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C Irthum, S Fossat, E Bey, P Duhamel, F Braye, A Mojallal
CONTEXT: Soft tissue defects of lower leg are still a challenge for the plastic surgeon. It should provide an effective and functional coverage with a minimal morbidity on the donor site. Free anterolateral thigh flap present in these areas many advantages over the pedicled local flaps and free muscle flaps used conventionally. We try to define its place through our experience with a bicentric retrospective study. MATERIALS AND METHODS: A retrospective analysis of all cases of reconstruction of the lower leg using the free ALT flap was performed in two centers of reconstructive surgery...
August 24, 2016: Annales de Chirurgie Plastique et Esthétique
Tariq Masood, Riaz Ahmed, Obaidullah
BACKGROUND: Distally based sural fascio-cutaneous flap is a commonly performed plastic surgery procedure for the coverage of distal third of leg, ankle and foot defects. However congestion is the main complication of this flap which results into partial or complete loss of the flap. We devised a special splint to reduce this complication and retrospectively reviewed its effect on this complication between two groups. METHODS: This retrospective study was carried out at Northwest General hospital between 1995 and 2012...
January 2016: Journal of Ayub Medical College, Abbottabad: JAMC
Andrej Ring, Pascal Kirchhoff, Ole Goertz, Bjorn Behr, Adrien Daigeler, Marcus Lehnhardt, Kamran Harati
INTRODUCTION: Solid malignancies at the foot and ankle region are rare and include mainly soft-tissue sarcomas, bone sarcomas, and skin malignancies. Complete surgical resection with clear margins still remains the mainstay of therapy in these malignancies. However, attainment of negative surgical margins in patients with locally advanced tumors of the foot and ankle region may require extensive surgery and could result in loss of extremity function. In these circumstances, plastic surgical techniques can frequently reduce functional impairment and cover soft-tissue defects, particularly in cases of large tumor size or localization adjacent to critical anatomic structures, thereby improving the quality of life for these patients...
2016: Frontiers in Surgery
Chimeglkham Banzrai, Hiroyuki Nodera, Toshitaka Kawarai, Saki Higashi, Ryo Okada, Atsuko Mori, Yoshimitsu Shimatani, Yusuke Osaki, Ryuji Kaji
This study aimed to characterize the excitability changes in peripheral motor axons caused by hindlimb unloading (HLU), which is a model of disuse neuromuscular atrophy. HLU was performed in normal 8-week-old male mice by fixing the proximal tail by a clip connected to the top of the animal's cage for 3 weeks. Axonal excitability studies were performed by stimulating the sciatic nerve at the ankle and recording the compound muscle action potential (CMAP) from the foot. The amplitudes of the motor responses of the unloading group were 51% of the control amplitudes [2...
2016: Frontiers in Physiology
Jong Hyun Kim, Woo Sang Sim, Byeong Hee Won
PURPOSE: Poor recovery of postural stability poststroke is the primary cause of impairment in activities and social participation in elderly stroke survivors. The purpose of our study was to experimentally evaluate the effectiveness of our new elastic ankle-foot orthosis (AFO), compared to a traditional AFO fabricated with hard plastic, in improving postural stability in elderly chronic stroke survivors. PATIENTS AND METHODS: Postural stability was evaluated in ten chronic stroke patients, 55...
2015: Clinical Interventions in Aging
Daniel Baumfeld, Fernando C Raduan, Benjamim Macedo, Thiago Alexandre Alves Silva, Tiago Baumfeld, Danilo Fabrino Favato, Marco Antonio Percope de Andrade, Caio Nery
BACKGROUND: Excessive shoe heel abrasion is of concern to patients and shoe manufacturers, but little scientific information is available about this feature and its possible causes. The purpose of this study was to relate this phenomenon with biomechanical factors that could predispose to shoe heel abrasion. METHODS: Ninety-seven recruits (median age 25) were enrolled in this study. Shoe abrasion was assessed manually with a metric plastic tape on the posterior part of the heel that comes in contact with the ground...
