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Vittorio Mattugini, Carmine Citarelli, Fabio Cosseddu, Marco Ghilard, Guido Luppichini, Francesco Casella, Giulio Agostini, Federico Sacchetti, Rodolfo Capanna
Fibular head avulsion fractures are rare injuries determined by traction of the fibular attachment of the lateral collateral ligament (LCL). Surgical treatment is often recommended with different techniques such as tension band fixation or lag screws stabilization. In this article, we describe a fixation technique of fibular head fractures obtained through the use of anchors. A 45-year-old athletic patient came to our attention in our traumatologic service after a motorcycle accident. He reported a complex injury of the posterolateral corner with an avulsion fracture of the left fibular head...
March 12, 2018: Surgical Technology International
Ryan R Kerney, James Hanken, David C Blackburn
Direct-developing amphibians form limbs during early embryonic stages, as opposed to the later, often postembryonic limb formation of metamorphosing species. Limb patterning is dramatically altered in direct-developing frogs, but little attention has been given to direct-developing salamanders. We use expression patterns of two genes, sox9 and col2a1, to assess skeletal patterning during embryonic limb development in the direct-developing salamander Plethodon cinereus. Limb patterning in P. cinereus partially resembles that described in other urodele species, with early formation of digit II and a generally anterior-to-posterior formation of preaxial digits...
March 12, 2018: Evolution & Development
Hyun Ho Han, Yeon Ji Lee, Suk-Ho Moon
BACKGROUND: When a small, thin, and durable flap is required for coverage of the foot, the proximal peroneal artery perforator (PPAP) free flap may be a novel option. However, few clinical results and anatomical studies on the PPAP flap have been published. METHODS: A total of 24 PPAP flaps used in 22 patients from January 2013 to December 2016 were analyzed. All flaps were elevated in the subfascial plane based on a single perforator from the peroneal artery between the soleus and peroneus muscles...
February 22, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Lin Wang, Yingze Zhang, Zhaohui Song, Hengrui Chang, Ye Tian, Fei Zhang
PURPOSE: To describe and evaluate the novel method of using elastic bionic fixation device in treating the distal tibiofibular syndesmosis (DTS) injury. METHODS: From June 2013 to January 2014, 17 subjects with ankle fractures combined with DTS separation were treated by the elastic bionic fixation device. The syndesmotic parameters, healing, functional scores, and possible complications were recorded. RESULTS: All patients had a mean follow-up of 23...
March 9, 2018: International Orthopaedics
Jo Anne Au Yong, Daniel D Lewis, Scott B Citino, Mark W Cunningham, Alan R Cross, James P Farese, Luisito S Pablo
The clinical outcomes of six free-ranging Florida panthers ( Puma concolor coryi) that underwent surgical stabilization of appendicular long-bone fractures (three femoral fractures, one tibial and one tibial and fibular fracture and two radial and ulnar fractures) were evaluated. These panthers presented to the University of Florida from 2000-2014. Estimated age of the panthers ranged from 0.5 to 4.5 yr, and weights ranged from 22 to 65 kg. Causes of injuries were vehicular collision ( n = 4) and capture related ( n = 2)...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
D Pauchet, J-L Pigot, F Chabolle, C-A Bach
Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned...
March 2, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Da-Hui Sun, Yi Zhao, Ji-Ting Zhang, Dong Zhu, Bao-Chang Qi
RATIONALE: It is challenging to visualize and reduce a posterolateral tibial plateau fracture through an anterolateral approach as the tibial plateau fragments are often covered by the fibular head and ligamentous structures. PATIENT CONCERNS: In this case report, we describe a patient with a depression fracture of the posterolateral quadrant combined with a split fracture of the posteromedial quadrant and an avulsion fracture of the tibial intercondylar eminence...
January 2018: Medicine (Baltimore)
Jian Zhang, Wen-Si He, Cheng Wang, Yi-Guo Yan, Zhi-Hua Ouyang, Jing-Bo Xue, Xue-Lin Li, Wen-Jun Wang
Multilevel cervical reconstruction and fusion after cervical tuberculosis has always been a challenge. The current implantation materials for cervical fusion, including titanium mesh, cage, and plate are limited by its inferior biological mechanical characteristics and the properties of the metallic material. This has led to the increased risk of recurrent infection after surgery. In addition, the unique nature of tuberculosis infection results in the low rate of cervical fusion and high risk of recurrence...
January 2018: Medicine (Baltimore)
Megan E Cain, Job N Doornberg, Robin Duit, Jock Clarnette, Ruurd Jaarsma, Bhavin Jadav
BACKGROUND: Intramedullary-nails (IMN) are the treatment of choice for most tibial shaft fractures due to their minimally-invasive nature and non-demanding surgical technique. However, a potential iatrogenic pitfall is intra-articular interlocking screw positioning within the proximal (PTFJ) and distal (DTFJ) tibiofibular joints that may go unrecognized. OBJECTIVE: To evaluate the incidence of intra-articular screw penetration of the PTFJ and DTFJs after interlocking of IMN for tibial fractures...
March 1, 2018: Injury
Busra Candan, Soner Albay
BACKGROUND: The aim of this study is to determine of cutaneous innervation of dorsum of the foot on fetal cadavers. MATERIALS AND METHODS: In this study 200 limbs from 100 embalmed fetuses (54 males and 46 females) were studied in Anatomy Laboratory. Contributions of medial, lateral and intermediate dorsal cutaneous nerves (MDCN, LDCN and IDCN) of the foot were identified. FINDINGS: Cutaneous innervation of dorsum of the foot was classified into five Types...
