal recessive cerebellar ataxia caused by mutations in the α-tocopherol transfer protein coding gene localized on chromosome 8q, leading to lower levels of serum vitamin E. More than 91 patients diagnosed with ataxia with vitamin E deficiency have been reported worldwide. The majority of cases originated in the Mediterranean region, and the 744delA was the most common mutation among the 22 mutants previously described. We examined the clinical and molecular features of a large cohort of 132 Tunisian patients affected with ataxia with vitamin E deficiency...
February 2014: Brain: a Journal of Neurology
Shi-Neng James Ling, Natalie Chuen-Ying Ong, John Bevan North
OBJECTIVES: The aims of this research were to characterise the injury patterns associated with nail guns, highlight their potential complications and review treatment options. METHODS: A retrospective case series was conducted of all patients with a nail gun injury to the upper or lower limb who presented to the Princess Alexandra Hospital from 1 January 2007 to 30 July 2012. RESULTS: Young men in the work environment were at most risk of sustaining a nail gun injury to their non-dominant hand...
December 2013: Emergency Medicine Australasia: EMA
Maorong Wang, Yunfeng Gu, Fusheng Chen, Jun Li, Jiangning Wang, Yefeng Yin
OBJECTIVE: To evaluate the effectiveness of anterolateral thigh and groin conjoined flap in emergent repair of ultra-long complex tissue defects in forearm and hand. METHODS: Between February 2009 and October 2011, 6 patients with complex tissue defect of dorsal forearm and hand were in adminsion. There were 5 male and 1 female with an average age of 38.5 years (range, 32-47 years). Injury reasons included machine injury in 5 cases and traffic accident injury in 1 case...
August 2013: Chinese Journal of Reparative and Reconstructive Surgery
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