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https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#1
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29343893/assessment-of-perfusion-of-free-flaps-used-in-head-and-neck-reconstruction-using-pulsatility-index
#2
Akshay Kapoor, Malay Karmakar, Collin Roy, Kaushal Priya Anand
Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#3
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29339841/role-of-autologous-non-vascularised-intramedullary-fibular-strut-graft-in-humeral-shaft-nonunions-following-failed-plating
#4
Sreekanth Kashayi-Chowdojirao, Aashish Vallurupalli, Vijay Krishna Chilakamarri, Chandrasekhar Patnala, Lalith Mohan Chodavarapu, Nageswara Rao Kancherla, Asif Hussain Khazi Syed
Background: Non-union humeral shaft fractures are seen frequently in clinical practice at about 2-10% in conservative management and 30% in surgically operated patients. Osteosynthesis using dynamic compression plate (DCP), intramedullary nailing, locking compression plate (LCP), Ilizarov technique along with bone grafting have been reported previously. In cases of prior failed plate-screw osteosynthesis the resultant osteopenia, cortical defect, bone loss, scalloping around screws and metallosis, make the management of non-union more complicated...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29333367/stepwise-verification-of-bone-regeneration-using-recombinant-human-bone-morphogenetic-protein-2-in-rat-fibula-model
#5
Jung-Woo Nam, Hyung-Jun Kim
Objectives: The purpose of this study was to introduce our three experiments on bone morphogenetic protein (BMP) and its carriers performed using the critical sized segmental defect (CSD) model in rat fibula and to investigate development of animal models and carriers for more effective bone regeneration. Materials and Methods: For the experiments, 14, 16, and 24 rats with CSDs on both fibulae were used in Experiments 1, 2, and 3, respectively. BMP-2 with absorbable collagen sponge (ACS) (Experiments 1 and 2), autoclaved autogenous bone (AAB) and fibrin glue (FG) (Experiment 3), and xenogenic bone (Experiment 2) were used in the experimental groups...
December 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29330991/diaphyseal-nutrient-foramina-in-dried-human-adult-long-bones-of-lower-limb-in-pakistan
#6
Ejaz Afzal, Fatima Sherin, Omair Khan, Noaman Hussain Siddiqui
BACKGROUND: osteogenesis needs circulation of blood in the bones. Bone growth, repair of fracture, maintenance of bone vitality and other injures also need blood circulation in proper way. Blood is allowed to flow via holes in the diaphysis, which are called as nutrient foramina. METHODS: The crosssectional study was done in the department of Anatomy, Ayub and Khyber Medical College (Osteology Sections). The aim was to observe diaphyseal nutrient foramina in the human long bones of the lower limb...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29326370/a-rare-case-of-giant-cell-tumour-gct-of-bone-with-lung-metastases
#7
Dheerendra Kumar Sachan, Nupur Bansal, Surabhi Gupta, Sanjeev Kumar
A case of 16-year-old girl with giant cell tumour of right fibula is presented to us with bilateral lung metastases. In view of widespread bilateral lung metastatic lesions, the patient was given multimodality treatment. Chemotherapy followed by radiotherapy to the local site as well as lung bath has been given and has shown good response.
January 11, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29320936/role-of-the-deltoid-ligament-in-syndesmotic-instability
#8
Jafet Massri-Pugin, Bart Lubberts, Bryan G Vopat, Jonathon C Wolf, Christopher W DiGiovanni, Daniel Guss
BACKGROUND: The deltoid ligament (DL) is the principal ligamentous stabilizer of the medial ankle joint. Little is known, however, about the contribution of the DL toward stabilizing the syndesmosis. The aim of this study was to arthroscopically evaluate whether the DL contributes to syndesmotic stability in the coronal plane. METHODS: Eight above-knee cadaveric specimens were used in this study. A lateral hook test was performed by applying 100 N of lateral force to the fibula in the intact state and after sequential transection of the DL, anterior-inferior tibiofibular ligament (AITFL), interosseous ligament (IOL), and posterior-inferior tibiofibular ligament (PITFL)...
