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Limb salvage

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https://www.readbyqxmd.com/read/29683087/resolving-the-high-stakes-of-limb-salvage-with-skin-perfusion-pressure
#1
Matthew C Bunte, Mehdi H Shishehbor
No abstract text is available yet for this article.
April 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29682105/when-are-endovascular-and-open-bypass-treatments-preferred-for-femoropopliteal-occlusive-disease
#2
REVIEW
Ali F AbuRahma
Several meta-analyses and multicenter trials have shown that chronic limb ischemia did not occur for up to 5 years in 50%-70% of patients who underwent saphenous vein grafts, with limb salvage and perioperative mortality rates of >80% and 3%, respectively. However, open surgical bypass can have limitations, including postoperative morbidity/wound complications of 10%-20% and prolonged length of hospital stay and outpatient care. Several studies have analyzed clinical outcomes for patients with critical limb ischemia treated with endovascular therapies, but they have been mainly retrospective with significant heterogeneity or were single center...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29681818/successful-limb-sparing-wide-excision-of-a-giant-lipofibromatosis-in-a-5-year-old-girl
#3
Putu Anda Tusta Adiputra
A 5-year-old girl presented with a big painless mass, sized 24 × 37 × 35 cm, in her lower left limb. MRI revealed a huge heterogeneous mass splaying from the left distal femur to the calcaneal region without bony erosion but compressing the arteries and causing bowing of the left tibia and fibula bones. The difficulty was to determine the best course of action taken which would either be limb salvation or amputation. Considering that only a few muscles could be saved, the author initially recommended amputation but still considered a limb-sparing procedure...
January 2018: Case Reports in Oncology
https://www.readbyqxmd.com/read/29668473/the-history-of-bone-tumour-treatment-and-the-state-of-the-art-in-vienna
#4
Rainer Kotz
PURPOSES: Bone tumours have been a tragedy for the patient in any time period. In the majority of the cases it occurs in children or young adults. In the past the affected limbs could not be spared and the overall prognosis was poor. METHODS: Chemotherapy successfully introduced for the purpose of overcoming the poor overall prognosis (Rosen and Jaffe) and tumour prostheses were invented for the purpose of salvaging the affected limbs (Marcove, Scales, Campanacci, Sivas, Salzer)...
December 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/29665749/early-and-mid-term-results-in-the-endovascular-treatment-of-popliteal-aneurysms-with-the-multilayer-flow-modulator
#5
Alessandro Ucci, Ruggiero Curci, Matteo Azzarone, Claudio Bianchini Massoni, Antonio Bozzani, Carla Marcato, Enrico Maria Marone, Paolo Perini, Tiziano Tecchio, Antonio Freyrie, Angelo Argenteri
Background The endovascular approach became an alternative to open surgical treatment of popliteal artery aneurysm over the last few years. Heparin-bonded stent-grafts have been employed for endovascular popliteal artery aneurysm repair, showing good and stable results. Only few reports about the use of multilayer flow modulator are available in literature, providing small patient series and short follow-up. The aim of this study is to report the outcomes of patients with popliteal artery aneurysm treated with the multilayer flow modulator in three Italian centres...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29661291/hemodialysis-patients-have-worse-outcomes-after-infrageniculate-revascularization-procedures
#6
Caitlin W Hicks, Joseph K Canner, Kevin Kirkland, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: Hemodialysis (HD) has been shown to be an independent predictor of poor outcomes after femoropopliteal revascularization procedures in patients with chronic limb-threatening ischemia. However, HD patients tend to have isolated infrageniculate disease, an anatomic risk factor for inferior patency. We aimed to compare outcomes for HD versus non-HD patients after infrageniculate open lower extremity bypass (LEB) and endovascular peripheral vascular interventions (PVIs). METHODS: Data from the Society for Vascular Surgery Vascular Quality Initiative database (2008-2014) were analyzed...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29648876/use-of-patient-specific-3d-printed-titanium-implants-for-complex-foot-and-ankle-limb-salvage-deformity-correction-and-arthrodesis-procedures
#7
Travis J Dekker, John R Steele, Andrew E Federer, Kamran S Hamid, Samuel B Adams
BACKGROUND: The advancement of 3D printing technology has allowed for the use of custom-designed implants for difficult-to-treat foot and ankle pathologies. This study reports on the radiographic and functional outcomes of a case series of patients treated with patient-specific 3D-printed titanium implants. METHODS: Fifteen consecutive patients treated with custom-designed 3D-printed implant cages for severe bone loss, deformity correction, and/or arthrodesis procedures were included in this study...
