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https://www.readbyqxmd.com/read/29778637/total-mandibulectomy-defect-in-the-setting-of-chronic-bisphosphonate-use
#1
Ameya A Jategaonkar, Arvind K Badhey, Fiyin Sokoya, Sameep Kadakia, Steven Mudrovich, Yadranko Ducic
Bisphosphonates are among several drugs known in modern medicine to have a potentially deleterious effect on the mandible with chronic use. While purportedly causing a necrotic reaction in the bone, the complete mechanism is not fully elucidated yet as cases are quite rare in the general public. Despite the esoteric nature of this entity, patients suffering from bisphosphonate induced necrosis have a complicated and prolonged course often involving varying degrees of mandibular debridement with severe cases requiring reconstruction...
May 16, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29776771/association-between-pain-severity-and-clinicohistopathologic-findings-in-the-mandibular-canal-and-inferior-alveolar-nerve-of-patients-with-advanced-mandibular-osteoradionecrosis
#2
Yujiro Hiraoka, Masaya Akashi, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Takumi Hasegawa, Kazunobu Hashikawa, Hiroto Terashi, Takahide Komori
OBJECTIVE: Pain is one of the most problematic symptoms in patients with osteoradionecrosis of the jaws. This study investigated the associations between pain severity and morphologic alterations of the mandibular canal and inferior alveolar nerve, in respective computerized tomography images and resected specimens of mandibular osteoradionecrosis. STUDY DESIGN: We assessed 14 lesions in 13 patients who underwent segmental mandibulectomy for surgical debridement and simultaneous reconstruction with free fibula flap (1 patient exhibited bilateral lesions)...
April 16, 2018: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29775983/classification-and-microvascular-flap-selection-for-anterior-cranial-fossa-reconstruction
#3
James D Vargo, Wojciech Przylecki, Paul J Camarata, Brian T Andrews
BACKGROUND:  Microvascular reconstruction of the anterior cranial fossa (ACF) creates difficult challenges. Reconstructive goals and flap selection vary based on the defect location within the ACF. This study evaluates the feasibility and reliability of free tissue transfer for salvage reconstruction of low, middle, and high ACF defects. METHODS:  A retrospective review was performed. Reconstructions were anatomically classified as low (anterior skull base), middle (frontal bar/sinus), and high (frontal bone/soft tissue)...
May 18, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29762181/intraneural-ultrasound-guided-sciatic-nerve-block-minimum-effective-volume-and-electrophysiologic-effects
#4
Gianluca Cappelleri, Andrea Luigi Ambrosoli, Marco Gemma, Valeria Libera Eva Cedrati, Federico Bizzarri, Giorgio Francesco Danelli
BACKGROUND: Both extra- and intraneural sciatic injection resulted in significant axonal nerve damage. This study aimed to establish the minimum effective volume of intraneural ropivacaine 1% for complete sensory-motor sciatic nerve block in 90% of patients, and related electrophysiologic variations. METHODS: Forty-seven consecutive American Society of Anesthesiologists physical status I-II patients received an ultrasound-guided popliteal intraneural nerve block following the up-and-down biased coin design...
May 15, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29753451/single-stage-reconstruction-of-post-traumatic-and-post-excisional-composite-perigenual-defects-using-chimeric-pedicled-propelled-osteomyocutaneous-fibula-flap
#5
T M Balakrishnan, Sruthi Sridhar, J Jaganmohan, Hemantha Kumar Govinda Rajan, Singaravadivelu Vaidyanathan
INTRODUCTION: Composite perigenual defects (CPGDs) are exacting the expertise of the reconstructive surgeons. Segmental skeletal defects continue to be a challenge for both orthopedic and plastic surgeons. There are many techniques available for the reconstruction of segmental skeletal defects in the perigenual region. This study explores the outcomes of pedicled chimeric propelled osteomyocutaneous fibula flap reconstruction of post traumatic and post excisional composite perigenual defects (CPGDs) MATERIALS AND METHODS: It was a retrospective study conducted from 2011 to 2016 including 16 patients (5 post excisional defects and 11 post traumatic defects)...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29753300/superficial-circumflex-iliac-artery-based-iliac-bone-flap-transfer-for-reconstruction-of-bony-defects
#6
Hidehiko Yoshimatsu, Takuya Iida, Takumi Yamamoto, Akitatsu Hayashi
BACKGROUND:  The superficial circumflex iliac artery (SCIA)-based iliac bone flap has yet to be widely used. The purpose of this article is to validate the feasibility of SCIA-based iliac bone flap transfers for reconstruction of small to moderate-sized bony defects. Retrospective outcome comparisons between SCIA-based iliac bone flaps and fibula flaps were made. METHODS:  Twenty-six patients with bony tissue defects underwent reconstructions using either free SCIA-based iliac bone flaps (13) or fibula flaps (13)...