2015: Journal of Orthopaedic Surgery and Research
Kenneth W Hegewald, Matthew D Doyle, Nicholas W Todd, Shannon M Rush
Many surgical procedures have been described for Achilles tendon pathology; however, no overwhelming consensus has been reached for surgical treatment. Open repair using a central or paramedian incision allows excellent visualization for end-to-end anastomosis in the case of a complete rupture and detachment and reattachment for insertional pathologies. Postoperative wound dehiscence and infection in the Achilles tendon have considerable deleterious effects on overall functional recovery and outcome and sometimes require plastic surgery techniques to achieve coverage...
January 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Jamal Ahmad
Diabetic foot problems are responsible for nearly 50% of all diabetes-related hospital bed days. Approximately 10-15% of diabetic patients developed foot ulcers at some state in their life and 15% of all load in amputations are performed in patients with diabetes. There is a need to provide extensive education to both primary care physicians and the patients regarding the relationship between glucose control and complications encountered in the foot and ankle. The management of diabetic foot disease is focussed primarily on avoiding amputation of lower extremities and should be carried out through three main strategies; identification of the "at risk" foot, treatment of acutely diseased foot, and prevention of further problems...
January 2016: Diabetes & Metabolic Syndrome
Yusuf M Khalid, Darwin Gouwanda, Subramanian Parasuraman
Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition...
June 2015: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Maria Willerslev-Olsen, Tue Hvass Petersen, Simon Francis Farmer, Jens Bo Nielsen
Foot drop and toe walking are frequent concerns in children with cerebral palsy. The main underlying cause of these problems is early damage and lack of maturation of the corticospinal tract. In the present study we investigated whether 4 weeks of daily treadmill training with an incline may facilitate corticospinal transmission and improve the control of the ankle joint in children with cerebral palsy. Sixteen children with cerebral palsy (Gross Motor Classification System I:6, II:6, III:4) aged 5-14 years old, were recruited for the study...
March 2015: Brain: a Journal of Neurology
Jeffrey Manway, Peter Highlander
UNLABELLED: Open fractures have been associated with high rates of morbidity and mortality. Morbidity and mortality rates have improved with the advancements in infectious disease, plastic and reconstructive surgery, as well as damage control orthopaedics. Despite these advancements, few reports have focused on management of open foot and ankle fractures. This review outlines evidence-based principles for open fracture management and how these principles are applied to the foot and ankle...
February 2015: Foot & Ankle Specialist
T Ménez, B Chaput, A Bonte, J M Alet, J L Grolleau, A Michot, P Pélissier
INTRODUCTION: Complex heel injuries in children are rare and their management requires coverage combining resistance and thinness, to allow walking and footwear. The objective of this study was to create a decision-making algorithm for heel defect in children. MATERIALS: Children received for heel defect, reconstructed with flap in our plastic surgery unit of Bordeaux with a follow-up greater than 10 years were investigated. Three children operated between 1999 and 2003 were included...
February 2016: Annales de Chirurgie Plastique et Esthétique
Noel Rao, Jason Wening, Daniel Hasso, Gnanapradeep Gnanapragasam, Priyan Perera, Padma Srigiriraju, Alexander S Aruin
Objective. To compare the effects of two types of ankle-foot orthoses on gait of patients with cerebrovascular accident (CVA) and to evaluate their preference in using each AFO type. Design. Thirty individuals with acute hemiparetic CVA were tested without an AFO, with an off-the-shelf carbon AFO (C-AFO), and with a custom plastic AFO (P-AFO) in random order at the time of initial orthotic fitting. Gait velocity, cadence, stride length, and step length were collected using an electronic walkway and the subjects were surveyed about their perceptions of each device...
2014: Rehabilitation Research and Practice
Bilsev Ince, Mehmet Daaci, Zeynep Altuntas, Tugba Sodali, Fatma Bilgen, Mustafa Kursat Evrenos
BACKGROUND AND OBJECTIVE: Reconstructing defects related to the leg soft tissue may be quite difficult because the soft tissue over the bone is rather thin and the tendons lie right under the skin. Distal pedicle sural neurocutaneous flap with its long pedicle composed of skin, subcutaneous tissue and fascia is suitable for superficial defects. This study aimed to determine the usability of the delayed reverse-flow (distally based) islanded sural flap for correcting tibial and ankle defects...
