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Neurovascular complications

Rajan R Murgai, Edward Compton, Akash R Patel, Deirdre Ryan, Robert M Kay
BACKGROUND: Although postoperative cast immobilization is routinely used in children, it is not without complications. Few studies have focused on interventions to decrease their frequency. The purpose of this study was to determine if foam padding in postoperative lower extremity casts decreased the rate of cast complications. METHODS: A retrospective review of patients who underwent lower extremity casting after elective surgery at a tertiary pediatric hospital from 2006 to 2013 was conducted...
June 20, 2018: Journal of Pediatric Orthopedics
M'Peko Osawa F Mayele, X Bertrand
Subarachnoid hemorrhage is a neurovascular emergency affecting relatively young adults. A ruptured cerebral aneurysm is the main non-traumatic cause. Except for the non-specific symptom of headache, which frequently occurs in subarachnoid hemorrhage, the clinical presentation is atypical, making the diagnosis difficult with possible dramatic consequences. The diagnosis is based on the CT scan without contrast, which, when negative, will be followed by a lumbar puncture. The etiologic analysis is based on an urgent arteriography, revealing the characteristics of the aneurysm such as the anatomy of the intracerebral vessels, the identification of the bleeding site and the size and location of the aneurysm...
May 2018: Revue Médicale de Liège
Samer Amhaz-Escanlar, Alberto Jorge-Mora, Teresa Jorge-Mora, Manuel Febrero-Bande, Maximo-Alberto Diez-Ulloa
PURPOSE: Lateral mass screws combined with rods are the standard method for posterior cervical spine subaxial fixation. Several techniques have been described, among which the most used are Roy Camille, Magerl, Anderson and An. All of them are based on tridimensional angles. Reliability of freehand angle estimation remains poorly investigated. We propose a new technique based on on-site spatial references and compare it with previously described ones assessing screw length and neurovascular potential complications...
June 20, 2018: European Spine Journal
Iván Mañero Vazquez, Oihane García-Senosiain, Trinidad Labanca, Esther Gómez Gil
BACKGROUND: In male-to-female genital sex reassignment surgery, the clitoris, its prepuce, and the labia minora remain among the most difficult structures to construct. We describe the authors' clitoroplasty and vulvoplasty technique. METHODS: All patients who underwent male-to-female sex reassignment surgery at a single center, between June 2012 and June 2016, were prospectively included. The standard pedicled island neurovascular flap of the glans penis was harvested in a letter M fashion with attached preputial skin...
June 19, 2018: Annals of Plastic Surgery
Jian Wang, Xiaobo Tang, Peilong Dong, Zhiyun Li
Objective: To explore the effectiveness of high strength suture fixation in treatment of patellar transverse fracture. Methods: Between June 2014 and June 2016, 38 patients with the patellar transverse fracture were treated with high strength suture internal fixation. There were 24 males and 14 females with the age of 26 to 64 years (mean, 45 years). There were 6 cases of accident injury and 32 cases of crashing injury. The time interval between injury and surgery was 2-8 days (mean, 5 days)...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Krishn Khanna, Abhinav Janghala, Nirav K Pandya
Background: Posterior hamstring harvest has been described in the adult population in a limited fashion, but no study is available describing the use of posterior hamstring harvest in an active pediatric and adolescent cohort. At times, surgeons may be faced with a challenging anterior harvest due to patient anatomic characteristics, particularly the anatomic features and size of the pes tendons. Clinicians need to have multiple harvest approaches at their disposal. Complications with hamstring harvest such as premature graft transection are more problematic in this population due to higher failure rates with allograft tissue...
June 2018: Orthopaedic Journal of Sports Medicine
Sinead H McEvoy, Mitchell C Raeside, Joshua Chaim, Behfar Ehdaie, Oguz Akin
OBJECTIVE: MRI of the prostate is widely used in prostate cancer for local staging. The purpose of this article is to show how preoperative prostate MRI findings may be used as a road map for surgery to preserve the neurovascular bundle, identify risk factors associated with positive surgical margins, and evaluate findings associated with intraoperative complications and functional recovery after surgery. CONCLUSION: Knowledge of surgically relevant imaging findings can increase radiologists' confidence in reporting them to our colleagues...