May 12, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29746363/lower-extremity-fractures-in-hospitalized-pediatric-patients-following-road-traffic-accidents
#7
Shay Tenenbaum, Jason T Bariteau, Ofir Chechik, Adi Givon, Kobi Peleg, Ran Thein
Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. Data were analyzed according to LEF mechanism of injury, age distribution, fracture types, associated injuries, surgical treatment, and their interrelations...
May 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29738854/age-related-changes-in-female-mouse-cortical-bone-microporosity
#8
Haniyeh Hemmatian, Michaël R Laurent, Astrid D Bakker, Dirk Vanderschueren, Jenneke Klein-Nulend, G Harry van Lenthe
Osteocyte lacunae are small cavities within the bone matrix. Their dimensions and spatial arrangement affect bone mechanical properties. Furthermore, their size and shape affect the strain in bone tissue close to the lacunae; hence, they are supposed to affect the mechanosensory function of the osteocytes residing in the lacunae. It was the purpose of this study to quantify the morphological features of osteocyte lacunae, whether these are affected by aging and whether these vary among different anatomical location...
May 5, 2018: Bone
https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#9
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29732952/clinical-comparison-of-scapular-fibular-and-iliac-crest-osseal-free-flaps-in-maxillofacial-reconstructions
#10
T Wilkman, A Husso, P Lassus
BACKGROUND AND AIMS: This study compared the three most used composite flaps in maxillofacial reconstructions in our institute. PATIENTS AND METHODS: Between 2000 and 2012, a total of 163 patients with mandibular, maxillary, and orbital defects received either scapular, fibular, or iliac crest osseal reconstructions in Helsinki University Hospital, Departments of Plastic Surgery and Maxillofacial Surgery. Data regarding the patient demographics, complications, and outcomes were analyzed...
May 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29723399/outcomes-of-microvascular-flap-reconstruction-of-the-head-and-neck-in-patients-receiving-systemic-immunosuppressive-therapy-for-organ-transplantation
#11
Mark V Schaverien, Riley A Dean, Jeffrey N Myers, Lin Fang, Rene D Largo, Peirong Yu
BACKGROUND: For organ transplant recipients, cancer secondary to immunosuppressive therapy threatens long-term survival. The associated multiple comorbidities make major free flap reconstruction following cancer surgery a complicated event. This study evaluates the outcomes of free flap reconstruction in this population. METHODS: A retrospective chart review of all head and neck free flap cases in patients with a history of organ transplantation receiving systemic immunosuppressive therapy between 2005 and 2017 at a single-institution was conducted...
May 3, 2018: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29715130/osteoscopic-surgery-of-giant-cell-tumor-of-bone-for-preservation-of-proximal-fibula
#12
Hiroyuki Futani, Shunsuke Kumanishi, G O Minakawa, Shinichi Yoshiya
BACKGROUND: Osteoscopy is a minimally-invasive endoscopic technique for inspecting lesions inside bone marrow cavities. We describe the feasibility of osteoscopic surgery of giant cell tumor of bone (GCTB) in order to preserve the proximal fibula, and thereby achieve immediate recovery and avoid complications. PATIENTS AND METHODS: Five patients with GCTB in the proximal fibula were treated using osteoscopic curettage with adjuvants (argon plasma coagulation and cementation)...
May 2018: Anticancer Research
https://www.readbyqxmd.com/read/29715060/ameloblastic-carcinoma-in-situ-review-of-literature-and-a-case-presentation-in-a-pediatric-patient
#13
Artur Fahradyan, Lauren Odono, Jeffrey A Hammoudeh, Lori Kathryn Howell
Ameloblastic carcinomas are rare malignant lesions with 3 mandibular pediatric cases reported in the literature. We present a case of ameloblastic carcinoma in situ in a 15-year-old male with a right mandibular cystic lesion on computed tomography. The incisional biopsy revealed plexiform ameloblastoma. Due to the infiltrating and aggressive nature of the tumor, the patient underwent hemimandibulectomy and immediate reconstruction with a vascularized osteocutaneous fibula free flap. The final pathology was read as ameloblastic carcinoma in situ...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29713435/three-dimensional-finite-element-analysis-of-the-splinted-implant-prosthesis-in-a-reconstructed-mandible
#14
Kyung-Hoi Heo, Young-Jun Lim, Myung-Joo Kim, Ho-Beom Kwon
PURPOSE: The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis. MATERIALS AND METHODS: Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants...