May 2014: Annals of Saudi Medicine
A G C Hay-David, S A Clint, R R Brown
INTRODUCTION: April 1st 2012 saw the introduction of National Trauma Networks in England. The aim to optimise the management of major trauma. Patients with an ISS≥16 would be transferred to the regional Major Trauma Centre (level 1). Our premise was that trauma units (level 2) would no longer manage complex foot and ankle injuries thereby obviating the need for a foot and ankle specialist service. METHODS: Retrospective analysis of the epidemiology of foot and ankle injuries, using the Gloucestershire trauma database, from a trauma unit with a population of 750,000...
December 2014: Injury
Huaiyuan Zheng, Juan Liu, Xinyi Dai, Arndt F Schilling
BACKGROUND: Skin and soft tissue defects at the level of the ankle and the heel remain a great challenge for plastic and reconstructive surgeons. There were just a few reports on the use of distal-based sural flap in pediatric patients. The purpose of this study was to introduce our experience in the treatment of skin and soft tissue defects of the pediatric feet by using this distally based sural neurocutaneous flap together with some technical modifications for a large-sized defect...
January 2016: Annals of Plastic Surgery
Luigi Tesio, Maria Grazia Benedetti, Viviana Rota, Marco Manfrini, Laura Perucca, Antonio Caronni
Rotationplasty (Borggreve-Van Nes operation) is a rare limb salvage procedure, most often applied to children presenting with sarcoma of the distal femur. In type A1 operation, the distal thigh is removed and the proximal tibia is axially rotated by 180°, remodeled, grafted onto the femoral stump, and then prosthetized. The neurovascular bundle is spared. The rotated ankle then works as a knee. The foot plantar and dorsal flexors act as knee extensors and flexors, respectively. Functional results may be excellent...
December 2014: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Eiichi Naito, Satoshi Hirose
How very long-term (over many years) motor skill training shapes internal motor representation remains poorly understood. We provide valuable evidence that the football brain of Neymar da Silva Santos Júnior (the Brasilian footballer) recruits very limited neural resources in the motor-cortical foot regions during foot movements. We scanned his brain activity with a 3-tesla functional magnetic resonance imaging (fMRI) while he rotated his right ankle at 1 Hz. We also scanned brain activity when three other age-controlled professional footballers, two top-athlete swimmers and one amateur footballer performed the identical task...
2014: Frontiers in Human Neuroscience
Suhani Sumalatha, Vinodhini Periyasamy, Ramachandra Bhatt, Antony Sylvan Dsouza, Mamatha Hosapatna
The Popliteal Artery (PA), which is the continuation of the Femoral artery, crosses the popliteal fossa at the distal border of popliteus; it divides into the Anterior and Posterior Tibial arteries. The Posterior Tibial Artery (PTA) divides into terminal branches proximal to popliteus, in which case the Anterior Tibial Artery (ATA) sometimes descends anterior to the muscle. Either the Anterior tibial or the PTA may be reduced or increased in size. The dorsalis pedis artery (DPA) is the continuation of the ATA, distal to the ankle...
June 2014: Journal of Clinical and Diagnostic Research: JCDR
Ramesha Kt, Prakashkumar Mn, Shankarappa M
BACKGROUND: One of the challenges in reconstructive surgeries, faced by a majority of surgeons, is the soft tissue defect management around the lower-third of the leg, plantar and dorsal feet. Due to the sensitive location and other related difficulties, only limited options are available in this region. A durable flap is the preferred option for coverage of such defects. OBJECTIVE: To evaluate the safety, success and efficacy of the extended reverse sural artery flap which was harvested, with extension to proximal-third of the leg...
May 2014: Journal of Clinical and Diagnostic Research: JCDR
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