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Limb salvage

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https://www.readbyqxmd.com/read/27923212/comparison-of-diabetic-charcot-patients-with-and-without-foot-wounds
#1
Dane K Wukich, David Sadoskas, Nicholas J Vaudreuil, Mitchell Fourman
BACKGROUND: The primary aim of this study was to evaluate the outcomes of a series of patients with Charcot neuroarthropathy (CN) who were evaluated in a tertiary care setting. We hypothesized that those patients with CN who presented with a Charcot-related foot wound would have lower rates of successful limb salvage than patients who presented without a wound. METHODS: Two hundred forty-five patients (280 feet) were identified with diabetic CN during the time period from January 1, 2005, to June 1, 2015...
October 23, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27919994/clinical-outcome-of-reconstruction-using-frozen-autograft-for-a-humeral-bone-tumor
#2
Hiroaki Kimura, Norio Yamamoto, Toshiharu Shirai, Hideji Nishida, Katsuhiro Hayashi, Yoshikazu Tanzawa, Akihiko Takeuchi, Shinji Miwa, Hiroyuki Tsuchiya
BACKGROUND: We developed a frozen autograft technique in which a tumor-bearing bone was treated with liquid nitrogen for reconstruction. The purpose of this study was to evaluate the functional outcomes of this technique after resection of humeral bone tumors. PATIENTS AND METHODS: Eight patients were included in the study. The freezing range was classified into 2 groups, depending on whether the joint surface of the humeral head was frozen. RESULTS: In the joint freezing group, the mean active shoulder abduction and flexion were 43...
December 2016: Anticancer Research
https://www.readbyqxmd.com/read/27914820/cell-therapy-in-critical-limb-ischemia-a-comprehensive-analysis-of-two-cell-therapy-products
#3
Claire Tournois, Bernard Pignon, Marie-Antoinette Sevestre, Rida Al-Rifai, Valerie Creuza, Gaël Poitevin, Caroline François, Philippe Nguyen
BACKGROUND: Cell therapy has been proposed as a salvage limb procedure in critical limb ischemia (CLI). In spite of the fact that clinical trials found some efficacy, the mechanism of action remains elusive. The objective of this study was to characterize two autologous cell therapy products (CTPs) obtained from patients with advanced peripheral arterial disease. METHODS: Bone marrow (BM-CTPs) (n = 20) and CTPs obtained by non-mobilized cytapheresis (peripheral blood [PB]-CTPs) (n = 20) were compared...
November 30, 2016: Cytotherapy
https://www.readbyqxmd.com/read/27914772/vascular-reconstruction-after-retroperitoneal-and-lower-extremity-sarcoma-resection
#4
M Wortmann, I Alldinger, D Böckler, A Ulrich, A Hyhlik-Dürr
PURPOSE: Soft tissue sarcomas (STS) of the retroperitoneum and the lower limb with invasion of major blood vessels are very rare malignancies. This study analyses the outcome of patients with vascular replacement during resection of STS of the retroperitoneum and the lower extremity with either arterial or concomitant arterial and venous infiltration. METHODS: Patients with vascular replacement during resection of sarcoma of the retroperitoneum and the lower extremity between 1990 and 2014 were included in this retrospective single center study...
November 20, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27912995/rehabilitation-strategies-and-outcomes-of-the-sarcoma-patient
#5
REVIEW
Sean Robinson Smith
Sarcomas are a relatively rare cancer that, depending on the location, can cause significant neuromusculoskeletal dysfunction and require rehabilitation interventions to reduce pain, restore function, and improve quality of life. This review focuses on sarcoma subtypes that frequently cause these complications: bony and soft tissue sarcomas leading to limb salvage or amputation, desmoid tumors, and malignant peripheral nerve sheath tumors. Rehabilitation approaches and outcomes are discussed, as well as considerations for childhood sarcoma survivors transitioning to adulthood...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#6
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27903472/-endovascular-treatment-of-poplital-artery-aneurysms-a-word-of-caution-after-long-term-follow-up
#7
Cosimo Maraglino, Gianluca Canu, Renzo Ambrosi, Franco Briolini, Riccardo Gotti, Pietro Cefalì, Fabio Calliari, Paolo Ferrero, Franco Terraneo
PURPOSE: The aim of this work was to evaluate the long-term patency of endo-grafting in the treatment of popliteal artery aneurysms (Paa) and to identify which factors may be predictor of graft occlusion. METHODS: All the patients that underwent endovascular repair of Paa were analyzed from 2006 until 2014 on the basis of symptoms, comorbidities, limb salvage and long-term patency. The predictive value of the different variables was assessed in univariate analysis for primary patency and, for factors resulted significant, a multivariate analysis was performed...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27897381/pathologic-fracture-in-childhood-and-adolescent-osteosarcoma-a-single-institution-experience
#8
Lindsay Haynes, Sue C Kaste, Kirsten K Ness, Jianrong Wu, Lucia Ortega-Laureano, Michael Bishop, Michael Neel, Bhaskar Rao, Israel Fernandez-Pineda
PURPOSE: Pathologic fractures occur in 5-10% of pediatric osteosarcoma (OS) cases and have historically been considered a contraindication to limb salvage. Our purpose was to describe the radiographic features of pathologic fracture and examine its impact on local recurrence rates, functional outcomes, and overall survival. METHODS: We retrospectively analyzed patients at our institution from 1990 to 2015 with pathologic fracture at diagnosis or during neoadjuvant chemotherapy...
