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limb salvaging

Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
Eric Klingelhoefer, Hendrik Bergert, Stephan Kersting, Stefan Ludwig, Norbert Weiss, Frank Schönleben, Robert Grützmann, Gabor Gäbel
BACKGROUND: Peripheral arterial disease (PAD) is one of the most underestimated diseases because of its high prevalence and unfavorable prognosis. Many PAD patients without suitable autologous veins or options for endovascular treatment receive prosthetic above-knee femoropopliteal bypass (PAKB). Until now predictors of prosthetic bypass failure and of increased amputation risk remain indistinct. This study aimed to identify predictive factors associated with better bypass patency and limb salvage to achieve a more favorable outcome after PAKB reconstruction...
August 2016: Journal of Vascular Surgery
Yohsuke Honda, Keisuke Hirano, Masahiro Yamawaki, Shinsuke Mori, Shigemitsu Shirai, Kenji Makino, Takahiro Tokuda, Takuro Takama, Masakazu Tsutumi, Yasunari Sakamoto, Hideyuki Takimura, Norihiro Kobayashi, Motoharu Araki, Yoshiaki Ito
We assessed wound healing in patients on hemodialysis (HD) with critical limb ischemia (CLI). This study enrolled 267 patients (including 120 patients on HD and 147 patients not on HD) who underwent endovascular therapy (EVT) for CLI. The primary endpoint was wound-healing rate at two years. Secondary endpoints were time to wound healing, wound recurrence rate, and limb salvage at two years. The percentage of male and young patients was higher in the HD patients (p < 0.01). A lower patency of the pedal arch after EVT was observed frequently in HD patients (p < 0...
October 6, 2016: Vascular
Shimpei Miyamoto, Masahide Fujiki, Fumihiko Nakatani, Eisuke Kobayashi, Masanobu Sakisaka, Minoru Sakuraba
BACKGROUND: Complex groin defects after sarcoma resection require reconstruction of multiple vital structures that can include the major vessels, the overlying skin, the abdominal wall, and the hip joint. We investigated the feasibility of limb preservation after complex groin reconstruction. METHODS: The subjects were 12 consecutive patients who underwent complex groin reconstruction after sarcoma resection. In all patients, the defect included a major artery (external iliac or femoral) and overlying skin...
October 6, 2016: Annals of Plastic Surgery
Katherine C Leonard, Michael P Kowaleski, William B Saunders, Robert J McCarthy, Randy J Boudrieau
OBJECTIVES: To describe the surgical technique and report short-term outcome for combined tibial plateau levelling osteotomy and tibial tuberosity transposition (TPLO-TTT) as an option in the treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation. METHODS: Medical records were reviewed (2011-2013) of dogs that underwent a standard tibial plateau levelling osteotomy followed by a tibial tuberosity transposition in the frontal plane and stabilized with pin and tension-band wire fixation as a component of surgical treatment for combined cranial cruciate ligament insufficiency and medial patellar luxation...
October 14, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Karl Nuss
Diseases of the bovine digit remain the major cause of painful lameness in cattle and commonly constitute a diagnostic and therapeutic challenge for clinicians. Prompt surgical wound revision is critical in acute injuries. Deep infections may be treated with debridement, resection of tendons, synovioscopy, joint lavage, arthrotomy and facilitated joint ankylosis. Postoperative care is more involved, lameness persists longer, and cost of treatment is higher after salvage techniques than after amputation of the digit...
November 2016: Veterinary Clinics of North America. Food Animal Practice
Erwin E Argueta, Alvaro Rosales, Jose A Suarez
OBJECTIVES: To describe our single center experience with the use of laser endartherectomy assisted balloon angioplasty in popliteal and infrapopliteal arterial disease. BACKGROUND: Peripheral arterial disease (PAD) carries significant morbidity to patients. Some patients may have multiple comorbid conditions potentially limiting therapeutic options for PAD. Endovascular interventions are aimed at decreasing arterial disease symptoms, improve wound healing and ultimately limb salvage...