January 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29314242/co-morbidities-only-account-for-a-small-proportion-of-excess-mortality-after-fracture-a-record-linkage-study-of-individual-fracture-types
#9
Weiwen Chen, Judy M Simpson, Lyn M March, Fiona M Blyth, Dana Bliuc, Thach Tran, Tuan V Nguyen, John A Eisman, Jacqueline R Center
BACKGROUND: Non-hip non-vertebral fractures (NHNV) constitute the majority of osteoporotic fractures but few studies have examined the association between these fractures, co-morbidity and mortality. OBJECTIVE: To examine the relationship between individual non-hip non-vertebral fractures, co-morbidities and mortality. METHODS: Prospective population-based cohort of 267,043 subjects (45 and Up Study, Australia) had baseline questionnaires linked to hospital administrative and all-cause mortality data from 2006 - 2013...
January 4, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29310461/utility-of-third-week-postoperative-radiographs-in-the-management-of-ankle-fractures
#10
Ercan Şahin, Mahmut Kalem
OBJECTIVES: To evaluate the costs and efficacy of radiographs taken in the third week after fixation of bimalleolar and trimalleolar fractures. PATIENTS AND METHOD: A retrospective evaluation was made of patients who underwent surgical fixation because of bimalleolar and trimalleolar fractures between January 1, 2008, and October 1, 2013. Patient demographics (age, gender, body mass index), fracture type, follow-up periods, and fixation methods were recorded, and the radiographs taken on postoperative day 1, at 3 weeks, 6 weeks, and the final follow-up were examined by 2 orthopedists...
January 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29310377/fat-grafting-for-resurfacing-an-exposed-implant-in-lower-extremity-a-case-report
#11
Yun-Nan Lin, Chieh-Han Chuang, Shih-Hao Huang, Shu-Hung Huang, Tsai-Ming Lin, I-Wen Lin, Sin-Daw Lin, Yur-Ren Kuo
RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29307065/metals-in-bones-of-the-middle-aged-inhabitants-of-sardinia-island-italy-to-assess-nutrition-and-environmental-exposure
#12
Beatrice Bocca, Giovanni Forte, Valentina Giuffra, Rita Maria Serra, Yolande Asara, Cristiano Farace, Marco Milanese, Eugenia Tognotti, Andrea Montella, Pasquale Bandiera, Roberto Madeddu
Metals in bones of 72 subjects lived between the twelfth and eighteenth century AC and collected in four Sardinian (Italian insular region) burial sites (Alghero, Bisarcio, Geridu, and Sassari) were determined and used as biomarkers to evaluate diet and potential social-environmental differences. Concentrations of Ba, Ca, Cd, Cu, Hg, Pb, Sr, and Zn were quantified in different types of compact bone (femur, fibula, humerus, radius, tibia, ulna) by sector field inductively coupled plasma mass spectrometry previous acidic digestion and differences among the various burial sites, centuries, types of bone, gender, and age were explored by univariate and multivariate analyses...
January 6, 2018: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/29298256/planning-for-bone-excision-in-ewing-sarcoma-post-chemotherapy-mri-more-accurate-than-pre-chemotherapy-mri-assessment
#13
Camille Thévenin-Lemoine, Louise Destombes, Julie Vial, Matthieu Wargny, Paul Bonnevialle, Yan Lefevre, Anne Gomez Brouchet, Jérome Sales de Gauzy
BACKGROUND: In determining the level of bone resection in Ewing sarcoma, the most suitable time at which to perform magnetic resonance imaging (MRI) remains controversial. Current guidelines recommend that surgical planning be based on MRI performed prior to neoadjuvant chemotherapy. The goal of this study was to determine whether pre-chemotherapy or post-chemotherapy MRI provides greater accuracy of tumor limits for planning bone excision in the management of Ewing sarcoma. METHODS: This was a single-center, retrospective study...
January 3, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29287221/ankle-fractures-getting-it-right-first-time
#14
Anna S Walsh, Victoria Sinclair, Patrick Watmough, Alistair A Henderson
INTRODUCTION: Ankle fractures are common injuries presenting to trauma departments and ankle open reduction and internal fixation (ORIF2) is one of the first procedures targeted in early orthopaedic training. Failure to address the fracture pattern with the appropriate surgical technique and hardware may lead to early failure, resulting in revision procedures or premature degenerative change. Patients undergoing revision ORIF are known to be at much greater risk of complications and many of these secondary procedures may be preventable...