November 5, 2016: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/27896674/editorial-comment-symposium-2015-meetings-of-the-musculoskeletal-tumor-society-and-the-international-society-of-limb-salvage
#9
EDITORIAL
John H Healey
No abstract text is available yet for this article.
November 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27896186/use-of-a-temporary-shunt-as-a-salvage-technique-for-distal-extremity-amputations-requiring-repair-by-vessel-grafting-during-critical-ischemia
#10
Bilsev Ince, Mehmet Dadaci, Zeynep Altuntas
BACKGROUND: Although the use of temporary shunts in proximal extremity amputations has been reported, no study has described the use of temporary shunts in distal extremity amputations that require vein grafting. Moreover, the total volume of blood loss when temporary shunts are used has not been reported. The aim of this study was to investigate the applicability of a temporary shunt for distal extremity amputations requiring repair by vessel grafting with an ischemia time of >6 hours...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27895379/functional-outcomes-after-successful-lower-extremity-arterial-injuries-repair
#11
Ziad Sophie, Lekhraj Mal
The study was conducted to measure functional outcome of patients who had successful lower extremity arterial reconstruction after vascular injury at a tertiary care centre in Karachi over 5 years from January 2008 to December 2013. In this descriptive cohort study, the functional outcomes were assessed with lower extremity functional scale (LEFS). The mean age the 75 patients in the study was 32±11 years. Limb salvage was successful in 72(96%) cases. The most common injured artery was superficial femoral artery 30(40%) followed by popliteal artery 19(25%)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27889202/analysis-of-the-elective-treatment-process-for-critical-limb-ischaemia-with-tissue-loss-diabetic-patients-require-rapid-revascularisation
#12
K Noronen, E Saarinen, A Albäck, M Venermo
OBJECTIVES: The number of elderly people is increasing; inevitably, the result will be more patients with critical limb ischaemia (CLI) in the future. Tissue loss in CLI is related to a high risk of major amputation. The aim of this study was to analyze the treatment process from referral to revascularisation, to discover possible delays and reasons behind them, and to distinguish patients benefitting the most from early revascularisation. METHODS: A retrospective analysis was performed of 394 consecutive patients with a combined 447 affected limbs, referred to the outpatient clinic during 2010-2011 for tissue loss of suspected ischaemic origin...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27879958/evaluation-of-a-6-year-old-multicentric-standard-endovascular-treatment-of-critical-limb-ischemia-in-the-drug-eluting-era
#13
Vincenzo Brizzi, Caroline Caradu, Xavier Berard, Gerard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: There has been increasing evidence to support the endovascular- first approach in the treatment of below the knee (BTK) lesions. Plain Old Balloon Angioplasty (POBA), with bailout bare-metal stent scaffolding in case of flow limiting dissection or recoil, have been considered the standard treatment of choice but industries are continually developing innovative equipment and dedicated technologies, such as drug-eluting platforms whose use is increasingly extended, despite significant costs and lack of high-quality evidence to support a well- established strategy...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27876523/quality-of-life-assessment-as-an-outcomes-measure-in-critical-limb-ischemia
#14
Olamide Alabi, Matthew Roos, Gregory Landry, Gregory Moneta
Critical limb ischemia (CLI) is a diagnosis plagued by significant comorbidity and high mortality rates. Overall survival remains poor in this population regardless of the procedure-related success as demonstrated by freedom from amputation, intervention, and patency. The literature has traditionally focused on physician-centered and lesion-centered outcomes with regards to limb salvage procedures, but there remains a relative paucity of studies of CLI patients describing patient-centered outcomes such as quality of life (QoL), independent living, and ambulation status...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876266/knee-arthrodesis-by-the-ilizarov-method-in-the-treatment-of-total-knee-arthroplasty-failure
#15
Andrea Antonio Maria Bruno, Alexander Kirienko, Andrea Peccati, Paolo Dupplicato, Massimo De Donato, Enrico Arnaldi, Nicola Portinaro
BACKGROUND: Currently, the main indication for knee arthrodesis is septic failure of a total knee arthroplasty (TKA). The purpose of this study was to evaluate the results of knee arthrodesis by circular external fixation performed in the treatment of TKA failure in which revision arthroplasty was not indicated. METHODS: The study involved 19 patients who underwent knee arthrodesis by the Ilizarov method. Clinical and functional assessments were performed, including Knee Society Score (KSS)...
