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https://www.readbyqxmd.com/read/28938387/critical-sized-bone-defects-sequence-and-planning
#1
Paul Toogood, Theodore Miclau
Bone defects associated with open fractures require a careful approach and planning. At initial presentation, an emergent irrigation and debridement is required. Immediate definitive fixation is frequently safe, with the exception of those injuries that normally require staged management or very severe type IIIB and IIIC injuries. Traumatic wounds that can be approximated primarily should be closed at the time of initial presentation. Wounds that cannot be closed should have a negative pressure wound therapy dressing applied...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28937784/lacertus-fibrosus-versus-achilles-allograft-reconstruction-for-distal-biceps-tears-a-biomechanical-study
#2
Anand M Murthi, Miguel A Ramirez, Brent G Parks, Shannon R Carpenter
BACKGROUND: The bicipital aponeurosis, or lacertus fibrosus, can potentially be used as a reconstruction graft in chronic distal biceps tendon tears. PURPOSE: To evaluate construct stiffness, load to failure, and failure mechanism with lacertus fibrosus versus Achilles allograft for distal biceps tendon reconstruction. STUDY DESIGN: Controlled laboratory study. METHODS: Ten fresh-frozen matched cadaveric pairs of elbows were used...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28924826/volumetric-and-linear-changes-at-dental-implants-following-grafting-with-volume-stable-three-dimensional-collagen-matrices-or-autogenous-connective-tissue-grafts-6-month-data
#3
Nadja Naenni, Stefan P Bienz, Goran I Benic, Ronald E Jung, Christoph H F Hämmerle, Daniel S Thoma
OBJECTIVES: The objective of this study was to test whether or not soft tissue augmentation with a volume-stable collagen matrix (VCMX) leads to similar volume gain around dental implants compared to autogenous subepithelial connective tissue graft (SCTG). MATERIALS AND METHODS: In 12 adult beagle dogs, immediate implants were placed with simultaneous guided bone regeneration. After 25-45 weeks, soft tissue augmentation was randomly performed using VCMX, SCTG, or a sham-operated control...
September 18, 2017: Clinical Oral Investigations
https://www.readbyqxmd.com/read/28922244/fibular-graft-effective-panorama-for-prosthetic-rehabilitation-of-resected-mandible
#4
Pankaj Kharade, Saidul Islam, Mahesh Verma, Swati Sharma, Ranjeet Bodh
Surgical management of extensive tumors in the mandibular region leads to massive disfigurement of the face. Also the prosthetic outcome of such patients rehabilitated with free soft tissue flaps is very poor. Reconstruction of extensive defects to overcome the disfigurement is a challenging procedure and can be achieved with free fibula flap. Free fibula graft provides sufficient length of bone for the reconstruction of the postsurgical defects. Excellent vascularity of fibula flap allows for easy uptake of the graft and osseointegration of the dental implants...
September 15, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#5
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28917520/short-term-complications-in-intra-and-extra-articular-anterior-cruciate-ligament-reconstruction-comparison-with-the-literature-on-isolated-intra-articular-reconstruction-a-multicenter-study-by-the-french-society-of-arthroscopy
#6
J C Panisset, R Pailhé, B Schlaterrer, L Sigwalt, B Sonnery-Cottet, C Lutz, S Lustig, C Batailler, S Bertiaux, F P Ehkirch, P Colombet, C Steltzlen, M L Louis, P D'ingrado, F Dalmay, P Imbert, D Saragaglia
INTRODUCTION: Lateral tenodesis (LT) is performed to limit the risk of iterative tear following anterior cruciate ligament (ACL) reconstruction in at-risk patients. By adding an extra procedure to isolated ACL graft, LT reconstruction increases operating time and may complicate postoperative course. The objective of the present study was to evaluate the rate of early complications. The study hypothesis was that associating ALL reconstruction to ACL reconstruction does not increase the complications rate found with isolated ACL reconstruction...
September 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28913395/simultaneous-bilateral-total-hip-arthroplasty-in-morquio-syndrome
#7
Imran Ilyas, Syed Kashif, Samar Rabbani, Husam A Alrumaih
A 16-year-old girl who had Morquio syndrome presented with severe bilateral hip pain and limited mobility because of bilateral hip osteoarthritis and fixed flexion deformities. She was wheelchair bound for the previous 6 months. Cervical spine flexion-extension views showed mild subluxation (<3 mm), and there was thoracolumbar spine kyphosis. Magnetic resonance imaging of the cervical and thoracolumbar spine showed hypoplasia of the odontoid and vertebral bodies, but no spinal cord compression. Bilateral cemented total hip arthroplasty was performed through a posterior approach under general anesthesia with fiberoptic intubation...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28911959/histological-changes-in-the-periosteum-following-subperiosteal-expansion-in-rabbit-scalp
#8
Mohamad Taghi Kiani, Nasrin Takzare, Ahad Khoshzaban, Elahe Jalilianfar, Leila Aghajanpour, Reza Tabrizi
PURPOSE: In intraoral bone grafting, tension-free coverage of the recipient site with periosteal flap results in optimal wound closure. Tissue expansion could be a suitable modality to obtain soft tissue in the oral cavity. The aim of this study was to assess the histology of the periosteum after subperiosteal expansion in the rabbit scalp. MATERIALS AND METHODS: In this animal study, 6 rectangular tissue expanders were placed in the skulls of 6 male white New Zealand rabbits; in 6 control rabbits, an incision was made to the periosteum but no expansion was performed...