March 3, 2018: Folia Morphologica (Warsz)
Justin J Fleming
The reamed intramedullary (IM) technique has many benefits. However, open plating is the most commonly used technique. Previously, IM stabilization was reserved for fibular fractures, which were given lower priority, and generally associated with injuries to the distal tibia or instances in which the soft tissue envelope was unsuitable for an open approach. This article reviews the literature and the level of evidence, and presents case examples and operative technique.
April 2018: Clinics in Podiatric Medicine and Surgery
Samir Omar Saleh, Mauro Figueiredo Carvalho de Andrade, Guilherme de Arruda Cuadrado, Kassem Samir Saleh, Flávia Emi Akamatsu, Alfredo Luiz Jacomo
BACKGROUND: Aneurysms of the deep veins of the lower limbs are rare and often asymptomatic. Although natural history is unclear, these aneurysms have been associated with deep venous thrombosis and fatal pulmonary embolism events. To our knowledge, this case represents the fifth patient with isolated aneurysm of a calf vein described in the literature and the second one affecting the fibular vein. CASE PRESENTATION: We report the case of a 20-year-old white man with an aneurysm of the fibular vein that we believe is the second case in the literature...
February 23, 2018: Annals of Vascular Surgery
Peter V Giannoudis, Christian Krettek, David W Lowenberg, Theodoros Tosounidis, Joseph Borrelli
Treatment of bone defects remains a challenging clinical problem. Despite our better understanding of bone repair mechanisms and advances made in microsurgical techniques and regenerative medicine, the reintervention rates and morbidity remain high. Surgical techniques such as allograft implantation, free vascularized fibular graft, distraction osteogenesis, loaded titanium cages, and the induced membrane technique continue to evolve, but the outcome can be affected by a number of parameters including the age of the patient, comorbidities, systemic disorders, the location of the defect, and the surgeon's preference and experience...
March 2018: Journal of Orthopaedic Trauma
Bin Yuan, Bao-Jian Ge, Bai-Yi Meng
Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Ebrahim Izadi, Rahij Anwar, Sarah Phillips, Venu Kavarthapu
Displaced osteochondral fractures of the body of talus quite often require a malleolar osteotomy to gain access to the fracture fragment during internal fixation. We describe a case report in which access to a displaced osteochondral fracture of the lateral talar dome was achieved using an arthroscopy-assisted fibular tunnel approach. This technique resulted in satisfactory fracture healing and a satisfactory clinical outcome.
February 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Kun-Ming Ren, Pei-Liang Zhang
OBJECTIVE: To evaluate the short-and mid-term curative effect of high fibular osteotomy on knee osteoarthritis. METHODS: From October 2014 to July 2016, 76 patients with knee osteoarthritis were treated with high fibular osteotomy. There were 22 males and 54 females, ranging in age from 47 to 82 years old, with an average of 61.62 years old. Internal tenderness of the knee joint was examined preoperatively. Preoperative examination showed medial knee pain and medial positive McMurray sign...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Mengshi Zhang, Li Yang, Feng Yuan, Ying Chen, Gufa Lin
The ontogenetic decline of regeneration capacity in the anuran amphibian Xenopus makes it an excellent model for regeneration studies. However, the cause of the regeneration ability decline is not fully understood. MicroRNAs regulate animal development, and have been indicated in various regeneration situations. However, little is known about the role of microRNAs during limb regeneration in Xenopus. This study investigates the effect of Dicer, an enzyme responsible for microRNA maturation, on limb development and regeneration in Xenopus...
February 17, 2018: Wound Repair and Regeneration
Gerard Chang, Suneel B Bhat, Steven M Raikin, Justin M Kane, Andrew Kay, Jamal Ahmad, David I Pedowitz, James Krieg
Ankle fractures are among the most common injuries requiring operative management. Implant choices include one-third tubular plates and anatomically precontoured plates. Although cadaveric studies have not revealed biomechanical differences between various plate constructs, there are substantial cost differences. This study sought to characterize the economic implications of implant choice. A retrospective review was undertaken of 201 consecutive patients with operatively treated OTA type 44B and 44C ankles...
February 16, 2018: Orthopedics
Kenneth Akakpo, Christopher Iobst, Matthew Old, Jonathan Grischkan
The fibular free flap has become the gold standard for mandibular reconstruction. Despite its vast array of benefits, this procedure has the potential for several complications. In the pediatric setting, the immature skeleton sets the stage for an increased risk of future skeletal abnormalities, both in the jaw, and in the donor site. Herein we describe the case of a toddler who underwent mandibular reconstruction using a fibula free flap and, years later, subsequently developed ankle instability as a result of residual fibula migration...
February 2018: International Journal of Pediatric Otorhinolaryngology
Barakat El-Alfy, Mazen Abulsaad, Wail Lotfy Abdelnaby
PURPOSE: The aim of the present study is to assess the results of free nonvascularized fibular graft in the induced membrane technique to manage bone defects. MATERIALS AND METHODS: Fifteen patients with segmental skeletal defects were treated by the induced membrane technique using free nonvascularized fibular graft. The ages ranged from 20 to 48 years with an average of 32 years. The cause of the defects was post-traumatic bone loss in all cases. The defects were located in the distal femur in nine cases, proximal tibia in two cases and middle third of the tibia in four cases...
February 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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