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https://www.readbyqxmd.com/read/28547674/diagnostic-accuracy-of-various-modalities-relative-to-open-bone-biopsy-for-detection-of-long-bone-posttraumatic-osteomyelitis
#1
Vivek Chadayammuri, Benoit Herbert, Jiandong Hao, Andreas Mavrogenis, Juan C Quispe, Ji Wan Kim, Heather Young, Mark Hake, Cyril Mauffrey
BACKGROUND: Long bone posttraumatic osteomyelitis (PTOM) is a relatively common complication following surgical fixation of open fractures. There is a lacking consensus on ideal strategies for diagnostic evaluation of long bone PTOM. While open bone biopsy and culture is considered the 'gold diagnostic standard,' its cost and invasiveness are often prohibitive and have prompted the search for alternate diagnostic methods. OBJECTIVE: To evaluate the sensitivity and specificity of various diagnostic modalities relative to open bone biopsy and culture for the detection of long bone PTOM...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28544074/single-stage-aesthetic-and-functional-reconstruction-of-composite-facial-gunshot-wound-with-a-chimeric-functioning-muscle-and-fibular-osseous-flap-case-report-and-review-of-the-literature
#2
Andreas Gravvanis, Konstantinos Apostolou, Dimitrios Anterriotis, Dimosthenis Tsoutsos
The current concepts in the aesthetic and functional reconstruction of complex oromandibular defects are presented with a case of a patient with self-inflicted gunshot wound to the face. The patient presented with a 6 cm composite mandibular defect; the buccomandibular and suborbital aesthetic zones of the cheek along with the mucosa lining, and the ipsilateral facial musculature were missing. A rapid prototyping model of the facial skeleton was used to assist in preoperative planning. A single stage reconstruction with two free flaps was planned; a free fibula osseous flap to reconstruct the mandibular defect, and a free chimeric ALT/functioning vastus lateralis muscle...
May 23, 2017: Microsurgery
https://www.readbyqxmd.com/read/28540318/retromalleolar-groove-deepening-in-recurrent-peroneal-tendon-dislocation-technique-tip
#3
Pim A D van Dijk, Bryan G Vopat, Daniel Guss, Alastair Younger, Christopher W DiGiovanni
Peroneal tendon dislocations are most prevalent in the active and athletic population, so accurate diagnosis and management are essential for optimal return of function. Although many nonoperative and surgical management options have been described, the optimal treatment method continues to be debated. In this technique article, a modified retromalleolar groove-deepening technique is described for addressing all anatomic variations of the posterior distal fibula and retromalleolar groove without unduly disturbing the important anatomic facets meant for retention in this region...
May 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28540152/epidemiological-clinical-and-microbiological-characteristics-of-patients-with-post-traumatic-osteomyelitis-of-limb-fractures-in-southwest-china-a-hospital-based-study
#4
Jiachen Peng, Youliang Ren, Wenbin He, Zhengdao Li, Jin Yang, Yi Liu, Zhonghui Zheng, Stephen L Kates, Edward M Schwarz, Chao Xie, Youjia Xu
Objective To determine the epidemiological, clinical and microbiological characteristics, of patients with post-traumatic osteomyelitis of extremity fractures, and provide evidence-based guidelines for early diagnosis and treatment, including empiric antibiotic therapy. Methods Human subject research was performed using institutional review board approved protocols. A retrospective chart review was conducted on 5,368 patients diagnosed with extremity traumatic fractures from January 1, 2012 to December 31, 2015, to identify osteomyelitis patients...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28539054/anatomic-structures-at-risk-when-utilizing-an-intramedullary-nail-for-distal-fibular-fractures-a-cadaveric-study
#5
David A Goss, Christopher W Reb, Terrence M Philbin
BACKGROUND: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail. METHODS: Ten human cadaveric lower extremities were instrumented with a fibular nail. The cadavers were dissected. The shortest distance, in millimeters (mm), between the site of procedural steps and nearby named structures of interest (ie, sural nerve, superficial peroneal nerve, and the peroneal tendons) was measured and recorded...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28538453/does-concurrent-tibial-intramedullary-nailing-and-fibular-fixation-increase-rates-of-tibial-nonunion-a-matched-cohort-study
#6
Michael Githens, Justin Haller, Julie Agel, Reza Firoozabadi
OBJECTIVES: To determine if there is a difference in rates of tibial nonunion in patients undergoing tibial intramedullary (IM) nailing and fibular fixation as compared to a matched cohort undergoing tibial IM nailing alone. DESIGN: Retrospective matched cohort study. SETTING: Single Level 1 academic trauma center. PATIENTS: Consecutive patients 18 years and older with a tibia and fibula fracture treated with tibial IM nailing and fibular fixation who were determined radiographically and clinically healed or had a minimum 1-year follow-up were included...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28529102/comparative-study-of-three-kinds-of-fibula-cutting-guides-in-reshaping-fibula-for-the-reconstruction-of-mandible-an-accuracy-simulation-study-in%C3%A2-vitro
#7
Zhiwei Dong, Bei Li, Rui Xie, Qin Wu, Li Zhang, Shizhu Bai
OBJECTIVES: In order to get predictable reassembling and higher accuracy in the reconstruction of the mandible, we designed three kinds of fibula cutting guides: (1) Two-edge wide groove guide (WGG); (2) Two-edge narrow groove guide (NGG); and (3) One-edge guide (OEG). The purpose of this study was to compare the accuracy of fibula remodelling using the three kinds of fibula cutting guides above in a simulation procedure in vitro. MATERIALS AND METHODS: Cutting and reshaping of fibula analogs were guided by the three kinds of guides mentioned above...
