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limb reconstruction

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https://www.readbyqxmd.com/read/27913804/restoration-of-shoulder-abduction-in-brachial-plexus-avulsion-injuries-with-double-neurotization-from-the-spinal-accessory-nerve-a-report-of-13-cases
#1
K W S J Huan, J S W Tan, S H Tan, L C Teoh, F C Yong
: In upper (C5-C7) and total (C5-T1) root avulsion brachial plexus injury, a method of double neurotization from a single donor spinal accessory nerve to two target nerves (suprascapular nerve and axillary nerve) may be done, leaving donor nerves available for reconstruction procedures to restore other aspects of upper limb function. A mean range of shoulder abduction of 91° (SD 25°) was achieved through this procedure in our study of 13 cases, of which seven cases were C5-C7 root avulsion and six cases were C5-T1 root avulsion brachial plexus injuries...
December 1, 2016: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/27912929/survival-failure-modes-and-function-of-combined-distal-femur-and-proximal-tibia-reconstruction-following-tumor-resection
#2
F Sevelda, W Waldstein, J Panotopoulos, C Stihsen, A Kaider, P T Funovics, R Windhager
BACKGROUND: Tumor spread to the knee joint or skip metastasis to the adjacent bones of the knee require reconstruction with combined distal femur and proximal tibia replacements. The literature on implant survival and failure modes with this type of reconstruction is sparse. The goals of this study were to determine the implant survival, the different failure modes and the functional outcome of this megaendoprosthetic reconstruction. PATIENTS AND METHODS: Thirty-nine patients with combined distal femur and proximal tibia reconstruction were retrospectively reviewed...
November 23, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27909861/surgical-reconstruction-for-fibular-hemimelia
#3
REVIEW
Dror Paley
Fibular hemimelia presents with foot deformity and leg length discrepancy. Previous classifications have focused on the degree of fibular deficiency rather than the type of foot deformity. Published methods of surgical reconstruction have often failed due to residual or recurrent foot deformity. The purpose of this report is to introduce new classification and reconstruction methods. The Paley SHORDT procedure is used to stabilize the ankle when there is a hypoplastic distal fibula with a dynamic valgus deformity...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909860/tibial-hemimelia-new-classification-and-reconstructive-options
#4
REVIEW
Dror Paley
Tibial hemimelia is a rare congenital lower limb deficiency presenting with a wide spectrum of associated congenital anomalies, deficiencies and duplications. Reconstructive options have been limited, and the gold standard for treatment has remained amputation with prosthetic fitting. There is now a better understanding of the genetics, etiology and pathoanatomy of tibial hemimelia. Armed with this knowledge, I present here a new classification to guide treatment and prognosis and then discuss new treatment strategies and techniques for limb reconstruction based on this new classification scheme...
December 1, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27909130/the-use-of-ultra-low-dose-ct-scans-for-the-evaluation-of-limb-fractures-is-the-reduced-effective-dose-using-ct-in-orthopaedic-injury-reduction-protocol-effective
#5
S R Konda, A M Goch, P Leucht, A Christiano, S Gyftopoulos, G Yoeli, K A Egol
AIMS: To evaluate whether an ultra-low-dose CT protocol can diagnose selected limb fractures as well as conventional CT (C-CT). PATIENTS AND METHODS: We prospectively studied 40 consecutive patients with a limb fracture in whom a CT scan was indicated. These were scanned using an ultra-low-dose CT Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury (REDUCTION) protocol. Studies from 16 selected cases were compared with 16 C-CT scans matched for age, gender and type of fracture...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27907934/restriction-of-postoperative-joint-loading-in-a-murine-model-of-anterior-cruciate-ligament-reconstruction-botulinum-toxin-paralysis-and-external-fixation
#6
Amir Lebaschi, Xiang-Hua Deng, Nathan W Coleman, Christopher L Camp, Jianchun Zong, Andrew Carbone, Camila B Carballo, Guang-Ting Cong, Zoe M Album, Scott A Rodeo
Control of knee motion in small animal models is necessary to study the effect of mechanical load on the healing process. This can be especially challenging in mice, which are being increasingly used for various orthopedic reconstruction models. We explored the feasibility of botulinum toxin (Botox; Allergan, Dublin, Ireland) paralysis and a newly designed external fixator to restrict motion of the knee in mice undergoing anterior cruciate ligament (ACL) reconstruction. Nineteen C57BL/6 mice were allocated to two groups: (1) Botox group (n = 9) and (2) external fixator group (n = 10)...
December 1, 2016: Journal of Knee Surgery
https://www.readbyqxmd.com/read/27903471/bovine-pericardium-as-new-technical-option-for-in-situ-reconstruction-of-aortic-graft-infection
#7
Brigitta Lutz, Christian Reeps, Gabor Biro, Christoph Knappich, Alexander Zimmermann, Hans-Henning Eckstein
OBJECTIVE: Alloplastic aortic graft infection is a devastating complication following aortic surgery. It is associated with excessively high mortality and morbidity caused by anastomotic rupture or septicemia. Many authors consider in situ replacement after complete surgical graft removal as the method of choice. However, there is an ongoing debate about the most suitable material for reconstruction. We present our first experiences with replacing the descending and infra-renal aorta using custom-made bovine pericardium grafts...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27900509/conversion-of-hip-fusion-to-total-hip-arthroplasty-clinical-radiological-outcomes-and-complications-in-40-hips
#8
Mustafa Celiktas, Ozkan Kose, Adil Turan, Ferhat Guler, Cagri Ors, Emre Togrul
OBJECTIVE: The purpose of this retrospective study is to report the clinical and radiological outcome of total hip arthroplasty in patients with previous hip arthrodesis. PATIENTS AND METHODS: We retrospectively reviewed 28 (40 hips) prospectively followed patients in whom ankylosed hips were converted to total hip arthroplasty (THA) between 2010 and 2014 in our institution. The average age at the time of the conversion operation was 40.8 ± 9.8 years (range 24-62)...