October 1, 2016: International Journal of Cardiology
S Raja Sabapathy, David Elliot, Hari Venkatramani
With the available microsurgical techniques, salvage of the limb can almost always provide a useful upper limb, even in the most complex combined injuries. Having a low threshold for revascularization of doubtfully viable extremities and making full use of the current armamentarium of soft tissue cover techniques, including flow through free flaps, will salvage many limbs. Secondary procedures, including free functioning muscle transfers and toe transfers, further increase the possible functional outcome. Even in the most complex combined injuries, intelligent reconstruction will obtain better outcomes than the best available prosthesis, making the efforts of salvage worthwhile...
November 2016: Hand Clinics
Yong-Seok Han, Jun Hee Lee, Yeo Min Yoon, Chul Won Yun, Hyunjin Noh, Sang Hun Lee
Mesenchymal stem cells (MSCs) are 'adult' multipotent cells that promote regeneration of injured tissues in vivo. However, differences in oxygenation levels between normoxic culture conditions (21% oxygen) and both the MSC niche (2-8% oxygen) and ischemic injury-induced oxidative stress conditions in vivo have resulted in low efficacy of MSC therapies in both pre-clinical and clinical studies. To address this issue, we examined the effectiveness of hypoxia preconditioning (2% oxygen) for enhancing the bioactivity and tissue-regenerative potential of adipose-derived MSCs...
October 6, 2016: Cell Death & Disease
Wiroon Laupattarakasem, Pat Laupattarakasem
We describe a sliding knot that is ideally lockable by transforming the original simple figure-of-8 configuration into a true interlocking, low-profile knot with an α-α configuration that creates strong primary knot security when tying is finished. Reversed half-hitches on alternating posts for secondary knot security can be added, but to save surgical time, these are not obligatory. Three simple knot-tying methods are presented; the choice of which to use is based on the surgeon's preference. Pulling the loop limb simultaneously on both sides of the knot could trigger premature knot flipping...
August 2016: Arthroscopy Techniques
E Saarinen, P Kauhanen, M Söderström, A Albäck, M Venermo
INTRODUCTION: As the population ages and the incidence of diabetes increases, the expected number of patients with critical limb ischaemia (CLI) requiring distal revascularization will remain high or even increase. The aim of this study was to investigate the long-term results of inframalleolar bypass. MATERIAL AND METHODS: A total of 352 inframalleolar bypasses for CLI performed between 2002 and 2013 were included. Risk factors were evaluated and patency (both clinical and imaging based), leg salvage, survival, and amputation free survival (AFS) assessed...
October 2, 2016: European Journal of Vascular and Endovascular Surgery
Raju Vaishya, Vipul Vijay, Ram Sagar Pandit, Amit K Agarwal
INTRODUCTION: Fractures of the distal humerus are a rare entity accounting for approximately 2% of the humeral fractures. Non union of the distal humerus is further rare and poses a major challenge. These fractures usually respond to open reduction and bone grafting but some may fail multiple surgical attempts at union and hence are labelled as "resistant" non union. We report a case of resistant non union of the distal humerus which was managed by total elbow arthroplasty. CASE PRESENTATION: A 49-year-old male presented to the out patient department with history of a compound comminuted fracture of the distal end of the humerus approximately 25 years back...
April 2016: Journal of Orthopaedic Case Reports
O B Pattanashetty, Dayanand B B, Arravind Pillai, Preetish Endigeri
INTRODUCTION: Dedifferentiated chondrosarcoma (DDCS) is a rare and malignant form of primary bone tumor refractive to chemotherapy and radiotherapy. It accounts for 1-2% of all primary bone tumors. Surgical resection, limb-salvage surgeries and amputation remain the mainstay of treatment. The prognosis of dedifferentiated chondrosarcoma is poor. CASE REPORT: We report a case of a 51-year-old male having a swelling and an ulcer distal to the left knee later diagnosed with dedifferentiated chondrosarcoma of proximal tibial and fibular metaphysis...