April 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29644315/limb-salvage-and-reconstruction-following-a-zebra-attack
#8
Jacob T Carlson, James C Yuen, Matthew R Smeds
Animal bites are fairly rare events but can cause devastating traumatic injuries to the victim. In addition to the soft tissue, vascular, and orthopedic trauma inflicted by these occurrences, bite injuries also have the potential to introduce an inoculum of microbes, which may progress to an infection if not treated properly and expeditiously. We present the case of a healthy male who sustained multiple bite wounds from a domestic zebra to his left upper extremity. This attack caused severe damage, including devascularization of the arm at the brachial artery, disruption of the distal biceps and brachialis, stripping of the forearm nerves, and shearing of the overlying soft tissue...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29644299/surgical-management-of-compartment-syndrome-and-the-gradual-closure-of-a-fasciotomy-wound-using-a-dermaclose-device
#9
Gregory C Manista, Andrew Dennis, Matthew Kaminsky
The immediate recognition and timely response of compartment syndrome due to damage caused by penetrating trauma has immense clinical outcomes. The following is a case report of a complicated fasciotomy in a 33-year-old male who suffered a gunshot wound to his left lower extremity and the surgical management leading to adequate limb salvage and recovery.
April 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29642735/below-the-knee-retrograde-access-for-peripheral-interventions-a-valuable-technique-for-the-limb-salvage-toolbox
#10
Evan J Ryer, James R Elmore
No abstract text is available yet for this article.
April 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29629581/vascularized-fibular-epiphyseal-transfer-for-proximal-humeral-reconstruction-in-children-with-a-primary-sarcoma-of-bone
#11
J D Stevenson, R Doxey, A Abudu, M Parry, S Evans, F Peart, L Jeys
Aims Preserving growth following limb-salvage surgery of the upper limb in children remains a challenge. Vascularized autografts may provide rapid biological incorporation with the potential for growth and longevity. In this study, we aimed to describe the outcomes following proximal humeral reconstruction with a vascularized fibular epiphyseal transfer in children with a primary sarcoma of bone. We also aimed to quantify the hypertrophy of the graft and the annual growth, and to determine the functional outcomes of the neoglenofibular joint...
April 1, 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29627149/combined-bilobed-trapezius-myocutaneous-and-scapula-osteomyocutaneous-flaps-for-the-restoration-of-through-and-through-defects-of-the-mandible-following-salvage-surgery-for-recurrent-head-and-neck-tumours
#12
W-L Chen, Z-Q Huang, B Zhou, Y Wang, R Chen
This study was performed to evaluate the outcomes of combined bilobed trapezius myocutaneous and scapula osteomyocutaneous flaps for the restoration of through-and-through defects of the mandible. The subjects were six patients with recurrent malignant tumours who underwent salvage surgeries and reconstruction with combined flaps based on the transverse cervical vessels (TCVs). All patients had combined bone (four type H, one type LCL, and one type C) and extensive soft tissue defects (through-and-through defects) following salvage surgery...
April 4, 2018: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29619536/penetrating-femoral-artery-injuries-an-urban-trauma-centre-experience
#13
Shreya Rayamajhi, Nivashini Murugan, Andrew Nicol, Sorin Edu, Juan Klopper, Nadraj Naidoo, Pradeep Navsaria
AIM: This study reviews a single centre experience with penetrating femoral artery injuries. PATIENTS AND METHODS: The records of all patients with femoral artery injuries admitted to the Trauma Centre at Groote Schuur Hospital from January 2002 to December 2012 were reviewed. These were analysed for demographics, injury mechanism, perioperative, and surgical management. Outcome was categorised by limb salvage. RESULTS: One-hundred and fifty-eight (158) patients with femoral artery injuries were identified...
April 4, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29615358/outcomes-of-infrageniculate-retrograde-versus-transfemoral-access-for-endovascular-intervention-for-chronic-lower-extremity-ischemia
#14
Ashraf G Taha, Adham N Abou Ali, George Al-Khoury, Michael J Singh, Michel S Makaroun, Efthymios D Avgerinos, Rabih A Chaer
OBJECTIVE: Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia. METHODS: This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29615012/how-does-iliosacral-bone-tumor-resection-without-reconstruction-affect-the-ipsilateral-hip-joint
#15
Tao Jin, Weifeng Liu, Hairong Xu, Yuan Li, Lin Hao, Xiaohui Niu
BACKGROUND: Whether reconstruction is more beneficial after iliosacral bone tumor resection remains controversial. Because of high rates of complications and recurrence, few patients benefit from reconstruction. The aim of this study is to assess functional outcomes and to reveal changes in the ipsilateral hip joint after partial iliosacral resection. METHODS: From 1998 to 2016, 21 patients aged 20-66 years underwent iliosacral resection, 18 without reconstruction (group 1) and 3 with reconstruction (group 2)...