August 31, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28902161/biological-evaluation-of-flexible-polyurethane-poly-l-lactic-acid-composite-scaffold-as-a-potential-filler-for-bone-regeneration
#9
Yuk Fai Lui, Wing Yuk Ip
Degradable bone graft substitute for large-volume bone defects is a continuously developing field in orthopedics. With the advance in biomaterial in past decades, a wide range of new materials has been investigated for their potential in this application. When compared to common biopolymers within the field such as PLA or PCL, elastomers such as polyurethane offer some unique advantages in terms of flexibility. In cases of bone defect treatments, a flexible soft filler can help to establish an intimate contact with surrounding bones to provide a stable bone-material interface for cell proliferation and ingrowth of tissue...
September 13, 2017: Materials
https://www.readbyqxmd.com/read/28894659/prevention-of-mandible-reconstruction-plate-exposure-by-costal-cartilage-wrapping
#10
Motonao Iwasawa, Yoshito Mishima, Miho Ohtsubo
After mandibulectomy in cancer surgery, reconstruction is often performed with a reconstruction plate covered with a soft-tissue free flap in patients in poor condition. However, the rate of complications for mandibular reconstruction is higher with a reconstruction plate than with vascularized bone grafts. We have developed a costal cartilage wrapping method to prevent exposure of the mandible reconstruction plate. The eighth costal cartilage was removed and split into 2 pieces to wrap around the reconstruction plate...
August 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28893049/comparative-evaluation-of-the-efficacy-of-bioactive-ceramic-composite-granules-alone-and-in-combination-with-platelet-rich-fibrin-in-the-treatment-of-mandibular-class-ii-furcation-defects-a-clinical-and-radiographic-study
#11
Hima S Lohi, Dilip G Nayak, Ashita S Uppoor
INTRODUCTION: Predictable closure of furcation defects with bone grafts, Guided Tissue Regeneration (GTR) and a combination of the two has remained an elusive goal so far. Hence, evaluation of biomimetic agents as candidate technologies for periodontal regeneration merit due consideration. In this study, Choukroun's Platelet Rich Fibrin (PRF), a second generation platelet concentrate, is combined with bone graft to examine if the addition enhances the therapeutic potential of bone graft in the management of Class II furcation defects...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891728/bioengineered-dermal-substitutes-for-the-management-of-traumatic-periocular-tissue-loss
#12
Tiffany A Chen, Juan A Ayala-Haedo, Nathan W Blessing, Katie Topping, Chrisfouad R Alabiad, Benjamin P Erickson
PURPOSE: Traumatic periocular injuries occasionally result in significant soft tissue loss, for which there are limited management options that provide satisfactory cosmetic and functional outcomes. The authors describe the use of a bioengineered dermal substitute (Integra® Dermal Regeneration Template [DRT], Integra LifeSciences, Plainsboro, NJ) as an alternative to immediate flap reconstruction or skin grafting. METHODS: Retrospective interventional case series of patients who underwent DRT placement for periocular tissue loss at the time of trauma...
September 11, 2017: Orbit
https://www.readbyqxmd.com/read/28888300/heterotopic-ossification-and-hypertrophic-scars
#13
REVIEW
Shailesh Agarwal, Michael Sorkin, Benjamin Levi
Burns and trauma cause superficial and deep soft tissue wounds that cannot heal to the preinjury state. Healing requires cell proliferation and differentiation into the injured tissue type, laying down extracellular matrix, often as collagens. Heterotopic ossification causes severe pain, nonhealing wounds, and restricted range of motion. Treatment includes radiation therapy, nonsteroidal anti-inflammatory drugs, bisphosphonates, and possibly surgical excision and prophylactic measures. Hypertrophic scars, nonosseous lesions caused by excessive collagen deposition, are often painful, functionally limiting, and aesthetically displeasing...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28879900/simultaneous-odontoid-excision-with-bilateral-posterior-c1-2-distraction-and-stabilization-utilizing-bilateral-posterolateral-corridors-and-a-single-posterior-midline-incision
#14
Arun K Srivastava, Sanjay Behari, Jayesh Sardhara, Kuntal Kanti Das
A simultaneous odontoid decompression and bilateral posterior atlanto-axial facetal distraction, C1-2 joint spacer/bone graft placement and stabilization may be performed utilizing the 'posterior-only' approach. This procedure may be performed utilizing a single posterior midline incision, a bilateral posterior approach to the C1-2 facet joints and a bilateral posterolateral approach to the odontoid process and C2 body. It may be carried out in situations where a C1-2 non-reduction/partial reduction using a 'posterior alone' procedure is anticipated due to the complex bony/soft tissue configuration anterior at the thecal sac existing at the cervicomedullary junction...