April 22, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28529045/influence-of-preoperative-imaging-on-fibula-free-flap-harvesting
#8
R Gryseleyn, M Schlund, P Pigache, T Wojcik, G Raoul, J Ferri
INTRODUCTION: The fibula free flap (FFF) is the gold standard for the reconstruction of large maxillofacial defects. Magnetic resonance angiography (MRA) seems to supersede digital subtraction angiography (DSA) as the reference in preoperative evaluation, being non-invasive and having equivalent diagnostic results. The aim of this study was to assess the impact of preoperative MRA versus DSA on the viability of FFF and its success rate. MATERIAL AND METHODS: A total of 216 patients, who underwent mandibular or maxillary FFF reconstruction from January 1995 to January 2011, were retrospectively included in the study...
May 18, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28514343/-effect-of-dexmedetomidine-on-perfusion-of-free-flaps-transferred-to-head-and-neck
#9
A S Dobrodeev, S A Rabinovich, I F Malykhina
The paper presents the impact of perioperative care on feasibility of free fibula flap transfer for facial reconstruction. Flaps vitality was measured by means of somatic oximetry in 85 patients aged 20-74 years receiving reconstruction procedures in midfacial and lower facial areas. The patients were divided in three groups according to sedation agent used postoperatively. It has been demonstrated that dexmedetomidine postoperative sedation significantly improved free fibula flaps perfusion compared to propofol sedation...
2017: Stomatologii︠a︡
https://www.readbyqxmd.com/read/28512689/long-term-results-of-fibular-achilles-tenodesis-westin-s-tenodesis-for-paralytic-pes-calcaneus-is-hypercorrection-avoidable-a-longitudinal-retrospective-study
#10
Helder Henzo Yamada, Patricia Maria Moraes de Barros Fucs
PURPOSE: The purpose of this study was to review all cases of patients submitted to Westin's tenodesis, who had calcaneus feet secondary to myelomeningocele sequel, in order to evaluate the anatomical change provided by surgery and also to verify, in a long-term follow-up, the inversion of the deformity depending on the patient's age. METHODS: In this longitudinal retrospective study, all medical records of patients with myelomeningocele sequelae submitted to Westin's tenodesis from 1993 to 2013 in a public university hospital were reviewed...
May 16, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28512196/the-developmental-biology-of-genetic-notch-disorders
#11
REVIEW
Jan Mašek, Emma R Andersson
Notch signaling regulates a vast array of crucial developmental processes. It is therefore not surprising that mutations in genes encoding Notch receptors or ligands lead to a variety of congenital disorders in humans. For example, loss of function of Notch results in Adams-Oliver syndrome, Alagille syndrome, spondylocostal dysostosis and congenital heart disorders, while Notch gain of function results in Hajdu-Cheney syndrome, serpentine fibula polycystic kidney syndrome, infantile myofibromatosis and lateral meningocele syndrome...
May 15, 2017: Development
https://www.readbyqxmd.com/read/28511363/solving-the-mystery-of-the-antero-lateral-ligament
#12
P H Sonia Farhan, Rathi Sudhakaran, Jai Thilak
INTRODUCTION: The cruciate ligaments are essential for the antero-posterior stability of the knee joint. In Anterior Cruciate Ligament (ACL) rupture, though reconstructive surgery is a widely accepted and proven procedure, there is still an unacceptably high re-injury rate. The fact that the rotational instability persists even after the surgical reconstruction of ACL injury has evoked a new interest in the study of the soft tissue structures on the anterolateral aspect of the knee joint...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507874/a-10-year-follow-up-of-a-free-vascularized-fibula-flap-clavicle-reconstruction-in-an-adult
#13
Louie Ye, G Ian Taylor
The free vascularized fibula flap has been widely used for clavicle reconstruction. Limited evidence exists for the long-term outcome of clavicle reconstruction using the free vascularized fibula flap in adults. We report the functional and aesthetic outcome in a 52-year old man a decade after clavicle reconstruction using a free vascularized fibula flap in combination with a modified Richardson Hook Plate. At the 10-year follow-up, panoramic shoulder X-ray showed the modified Richardson Hook Plate had remained firmly in place with the fibula and the hook positioned beneath the acromion...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28507870/intraoperative-change-in-defect-size-during-maxillary-reconstruction-using-surgical-guides-created-by-cad-cam
#14
Daiki Morita, Toshiaki Numajiri, Hiroko Nakamura, Shoko Tsujiko, Yoshihiro Sowa, Makoto Yasuda, Shigeru Hirano
Surgical osteotomy guides created by computer-aided design/computer-aided manufacturing (CAD/CAM) have been developed and are now widely used in maxillofacial reconstruction. However, there are no standard procedures for dealing with an intraoperative change in defect size. We report on a case in which we used our CAD/CAM guides to deal with an intraoperative change in defect size in a maxillary reconstruction. We planned the maxillary reconstruction using a free fibula flap because of left maxillary sinus cancer in a 73-year-old man...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28502762/clear-cell-odontogenic-carcinoma-diagnostic-difficulties-a-case-report
#15
U Ordioni, G Benat, M Hadj Saïd, A Gomez-Brouchet, C Chossegros, J-H Catherine
INTRODUCTION: Clear cell odontogenic carcinoma (COCC) is a rare tumor described by Hansen et al. in 1985. The clinical and radiological manifestations are multiple and the diagnosis is histological. OBSERVATION: A 64-year-old patient consulted us for a right mandibular osteolytic lesion associated to a homolateral labial hypoesthesia. A biopsy was performed under local anesthesia. Histology was consistent with a metastatic lesion of clear kidney cell carcinoma, COCC, or odontogenic squamous tumor...