June 12, 2018: AJR. American Journal of Roentgenology
Govind Gandhi, Mayank Vijayvargiya, Vivek Shetty, Vikas Agashe, Shailendra Maheshwari, Joseph Monteiro
Objective: The use of open reduction and internal fixation (ORIF) for unstable pelvic injuries is associated with extensive blood loss, iatrogenic neurovascular injury, and infection. Moreover, the placement of sacroiliac (SI) screws is a blinded procedure, guided primarily by palpation and two-dimensional radiological screening, which demands expertise. The complex three-dimensional anatomy of SI joint and its proximity to neurovascular structure require a safe and precise technique...
May 2018: Revista Brasileira de Ortopedia
Muhammad Haseeb, Khalid Muzafar, Abdul Ghani, Khurshid A Bhat, M Farooq Butt
INTRODUCTION: Open reduction and internal fixation using plates is the gold standard for the treatment of displaced forearm bone fractures in adults. The ulna being subcutaneous throughout has a constant approach. However, the radius is approached from either the dorsal or the volar side. Both the dorsal and the volar approaches to the radial shaft involve meticulous dissection and preservation of important neurovascular structures. The posterior interosseus nerve is at risk in the dorsal approach and the radial artery and its branches in the volar approach...
May 2018: Journal of Orthopaedic Surgery
S R Sundararajan, Abdul Azeem Badurudeen, R Ramakanth, Shanmuganathan Rajasekaran
Fractures of talar body are uncommon injuries often associated with fractures of other long bones and in polytraumatized patients. The integrity of the talus is essential for the normal function of the ankle, subtalar, and midtarsal joints. The relative infrequency of this injury limits the number of studies available to guide treatment. They occur as a result of high-velocity trauma and are therefore associated with considerable soft tissue damage. Axial compression with supination or pronation is the common mechanism of injury...
May 2018: Indian Journal of Orthopaedics
Roberto Gabrielli, Franco Ciocca, Angelica Dante, Aldo Musilli, Maurizio Maiorano, Marco Ventura
BACKGROUND: Redo area region operation is associated with a significant morbidity such as neurovascular injury, infection and lymphorrhea. The traditional management of occluded femoro-popliteal grafts often includes redissection of a scarred groin to obtain adequate inflow via the common femoral artery. These procedures are more technically demanding and require more expertise and judgment than the primary operation. We describe a case of using the ipsilateral iliac branch prosthesis of aorto-bifemoral as inflow for iliac-peroneal bypass, avoiding the previous groin incisions, to minimize the local complications related to a redo groin dissection and to decrease the operative time required to obtain an adequate inflow source...
June 7, 2018: Annals of Vascular Surgery
Leonardo Kapural, Suneil Jolly, Joao Mantoan, Harish Badhey, Ty Ptacek
BACKGROUND: Chronic hip joint pain is a common condition with an estimated prevalence of 7% in men and 10% in women, in a population sample aged over 45. Conservative treatment can include physical therapy, weight loss, a variety of pharmacologic agents ranging from nonsteroidal antiinflammatory drugs (NSAIDS) to opioids, and intraarticular injections with various substances. Definitive treatment of hip pain, however, has primarily centered on hip arthroplasty. OBJECTIVE: We describe a novel anterior approach to cooled radiofrequency (RF) hip denervation under combined ultrasound (US) and fluoroscopy guidance to avoid the neurovascular femoral bundle and reach proper landmarks...
May 2018: Pain Physician
Ahmed Farhoud, Wael Khedr, Hisham Aboul-Enein
Objective  Epidermoid cysts are benign slowly growing tumors commonly involving the cerebellopontine angle (CPA). The aim of this study was to analyze the surgical limitations, surgical strategies, complications, and outcome of resection of these lesions. Material and Methods  The clinical data and outcome of 32 cases operated for CPA epidermoid between 2007 and 2015 were retrospectively analyzed. The mean follow-up period was 42.6 months, and all patients were followed up at least for a whole year. Results  There were 15 males and 17 females...