September 2017: Neurology India
https://www.readbyqxmd.com/read/28874067/sural-flap-use-for-the-treatment-of-wounds-with-underlying-osteomyelitis-graft-size-a-predictor-in-outcome-a-systematic-review
#15
Sham Persaud, Anthony Chesser, Ryan Pereira, Adrianne Ross
The sural flap procedure is a versatile technique that can be used to cover many types of defects about the lower extremity. The management of soft tissue defects of the lower extremity with underlying osteomyelitis is difficult. The goal for any of these patients is to create a biomechanically stable foot for weight-bearing purposes with no continued infection. Data were gathered using multiple databases from the years 2000 to 2016. Data were compiled looking at the number of subjects, age, comorbidities, number of complications, number of failures, and average flap size of complications/failures...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28873059/traction-assisted-internal-negative-pressure-wound-therapy-with-bridging-retention-sutures-to-facilitate-staged-closure-of-high-risk-wounds-under-tension
#16
Michael V DeFazio, James M Economides, Ersilia L Anghel, Ryan K Mathis, John R Barbour, Christopher E Attinger
BACKGROUND/OBJECTIVE: Loss of domain often complicates attempts at delayed wound closure in regions of high tension. Wound temporization with traction-assisted internal negative pressure wound therapy (NPWT), using bridging retention sutures, can minimize the effects of edema and elastic recoil that contribute to progressive tissue retraction over time. The investigators evaluated the safety and efficacy of this technique for complex wound closure. MATERIALS AND METHODS: Between May 2015 and November 2015, 18 consecutive patients underwent staged reconstruction of complex and/or contaminated soft tissue defects utilizing either conventional NPWT or modified NPWT with instillation and continuous dermatotraction via bridging retention sutures...
July 26, 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28869962/mimicking-biological-stress-strain-behaviour-with-synthetic-elastomers
#17
Mohammad Vatankhah-Varnosfaderani, William F M Daniel, Matthew H Everhart, Ashish A Pandya, Heyi Liang, Krzysztof Matyjaszewski, Andrey V Dobrynin, Sergei S Sheiko
Despite the versatility of synthetic chemistry, certain combinations of mechanical softness, strength, and toughness can be difficult to achieve in a single material. These combinations are, however, commonplace in biological tissues, and are therefore needed for applications such as medical implants, tissue engineering, soft robotics, and wearable electronics. Present materials synthesis strategies are predominantly Edisonian, involving the empirical mixing of assorted monomers, crosslinking schemes, and occluded swelling agents, but this approach yields limited property control...
September 4, 2017: Nature
https://www.readbyqxmd.com/read/28869009/-hemifacial-atrophy-treated-with-lipofilling
#18
Kasper von Rosen, Rikke Bredgaard, Christina S Gramkow
Autologous lipofilling is a relatively new method of reconstructing congenital and acquired soft tissue defects. However, long-term results are unpredictable due to varying survival rate of the fat graft, and additional treatments are often required. We present a case of a 53-year-old woman who had a right hemifacial soft tissue deficit and received lipofilling twice with no complications and satisfactory cosmetic results. We consider conventional lipofilling to be safe and viable for facial soft tissue augmentation...
July 31, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28865571/editorial-commentary-fixation-of-soft-tissue-anterior-cruciate-ligament-grafts-in-osteoporotic-bone
#19
EDITORIAL
Robert A Pedowitz
Tibial-side fixation of soft-tissue grafts in osteoporotic bone has become an important concern, as anterior cruciate ligament reconstruction indications push toward older patients. Although soft-tissue fixation with an interference screw and cortical button may be statistically stronger than graft fixation with a screw or button alone, this hybrid construct is probably not optimized from a clinical perspective.
September 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28864387/tenosynovial-giant-cell-tumor-in-the-midfoot-treated-with-femoral-head-allograft-reconstruction
#20
Daniel J Fuchs, Paul J Switaj, Terrance D Peabody, Anish R Kadakia
Tenosynovial giant cell tumor (also known as giant cell tumor of tendon sheath or pigmented villonodular synovitis) is a rare soft tissue tumor that arises from the tenosynovium of a tendon sheath or the synovium of a diarthrodial joint. This disease process occurs infrequently in the foot and ankle but can result in significant bone erosion and destructive changes of affected joints. These cases are challenging to treat, because the tumor most commonly presents in young, active patients and can be associated with extensive bone loss...
August 29, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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