May 11, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28502602/uncontacted-tire-explosion-causing-trauma-to-bilateral-lower-extremities-a-case-report
#16
Ming-Yang Yu, Yun Su, Xiang-Jun Meng, Bo-Wu Luan, Gui-Shan Gu, Qiang Sun, De-Wei Zhao
It is uncommon for tire explosion related injuries on the lower extremity. The bilateral lower extremities were injured by tire explosion when the patient was seated in a bus. She sustained an open fracture with partial bone loss in the right calcaneus (a comminuted fracture in the right ankle joint) and a closed comminuted fracture in the left tibia and fibula. This damage was caused by uncontacted tire explosion, thanks to a thick floor between the exploded tire and the patient's feet. This type of injury on lower extremity caused by uncontacted tire explosion was uncommon...
March 16, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28497098/gravity-reduction-view-a-radiographic-technique-for-the-evaluation-and-management-of-weber-b-fibula-fractures
#17
Lauren K Ehrlichman, Tyler A Gonzalez, Alec A Macaulay, Mohammad Ghorbanhoseini, John Y Kwon
BACKGROUND: While various radiographic parameters and application of manual/gravity stress have been proposed to elucidate instability for Weber B fibula fractures, the prognostic capability of these modalities remains unclear. Determination of anatomic positioning of the mortise is paramount. We propose a radiographic technique, the Gravity Reduction View (GRV), which helps elucidate non-anatomic positioning and reducibility of the mortise. METHODS: The patient is positioned lateral decubitus with the injured leg elevated on a holder with the fibula directed superiorly...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28497002/overlap-between-fibular-aplasia-tibial-campomelia-and-oligosyndactyly-and-fuhrmann-s-syndromes-in-an-egyptian-female-infant
#18
Ebtesam M Abdalla, Ahmed A El-Beheiry
We report a rare congenital limb defect with combined features of both fibular aplasia, tibial campomelia, and oligosyndactyly (FATCO) and Fuhrmann's syndromes. A female newborn infant, born to nonconsanguineous Egyptian parents, presented with isolated abnormalities of the lower limbs comprising bilateral shortening and anterior bowing of the lower limbs at the distal third of the tibia and split foot. Radiographic examination revealed complete absence of both fibulae, anterolateral bowing and shortening of the tibia, bowing of the femora, and absence of several metatarsal and phalangeal bones...
June 2017: Journal of Pediatric Genetics
https://www.readbyqxmd.com/read/28495360/fractures-and-osteomalacia-in-a-patient-treated-with-frequent-home-hemodialysis
#19
Mark R Hanudel, Larry Froch, Barbara Gales, Harald Jüppner, Isidro B Salusky
Bone deformities and fractures are common consequences of renal osteodystrophy in the dialysis population. Persistent hypophosphatemia may be observed with more frequent home hemodialysis regimens, but the specific effects on the skeleton are unknown. We present a patient with end-stage renal disease treated with frequent home hemodialysis who developed severe bone pain and multiple fractures, including a hip fracture and a tibia-fibula fracture complicated by nonunion, rendering her nonambulatory and wheelchair bound for more than a year...
May 9, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28489628/lengthening-of-newly-formed-humerus-after-autologous-fibula-graft-transplantation-following-intercalary-tumor-resection
#20
Hakan Pilge, Martin Ruppert, Bernd Bittersohl, Bettina Westhoff, Rüdiger Krauspe
Secondary limb lengthening after intercalary bone resection in pediatric patients is still challenging. After the resection, a free fibula autograft can be used to reconstruct the osseous gap. However, in particular in young pediatric patients, insufficient growth of the epiphyseal plate after transplantation may lead to a significant limb-length discrepancy (LLD). In this case, the autograft was used for limb lengthening. We report on the lengthening of a humerus regenerate after fibula autograft transplantation into a humeral defect in a pediatric/young adolescent patient...
May 5, 2017: Journal of Pediatric Orthopedics. Part B
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