April 2016: Journal of Orthopaedic Case Reports
Seung-Kee Min, Young Hwan Kim, Jin Hyun Joh, Jin Mo Kang, Ui Jun Park, Hyung-Kee Kim, Jeong-Hwan Chang, Sang Jun Park, Jang Yong Kim, Jae Ik Bae, Sun Young Choi, Chang Won Kim, Sung Il Park, Nam Yeol Yim, Yong Sun Jeon, Hyun-Ki Yoon, Ki Hyuk Park
Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal...
September 2016: Vascular Specialist International
James Richman, Adam Cota, Steven Weinfeld
BACKGROUND: Surgical strategies to address deformities of the ankle and hindfoot in patients with Charcot arthropathy include the use of retrograde intramedullary nails and ring fixators. The literature has not shown superiority of one technique over the other. This study presents a single surgeon's case series of Charcot arthropathy patients treated with either a ring fixator or retrograde intramedullary nail to achieve tibiotalocalcaneal arthrodesis. METHODS: We performed a retrospective analysis of 27 consecutive patients with Charcot arthropathy who underwent a tibiotalocalcaneal arthrodesis using either a retrograde intramedullary (IM) nail (n = 16 patients) or a ring fixator (RF) (n = 11 patients) by a single surgeon...
October 2, 2016: Foot & Ankle International
Michele Ammendola, Rosario Sacco, Lucia Butrico, Giuseppe Sammarco, Stefano de Franciscis, Raffaele Serra
Diabetic foot ulcerations may determine minor or major amputation, with a high impact on patients' life expectation and quality of life and on economic burden. Among minor amputations, transmetatarsal amputation (TMA) appears to be the most effective in terms of limb salvage rates and in maintaining foot and ankle biomechanics. In spite of this, TMA needs particular pre- and postoperative management in order to avoid the frequent failure rates. A systematic review was undertaken of studies concerning TMA and its care in diabetic foot gangrene...
October 3, 2016: International Wound Journal
Fan Tang, Yong Zhou, Li Min, Wenli Zhang, Rui Shi, Yi Luo, Hong Duan, Chongqi Tu
OBJECTIVE: To evaluate the medium-term outcome of limb-salvage surgery using all-polyethylene tibial endoprosthetic replacement following en-block resection for distal femoral tumors. METHODS: Forty-nine patients with distal femoral tumor were treated between June 2006 and June 2012. The follow-up period was 6-110 months (average 53.4 months). The prosthetic survival was analyzed using the Kaplan-Meier method. The classification of failure of limb salvage after reconstructive surgery for bone tumors was adapted...
2016: OncoTargets and Therapy
Luca Dalla Paola, Anna Carone, Giulio Boscarino, Giuseppe Scavone, Lucian Vasilache
Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator...
September 29, 2016: International Journal of Lower Extremity Wounds
Kristýna Špillerová, Fausto Biancari, Nicla Settembre, Anders Albäck, Maarit Venermo
BACKGROUND: The definition of angiosome-targeted revascularization is confusing, especially when a tissue lesion affects several angiosomes. Two different definitions of direct revascularization exist in the literature. The study aim was: 1) to compare the two definitions of direct revascularization in patients with foot lesions involving more than one angiosome, and 2) to evaluate which definition better predicts clinical outcome. MATERIALS AND METHODS: This study cohort comprises 658 patients with Rutherford 5-6 foot lesions who underwent infrapopliteal endovascular or surgical revascularization between January 2010 and July 2013...
September 29, 2016: Annals of Vascular Surgery
Viviana Rota, Maria Grazia Benedetti, Yusuke Okita, Marco Manfrini, Luigi Tesio
Knee rotationplasty (KRP) is a type of surgery in which the rotated ankle serves as a new knee after being removed for bone tumor. Although this limb salvage surgery is rarely indicated in properly selected patients, it may offer functional advantages over transfemoral amputation, and more durable results compared with a prosthesis. The walking mechanics of adult patients after KRP is believed to be close to that of below-knee amputees. In this study, we evaluated steady-state walking of KRP patients from the viewpoint of the overall muscle power needed to keep the body centre of mass in motion...
September 28, 2016: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
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