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Latissimus dorsi

Nicholas R Pagani, Antonio Cusano, Xinning Li
Latissimus dorsi tendon transfer is an effective option for young and active patients with massive irreparable posterosuperior rotator cuff tears and intact subscapularis tendon. This approach has been shown to relieve pain and improve shoulder function in both the short and long term. We describe a surgical technique using an acromial osteotomy to better expose the greater tuberosity for the tendon transfer without disrupting the deltoid muscle. The latissimus dorsi tendon is reinforced with a human dermal collagen matrix (GraftJacket; Wright Medical Group) for additional augmentation of the muscle to gain more excursion for the tendon transfer to the greater tuberosity...
February 2018: Arthroscopy Techniques
Magdalena Grzonkowska, Mateusz Badura, Mariusz Baumgart, Anna Wiczołek, Jakub Lisiecki, Maciej Biernacki, Michał Szpinda
BACKGROUND: The inferior lumbar triangle of Petit is bounded by the iliac crest, lateral border of the latissimus dorsi and the medial border of the external oblique. OBJECTIVES: In the present study, we aimed to quantitatively examine the base, sides, area, and interior angles of the inferior lumbar triangle in the human fetus so as to provide their growth dynamics. MATERIAL AND METHODS: Using anatomical dissection, digital image analysis (NIS-Elements AR 3...
February 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Nicholas L Berlin, Jennifer B Hamill, Ji Qi, Hyungjin M Kim, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Survey-based research is essential for evaluating the outcomes of health care in an era of patient-centered care. However, many such studies are hampered by poor response rates in completion of study questionnaires, thus limiting the generalizability of any findings. The objectives of this analysis were to identify independent variables associated with nonresponse to surveys following breast reconstruction to improve future patient-reported outcomes research. MATERIALS AND METHODS: The Mastectomy Reconstruction Outcomes Consortium is a prospective cohort study involving 11 leading medical centers from the United States and Canada...
April 2018: Journal of Surgical Research
Il Hoon Sung, Dong Woo Jang, Se Wan Kim, Youn Hwan Kim, Sang Wha Kim
BACKGROUND: Reconstruction of complicated diabetic lower leg and foot defects involving multiple tissue components remains a challenge. The purpose of this report is to introduce thoracodorsal artery perforator (TDAP) chimeric flaps for reconstructing diabetic lower leg and foot soft tissue defects. PATIENTS AND METHODS: Between April 2010 and August 2016, 17 patients with multiple diabetic lower leg and foot defects underwent reconstruction with TDAP chimeric flaps...
March 5, 2018: Microsurgery
Elisa Doria Pires, Paula Rezende Camargo
BACKGROUND: This study measured strength of the trunk and hip, and compared Y Balance Test and Upper Quarter Y Balance Test in individuals without and with scapular dyskinesis. Strength and endurance of the scapulothoracic muscles were also assessed. METHODS: Forty-four individuals without shoulder pain were divided in 2 groups: without scapular dyskinesis (age 26.00, SD 4.10 years) and scapular dyskinesis (age 23.68, SD 4.20 years). Scapular dyskinesis was assessed by clinical observation of the scapular motion during arm elevation, and was classified as present or absent...
February 27, 2018: Clinical Biomechanics
Andrea Droghetti, Erika Basso Ricci, Paolo Scimia, Fabiola Harizai, Massimiliano Marini
BACKGROUND: The standard technique for implanting a subcutaneous defibrillator (S-ICD) requires three incisions and the pocket of the device is created in the subcutaneous tissue of the left lateral thoracic wall. However, a two-incision technique may be adopted, in which the cranial parasternal region is avoided and the device is positioned more deeply, completely under the latissimus dorsi muscle. This can also be combined with Ultrasound-Guided Serratus Anterior Plane Block (US-SAPB) for intraoperative anesthesia and perioperative analgesia...
March 1, 2018: Pacing and Clinical Electrophysiology: PACE
Hiroiku Hara, Yusuke Date
The partient was 76-year-old male. He had acute empyema due to lung abscess and open-window thoracotomy was performed to control infection. 3 years and 9 months later, the bronchial fistula was closed with abdominal rectus muscle and greater omentum. These are very useful when other muscles such as latissimus dorsi muscle, serratus anterior muscle and pectoralis major muscle are not available.