November 18, 2016: Knee
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#16
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27870693/limb-salvage-with-intrepid-dynamic-exoskeletal-orthosis-versus-transtibial-amputation-a-comparison-of-functional-gait-outcomes
#17
Katharine I Mangan, Trevor D Kingsbury, Brittney N Mazzone, Marilynn P Wyatt, Kevin M Kuhn
OBJECTIVES: To determine if there is a difference in functional gait outcomes between patients with limb injuries treated with either transtibial amputation or limb preservation with the Intrepid Dynamic Exoskeletal Orthosis. DESIGN: Retrospective prognostic study. SETTING: Tertiary referral military hospital. PATIENTS: This study included 10 transtibial amputees and 10 limb preservation patients using the Intrepid Dynamic Exoskeletal Orthosis who were matched by body mass index after excluding for nontraumatic, proximal ipsilateral, contralateral, spine, or traumatic brain injuries...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27865310/the-diabetic-charcot-foot-from-1936-to-2016-eighty-years-later-and-still-growing
#18
REVIEW
Crystal L Ramanujam, Thomas Zgonis
Knowledge of diabetic Charcot neuroarthropathy (DCN) has grown tremendously since this condition was first described in 1936 by William Riely Jordan. Despite advancements in diagnostic approaches and treatment options making DCN limb salvage a more viable option, ongoing and additional research is needed to determine the definitive pathogenesis, which may aid in prevention of the condition. This article chronicles the main developments for the study and management of DCN since 1936 and recommends using the term diabetic Charcot-Jordan foot when specifically managing foot and ankle neuroarthropathy joints in patients with diabetic neuropathy...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27863500/simultaneous-reconstruction-of-the-bone-and-vessels-for-complex-femoral-defect
#19
Shimpei Miyamoto, Masahide Fujiki, Nokitaka Setsu, Akira Kawai
BACKGROUND: Several methods have been reported for intercalary reconstruction of femoral defects. Of these, free vascularized fibula grafts (FVFG) are preferred because of their durability, bone-healing potential, and tolerance to infection. If the bone tumor invades the femoral vessels, simultaneous vascular reconstruction also becomes necessary and significant technical hurdles make limb salvage difficult. CASE PRESENTATION: We present a 10-year-old girl who underwent limb-sparing surgery for a distal femur osteosarcoma...
November 18, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27863366/early-versus-late-thrombolysis-in-acute-arterial-occlusion-of-lower-extremity
#20
Hyun Gee Moon, Sang Cheol Cho, Sang Woo Jeong, Gyu Ik Lee, Young Eun Jo, Boram Youn, Won Yu Kang, Sun Ho Hwang, Wan Kim, Weon Kim
BACKGROUND: Acute arterial occlusion in lower extremity is an urgent condition which occurs when there is an abrupt interruption of blood flow into an extremity. Reperfusion through early intervention can increase limb salvage and decrease mortality. There was no common agreement when is the best to start thrombolysis in treating acute arterial occlusion. This study was designed to study the efficacy of an early thrombolysis compared with a late thrombolysis. METHOD: We identified all patients discharged from the Gwangju Veterans hospital with a diagnosis of acute arterial occlusion between 2006 and 2014...
November 2, 2016: International Journal of Cardiology
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