April 4, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29609479/improvement-in-quality-of-life-following-operative-correction-of-midtarsal-charcot-foot-deformity
#16
Ellen Kroin, Edwin O Chaharbakhshi, Adam Schiff, Michael S Pinzur
BACKGROUND: Patients with Charcot foot arthropathy report a poor quality of life following the development of deformity. Their quality of life is often not improved with "successful" historic accommodative treatment. There is increased current interest in operative correction of the acquired deformity with the stated goals of achieving both the traditional goals of resolution of infection and limb salvage as well as the desire to improve quality of life. The Short Musculoskeletal Functional Assessment (SMFA) outcomes instrument appears to be a valid tool for evaluating this complex patient population...
March 1, 2018: Foot & Ankle International
https://www.readbyqxmd.com/read/29608532/wound-surface-area-as-a-risk-factor-for-flap-complications-among-patients-with-open-fractures
#17
Phelan Shea, Nathan N O'Hara, Sheila A Sprague, Mohit Bhandari, Brad A Petrisor, Kyle J Jeray, Min Zhan, Gerard P Slobogean, Raymond A Pensy
BACKGROUND: Soft tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at our institution, we hypothesize that wounds greater than 200cm are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft tissue reconstruction with a rotational flap or free tissue transfer. METHODS: We performed a secondary analysis of FLOW trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture...
March 21, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29600673/-clinical-efficacy-analysis-of-transverse-tibial-bone-transport-combined-with-vacuum-drainage-for-the-treatment-of-diabetic-foot-ulcer
#18
Zhong-Wei Jia, Jian-Ping Yu, Yun-Xing Su, Xiu-Sheng Guo, Jin-Bin Yu, Zhi-Jun Yang, Jia-Wei Niu, Jie Wei
OBJECTIVE: To investigate clinical effect of transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage in treating diabetic foot ulcer. METHODS: From November 2015 and December 2016, clinical data of 19 diabetic foot ulcer patients treated with transverse tibial bone transport micro vessels regeneration technology combined with vacuum drainage were retrospective analyzed, including 15 males and 4 females aged from 42 to 82 years old with an average of (64...
March 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29599067/a-comparison-of-clinical-outcomes-between-primary-bypass-and-secondary-bypass-after-failed-plain-balloon-angioplasty-in-the-bypass-versus-angioplasty-for-severe-ischaemia-of-the-limb-basil-trial
#19
Lewis Meecham, Smitaa Patel, Gareth R Bate, Andrew W Bradbury
OBJECTIVE: Chronic limb threatening ischaemia (CLTI) is a growing global health problem. The UK NIHR HTA funded BASIL trial is still the only randomised controlled trial to have compared a "bypass surgery first" with a "plain balloon angioplasty (PBA) first" strategy for the management of CLTI. In patients who were likely to survive for 2 years and had a suitable vein, primary bypass (PB) was associated with better clinical outcomes. Furthermore, PBA was associated with a high technical and clinical failure rate and many went on to have secondary bypass (SB)...
March 27, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29595900/a-perioperative-approach-to-increase-limb-salvage-when-treating-foot-ulcers-in-patients-with-diabetes
#20
Raelina S Howell, Theresa Criscitelli, Jon S Woods, Brian M Gillette, Harold Brem, Scott Gorenstein
Foot ulceration in patients with diabetes increases the risk of lower extremity amputation. Major amputations produce substantial adverse consequences, increase length of hospital stay, diminish quality of life, and increase mortality. In this article, we describe approaches that decrease amputations and improve the quality of life for patients with diabetes and foot ulcers. We highlight the role of the perioperative nurse, who is essential to providing optimal patient care in the perioperative period. Perioperative care of patients with diabetes involves providing optimal surveillance for a break in the skin of the foot, screening for neuropathy, following guidelines for foot ulcer infections, preparing for pathophysiology-based debridement, using adjuvant therapies, and offloading the patient's affected foot...
April 2018: AORN Journal
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