April 2018: Journal of Neurological Surgery. Part B, Skull Base
Lior Koren, Eyal Ginesin, Shahem Elias, Ronit Wollstein, Shlomo Israelit
Introduction: Distal radius fractures (DRFs) are treated in the emergency department (ED) with a closed reduction in order to decrease neurovascular and soft tissue injury and as a first definitive step in conservative treatment. The type of anesthesia used may affect the ability to reduce the fracture and remains controversial. Objective: The purpose of this study was to compare the quality of radiographic reduction achieved in the ED of DRF reduced using sedation anesthesia to those reduced with hematoma block anesthesia...
May 2018: Plastic Surgery
Hongqi Yang, Qing Lei, Lihong Cai, Feng Liu, Weili Zhou, Song Chen, Li Chen, Tangyou Liu, Minghui Jiang, Kang Wang, Sishun Xiao, Wenqian Liu
Objective: To evaluate the effectiveness of unstable pelvic fractures treated by cannulated screw internal fixation with the assistance of three-dimensional (3D) printing insertion template. Methods: The clinical data of 10 patients who underwent surgical treatment for unstable pelvic fractures by cannulated screw internal fixation with the assistance of 3D printing insertion template between May 2015 and June 2016 were retrospectively analysed. There were 7 males and 3 females with an average age of 37...
February 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Xiaohai Yang, Feng Xu, Zifei Yin, Qing Wang
Objective: To summarize the effectiveness of 3.5 mm T support plate fixation for simple postero-lateral tibial plateau fractures by posterolateral inverted L-shaped approach. Methods: Between March 2011 and January 2016, 13 patients with simple posterolateral tibial plateau fracture were treated with 3.5 mm T support plate fixation by posterolateral inverted L-shaped approach. Of 13 cases, 6 were male and 7 were female, aged 28 to 52 years (mean, 43 years). The left side was involved in 5 cases and the right side in 8 cases...
July 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Alexander Yang, Zach Folzenlogen, A Samy Youssef
Modern surgical approaches are becoming more minimalistic, associated with the term 'minimally invasive'. The endoscope provides a more panoramic anatomical view in addition to the ability to access narrow deep corners with decent illumination and clear visualization. Endoscopic assisted microsurgery through a tailored small craniotomy is the foundation of keyhole surgery. The endoscope can be advanced deeper into the field, thus enhancing an exposure and allowing bimanual dissection, thus prompting smaller craniotomies and tailored key exposures...
May 22, 2018: Journal of Neurosurgical Sciences
Giampietro Ricci, Arianna Di Stadio, Luca D'Ascanio, Ruggero La Penna, Franco Trabalzini, Antonio Della Volpe, Jacques Magnan
INTRODUCTION: The use of surgical decompression of facial hemispasm due to the loop in the internal auditory canal is not always accepted due to the risk related to the surgical procedure. Currently a new surgical technique allows surgeons to work in safer conditions. OBJECTIVE: To report the results with endoscope-assisted retrosigmoid approach for facial nerve microvascular decompression in hemifacial spasm due to neurovascular conflict. The surgical technique is described...
May 9, 2018: Brazilian Journal of Otorhinolaryngology
M Sindou, P Mercier
Primary hemifacial spasm with few exceptions is due to the vascular compression of the facial nerve that can be evidenced with high resolution MRI. Microvascular decompression is the only curative treatment for this pathology. According to literature review detailed in chapter "conflicting vessels", the compression is located at the facial Root Exit Zone (REZ) in 95% of the cases, and in 5% distally at the cisternal or the intrameatal portion of the root as the sole conflict or in addition to one at brainstem/REZ...
May 18, 2018: Neuro-Chirurgie
Daniel Handy Eone, Prudence Christelle Danielle Ngono, Marie Josée Essi, Gaël Leckpa, Kennedy Olivier Muluem, Farikou Ibrahima, Maurice Aurélien Sosso
CONTEXT: Humeral plating osteosynthesis is controversial, particularly regarding the choice between anterior and lateral approach, data for which in the context of a low-income country are lacking. HYPOTHESIS: The anterior approach is an easy surgical technique, allowing good anatomic reconstruction. We hypothesize that the anterior approach is associated with fewer neurovascular lesions and functional sequelae than the lateral approach. MATERIALS AND METHODS: A retrospective study with assessment update was carried out over a period of 6 years 4 months from January 2010 to June 2016, with consecutive recruitment in the city of Yaoundé, Cameroon...
May 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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