November 28, 2017: Foot
https://www.readbyqxmd.com/read/29283912/paracentral-acute-middle-maculopathy-in-purtscher-retinopathy
#15
David Rivera-De La Parra, Jans Fromow-Guerra
PURPOSE: To describe paracentral acute middle maculopathy associated with Purtscher retinopathy, particularly in Purtscher flecken lesions as a retinal complication in a case secondary to fractures of long bones. METHODS: Case report. RESULTS: A 16-year-old boy with bilateral paracentral scotomata presented with bilateral paracentral acute middle maculopathy as part of Purtscher retinopathy in both eyes as consequence of tibia and fibula fractures...
December 27, 2017: Retinal Cases & Brief Reports
https://www.readbyqxmd.com/read/29282106/ankle-ligament-reconstruction-after-wide-resection-of-the-osteosarcoma-of-the-distal-fibula-a-case-report
#16
Tanawat Vaseenon, Jirawat Saengsin, Amornrat Kaminta, Nuttaya Pattamapaspong, Jongkolnee Settakorn, Dumnoensun Pruksakorn
BACKGROUND: Restoration of the lateral ankle after distal fibulectomy is a difficult reconstructive procedure. Many surgical techniques have been proposed. This report shows another fibular reconstructive option with promising outcome. CASE PRESENTATION: We report the case of a 30-year-old woman who presented with a solitary mass located in the lateral aspect of the ankle. The mass had grown rapidly for 2 months and caused increasing pain. Physical examination showed a 3...
December 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29245094/concomitant-rhomboid-shaped-tibiae-and-fibulae-finger-like-projections-and-orthopedic-management-in-a-new-variant-of-nievergelt-syndrome-a-case-report
#17
Tuna Pehlivanoğlu, Mehmet Demirel, Yavuz Sağlam, Halil İbrahim Balci, Hayati Durmaz
INTRODUCTION: The rare Nievergelt syndrome (NS) is the most severe form of mesomelic dysplasia and is characterized by disproportionate shortness of the limbs. The aim of this case report was to describe the clinical and radiological features of a rare case of NS. PRESENTATION OF CASE: Here we describe a female patient originally presenting with bilateral hand, lower leg, and foot deformities at the age of 10 years old. In addition to the characteristic features of NS, this patient presented with finger-like projections on her heels, bilateral hand anomalies, and atypical facial features...
December 8, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29244658/a-distally-based-sartorius-muscle-flap-for-a-gustilo-grade-iii-open-fracture-of-the-lateral-femoral-condyle-and-the-head-of-the-fibula-with-a-complex-soft-tissue-defect-a-case-report-and-review-of-the-literature
#18
Victoire Bouveau, Damien Potage, Arnaud Dubory, Romain Chevallier, Jean-Paul Meningaud, Jérémy Niddam, Charles-Henri Flouzat-Lachaniette
CASE: We present a case of lower-limb trauma associated with an extensive soft-tissue defect around the knee joint, which led to the exposure of bone and the metalwork that was used for the management of the associated fractures. Coverage was performed with a distally based sartorius muscle flap in a single-stage procedure, allowing good recovery with a nice aesthetic and functional outcome at the 1-year follow-up. Additionally, we discuss alternative options for the coverage of severe soft-tissue defects based on the clinical context...
December 13, 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29224810/utilization-of-a-pre-bent-plate-positioning-surgical-guide-system-in-precise-mandibular-reconstruction-with-a-free-fibula-flap
#19
Tingwei Bao, Jianfeng He, Changyang Yu, Wenquan Zhao, Yi Lin, Huiming Wang, Jianhua Liu, Huiyong Zhu
OBJECTIVES: We evaluated the effects of three-dimensional virtual planning and the use of a plate-embedded surgical guide in mandibular reconstruction with microvascular fibula flaps. MATERIALS AND METHODS: We retrospectively reviewed 35 patients who underwent primary mandibular reconstruction with a free fibula flap. They were divided into three groups according to the therapy they received. In group A, 12 patients underwent reconstruction using the modified surgical guide system, including virtual surgeries, pre-bent titanium plates, screw-predesignated cutting guides for mandibular and fibular osteotomies, and plate-embedded shaping guides...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29222966/optimizing-functional-outcomes-in-mandibular-condyle-reconstruction-with-the-free-fibula-flap-using-computer-aided-design-and-manufacturing-technology
#20
Z-Hye Lee, Tomer Avraham, Casian Monaco, Ashish A Patel, David L Hirsch, Jamie P Levine
PURPOSE: Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques...
November 15, 2017: Journal of Oral and Maxillofacial Surgery
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