February 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Özlenen Özkan, Ömer Özkan, Anı Çinpolat, Mehmet Can Ubur, Gamze Bektaş, Adil Jumshudov, Hilmi Uysal
BACKGROUND: The repair of extensive lower lip defects is difficult due to the presence of both functional and esthetic requirements. This report describes functional lip repair using the partial latissimus dorsi free flap without nerve coaptation. METHODS: Reconstruction of the lower lip due to subtotal and total tissue defects was performed using latissimus dorsi free flap on twelve patients, between 2013 and 2017. The etiology was squamous cell carcinoma in six patients, malignant melanoma in one, firearm injury in three and microstomia in two...
February 23, 2018: Microsurgery
Ulrich Irlenbusch, Olaf Rott, Lars Irlenbusch
AIM: Arthrodesis of the shoulder joint is a radical event, so it is difficult to explain its significance to patients. It has been the last resort in hopeless cases. Knowledge of long-term results and evaluation of advantages and disadvantages seems to be helpful in this regard. METHODS: Eleven patients with mean age of 45 (31 - 58) years were operated between 2000 and 2013. All patients could be included in the investigation (FU mean 8.5 [3 - 16] years; 8 male and 3 female; right 9, left 2)...
February 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
K P Letsas, S Xydonas, N Karamichalakis, M Efremidis, D Manolatos, G Bazoukis, D Asvestas, K Vlachos, S Georgopoulos, A Saplaouras, J Winter, A Sideris
BACKGROUND: The conventional technique for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation has been associated with pocket complications. The aim of this study was to evaluate the efficacy and safety of an alternative intermuscular technique for S‑ICD implantation. METHODS: S-ICDs were implanted in ten consecutive patients (ten males, mean age: 46.8 ± 14.7 years). The pocket for the pulse generator was made above the serratus anterior muscular fascia and beneath the latissimus dorsi muscle by detaching the fibrous tissue between the muscles...
February 21, 2018: Herz
James M Economides, David H Song
Background: Despite the popularity of latissimus dorsi (LD) flap in breast reconstruction, a breast implant is often necessary to achieve sufficient volume. Prior reports describe fat grafting to the LD flap as a secondary procedure to correct contour deformities and improve volume. Our institution has instituted autologous breast reconstruction with an LD flap and immediate fat transfer (LIFT). Methods: A retrospective review of all patients undergoing the LIFT procedure was undertaken...
January 2018: Plastic and Reconstructive Surgery. Global Open
Ryuichi Azuma, Shimpo Aoki, Masahiro Kuwabara, Tetsushi Aizawa, Hisato Nagano, Tomoharu Kiyosawa
Hinge flaps are commonly used for closure of a pharyngocutaneous fistula (PCF) or laryngocutaneous fistula. These flaps are employed to augment the wall of the pharynx or larynx, but the junction between the reconstructed and native lumens can eventually become narrow and irregular after reconstruction with standard hinge flaps. We devised a method of adding a triangular extension to the end of either or both flaps and used it to treat 3 patients. In 1 patient who developed a PCF (4 × 10 cm) after laryngectomy followed by radiotherapy, the fistula was closed with 2 hinge flaps...
January 2018: Plastic and Reconstructive Surgery. Global Open
Jin Woo Kim, Soo Hyun Woo, Suk Yoon Jang, Woo Seob Kim, Tae Hui Bae, Han Koo Kim
Most patients with reconstruction for extensive scalp defects require the use of a free flap. The suitability of the recipient vessel has a major impact on the surgery and postoperative outcome. Flaps that can be used to reconstruct the total scalp with a single flap include the latissimus dorsi (LD) and omental flaps; the LD flap is generally preferred since the omental flap results in relatively larger donor site morbidity. The recipient vessel most commonly used for scalp defect reconstruction is the superficial temporal vessel...
February 14, 2018: Journal of Craniofacial Surgery
Tarek A Amer, Mohamed S El Kholy
Long-standing cases of facial paralysis are currently treated with free functional muscle transfer. Several nerves are mentioned in the literature to supply the free muscle transfer. The aim of this study is to compare the split hypoglossal nerve and the cross-face nerve graft to supply the free functional muscle transfer in facial reanimation. Of 94 patients with long-standing, unilateral facial palsy, 49 were treated using the latissimus dorsi muscle supplied by the split hypoglossal nerve, and 45 patients were treated using the latissmus dorsi muscle supplied by healthy contralateral buccal branch of the facial nerve...