April 2018: Journal of Advanced Prosthodontics
https://www.readbyqxmd.com/read/29705234/syndesmosis-fixation-in-unstable-ankle-fractures-using-a-partially-threaded-5-0-mm-cannulated-screw
#15
Seung Yeol Lee, Sang Young Moon, Moon Seok Park, Byung Chae Jo, Hyunseok Jeong, Kyoung Min Lee
The present study evaluated the radiographic outcomes of syndesmosis injuries treated with a partially threaded 5.0-mm cannulated screw. The present study included 58 consecutive patients with syndesmosis injuries concurrent with ankle fractures who had undergone operative fixation with a partially threaded 5.0-mm cannulated screw to repair the syndesmosis injury. Radiographic indexes, including the medial clear space, tibiofibular overlap, tibiofibular clear space, and fibular position on the lateral radiograph, were measured on the preoperative, immediate postoperative, and final follow-up radiographs...
April 25, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29704953/risk-factors-associated-with-amputation-in-civilian-popliteal-artery-trauma
#16
Michael J Ramdass, Alyssa Muddeen, Patrick Harnarayan, Richard Spence, David Milne
Popliteal artery trauma is uncommon but is associated with a high risk of limb loss depending on the scenario involving blunt or penetrating trauma as well as the severity and extent of injury that has occurred. In our setting there is a significant amount of gang and civilian warfare resulting in Vascular Trauma. There were 32 patients over a decade who sustained traumatic injury to the popliteal artery consisting of 30 males (94%) and 2 females with an age range 16-59 years with a mean of 32. There were 20 cases of penetrating trauma (63%) and 12 cases of blunt trauma (37%)...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29698804/phenotype-variability-in-hajdu-cheney-syndrome
#17
Miriam Regev, Ben Pode-Shakked, Jeffrey M Jacobson, Annick Raas-Rothschild, David B Goldstein, Yair Anikster
Hajdu Cheney syndrome is a rare autosomal dominant skeletal dysplasia, with multi-organ involvement, caused by pathogenic variants in NOTCH2. It is characterized by progressive focal bone destruction, including acro-osteolysis and generalized osteoporosis, craniofacial anomalies, hearing loss, cardiovascular involvement and polycystic kidneys. Distinct radiographic findings, such as a serpentine fibula, may aid in facilitating the diagnosis. Despite several dozens of cases described in the literature, diagnosis often remains elusive, resulting in many cases in a delay in diagnosis reaching adolescence or adulthood...
April 23, 2018: European Journal of Medical Genetics
https://www.readbyqxmd.com/read/29698303/closed-reduction-osteotomy-and-fibular-graft-are-effective-in-treating-pediatric-femoral-neck-pseudarthrosis-after-infection
#18
Rajesh Kumar Kanojia, Sumit Gupta, Ajay Kumar, Bachha Kanakeya Reddy
BACKGROUND: When treatment of acute septic arthritis of the hip is delayed, severe sequelae can occur. This may take the form of coxa breva, vara, or valga. Pseudoarthrosis of the femoral neck is a rare complication with only a few studies to guide treatment. QUESTION/PURPOSES: In a small series of patients with pseudarthrosis of the femoral neck after acute septic arthritis, we wanted to determine (1) whether femoral neck union can be achieved using a variety of surgical approaches; (2) whether these patients satisfied criteria outlined by Hunka and Choi, defined as a stable hip, a flexion arc ≥ 70° and no fixed adduction or abduction contractures, fixed flexion deformity not more than 20°, pain relief, and restoration of activities of daily living after surgery; and (3) any treatment-related complications if observed...
April 23, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29692940/lymph-drainage-of-posttraumatic-edema-of-lower-limbs
#19
Ana Carolina Pereira de Godoy, Rodrigo Ocampos Troitino, Maria de Fátima Guerreiro Godoy, José Maria Pereira de Godoy
Objective: The present study was aimed at evaluating the use of mechanical and manual lymphatic therapy as a treatment for lymphedema resulting from orthopedic surgery that became painful after an episode of erysipelas. Case Report: A 70-year-old male patient suffered direct trauma resulting in a compound fracture of the tibia and fibula of the left leg. He was treated with an external fixator for four months followed by plaster cast immobilization for three weeks...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29686952/mermaid-syndrome-a-case-report-in-mauritius
#20
Kamleshun Ramphul, Stephanie G Mejias, Yogeshwaree Ramphul-Sicharam
Sirenomelia is a rare congenital malformation that results in the fusion of the lower limbs together with multiple visceral anomalies. We report a case of sirenomelia observed in Mauritius and the different findings seen in the baby. The baby had fused lower extremities and bony structures for each leg were present. The umbilical cord consisted of a single artery and one vein. The external genitalia was absent and an imperforate anus was also seen. An x-ray revealed poorly expanded lungs and two distinct sets of femur and tibia were seen on imaging...
February 20, 2018: Curēus
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