January 31, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Sebastian Skals, Jonas Vinstrup, Emil Sundstrup, Markus D Jakobsen, Christoffer H Andersen, Lars L Andersen
OBJECTIVE: Muscle atrophy is a common side-effect of bed rest during hospitalization. However, resistance training may minimize or even prevent these complications. Therefore, we evaluated the efficiency of four upper-body elastic resistance exercises that could be performed while lying or sitting in a hospital bed. METHODS: Twenty-two healthy subjects performed three repetitions of each exercise in a supine and seated position with a perceived intensity of 3 (low) and 8 (high) on the Borg CR10 Scale...
February 23, 2018: Physician and Sportsmedicine
Mina Baniasad, Farzam Farahmand, Mokhtar Arazpour, Hassan Zohoor
Background and Purpose: Understanding the role and significance of trunk and upper extremity muscles in paraplegic gait can help in designing more effective assistive devices for these patients and also provides valuable information for improving muscle strengthening programs. Methods: In a patient with a spinal cord injury (SCI) who could walk independently (rating scale of ambulatory capacity, 9) with the aid of bilateral ankle-foot orthosis and a walker, the kinematics, kinetics and electromyographic (EMG) activities of 16 muscles from the trunk and upper and lower extremities were recorded during gait...
2018: Topics in Spinal Cord Injury Rehabilitation
Adam Kwapisz, John M Tokish
An irreparable subscapularis may have a debilitating influence on glenohumeral joint biomechanics. Traditional treatment approaches are focused on tendon transfers, among which the most popular are pectoralis major and latissimus dorsi transfers. However, these techniques present significant retear rates, possible nerve injuries, and altered biomechanics. Other techniques like tibialis anterior or iliotibial autograft grafting also have many reported failures. We describe an all-arthroscopic anterior capsule reconstruction technique with an acellular dermal graft...
October 2017: Arthroscopy Techniques
M Zhao, Y B Wang, Y J Yan, W Wang, G Q Ru, X L He
Objective: To investigate the clinicopathologic characteristics, immunophenotype, differential and diagnostic features of atypical spindle cell lipomatous tumor (ASLT). Methods: Three cases of ASLT were collected from January 2010 to March 2017 at Zhejiang Provincial People's Hospital. The clinical and imaging features, histomorphology, immunophenotype and prognosis were analyzed. Fluorescence in situ hybridization (FISH) was used to detect MDM2 gene amplification, and relevant literature was reviewed. Results: All three patients were adult males, aged 38, 43 and 54 years, respectively...
February 8, 2018: Zhonghua Bing Li Xue za Zhi Chinese Journal of Pathology
Alison C McDonald, Daanish M Mulla, Paul W Stratford, Peter J Keir
The EMG-force relationship changes with muscle fatigue, making interpretation of load sharing between muscles challenging. The purpose of this investigation was to evaluate the efficacy of normalizing EMG to repeated, static, submaximal exertions to mitigate fatigue artifacts in EMG amplitude (increased amplitude without muscle force change). Participants completed repetitive work tasks, in 60-second cycles, until exhaustion. Surface EMG was recorded from 11 shoulder muscles (anterior, middle and posterior deltoids, infraspinatus, upper, middle and lower trapezius, latissimus dorsi, serratus anterior, sternal and clavicular heads of pectoralis major)...
January 9, 2018: Journal of Electromyography and Kinesiology
Nicholas J Clark, Bassem T Elhassan
PURPOSE OF REVIEW: This review aims to describe the tendon transfer options for treating irreparable rotator cuff tears (RCTs). Options for transfer include latissimus dorsi and lower trapezius transfers for posterior-superior RCTs and pectoralis major and latissimus dorsi transfer for anterior-superior RCTs. RECENT FINDINGS: While the latissimus dorsi tendon transfer has historically been performed for posterosuperior RCTs, the lower trapezius transfer is a more anatomic option and has demonstrated promising results in recent studies...
March 2018: Current Reviews in Musculoskeletal Medicine
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