November 29, 2016: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/27895379/functional-outcomes-after-successful-lower-extremity-arterial-injuries-repair
#9
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/27886207/characteristic-tetrapod-musculoskeletal-limb-phenotype-emerged-more-than-400-mya-in-basal-lobe-finned-fishes
#10
Rui Diogo, Peter Johnston, Julia L Molnar, Borja Esteve-Altava
Previous accounts of the origin of tetrapod limbs have postulated a relatively sudden change, after the split between extant lobe-finned fish and tetrapods, from a very simple fin phenotype with only two muscles to the highly complex tetrapod condition. The evolutionary changes that led to the muscular anatomy of tetrapod limbs have therefore remained relatively unexplored. We performed dissections, histological sections, and MRI scans of the closest living relatives of tetrapods: coelacanths and lungfish. Combined with previous comparative, developmental and paleontological information, our findings suggest that the characteristic tetrapod musculoskeletal limb phenotype was already present in the Silurian last common ancestor of extant sarcopterygians, with the exception of the autopod (hand/foot) structures, which have no clear correspondence with fish structures...
November 25, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27884329/saphenous-artery-based-flap-models-in-rats-new-flap-designs-for-experimental-studies
#11
Ersin Aksam, Berrak Aksam, Mustafa Erol Demirseren, Huban Sibel Orhun Yavuz
BACKGROUND: Experimental research using laboratory animals provides substantial data about reconstructive surgery. However, the literature does not include any experimental studies that have used flap models on the hind limbs of rats. To gain an understanding of the physiology of lower-extremity flaps and of flap failures, this study assessed the cutaneous perforators of the saphenous artery, and new flap models were designed for the hind limbs of rats. MATERIALS AND METHODS: The experiment was designed to include three stages and used 35 rats...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27876350/a-solution-to-the-vessel-shortage-during-free-vascularized-fibular-grafting-for-reconstructing-infected-bone-defects-of-the-femur-bridging-with-vein-transplantation
#12
Ren Gao-Hong, Li Run-Guang, Jiang Gui-Yong, Chen Chao-Jie, Bao Zhi-Gang
PURPOSE: The present study aimed to evaluate the feasibility and clinical efficacy of bridging vein transplantation to deal with the vessel shortage during free vascularized fibular grafting for reconstructing infected bone defects of the femur. METHODS: Twelve patients (aged 15-58 years) with infected bone defects of the femur (between 6.0 and 18.0cm) were recruited in this study. Vacuum sealing drainage were applied after extensive debridement of the infected bone defects and irrigated with 0...
October 22, 2016: Injury
https://www.readbyqxmd.com/read/27872726/reconstruction-of-long-digital-extensor-tendon-by-cranial-tibial-muscle-fascia-graft-in-a-dog
#13
Behrokh Marzban Abbasabadi, Aliakbar Ahmadzadeh, Shahab Ramezanpour, Amir Reza Hajati Ziabari
Tendon rupture in dogs is generally the result of a direct trauma. This report described the use of adjacent muscle autogenic fascial graft for reconstruction of distal rupture of long digital extensor tendon in a dog. A two-year-old male mix breed dog, was presented with a non-weight bearing lameness of the right hind limb and a deep rupture of lateral side of right tarsus. History taking revealed that this rupture appeared without any apparent cause, when walking around the farm, three days before. Radiography was done and no fracture was observed...
2016: Veterinary Research Forum
https://www.readbyqxmd.com/read/27871660/management-of-the-anterior-cruciate-ligament-injured-knee-in-the-skeletally-immature-athlete
#14
REVIEW
Christian N Anderson, Allen F Anderson
Intrasubstance tears of the anterior cruciate ligament (ACL) are being diagnosed with increasing frequency in the skeletally immature. Management options include nonoperative/ early surgical, or delayed surgical reconstruction. Nonoperative/delayed reconstruction results in worse functional outcomes than early reconstruction. Physicians are faced with a treatment dilemma; clinical and basic science studies have demonstrated risk of limb-length discrepancy and angular deformity with ACL reconstruction. Vertical drill tunnels decrease physeal damage and minimize growth deformity; however, this technique results in nonanatomic ACL graft placement...
January 2017: Clinics in Sports Medicine
https://www.readbyqxmd.com/read/27865314/surgical-treatment-options-for-the-diabetic-charcot-midfoot-deformity
#15
REVIEW
Yousef Alrashidi, Thomas Hügle, Martin Wiewiorski, Mario Herrera-Perez, Victor Valderrabano
Management of diabetic Charcot midfoot deformity is one of the most demanding aspects of foot and ankle surgery. Its treatment should aim at reducing the rate of complications, including foot and ankle amputations or limb loss. Attempting reconstruction at Eichenholtz stages I and II carries the risk of infection and loss of fixation. It is advisable to limit surgical reconstruction to Eichenholtz stage III in the absence of any evidence of infection or vascular insufficiency. Achilles lengthening or gastrocnemius-soleus release is an essential initial step in surgery...
January 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/27864460/use-of-the-octopus-endograft-technique-to-reconstruct-renovisceral-arteries-arising-from-the-false-lumen-of-a-rapidly-expanding-type-b-aortic-dissection-after-endovascular-repair
#16
Jiang Xiong, Yangyang Ge, Xiaoping Liu, Lijun Wang, Wei Guo
PURPOSE: To describe the use and 6-month outcomes of the octopus endograft technique to reconstruct renovisceral arteries arising from the false lumen (FL) of a type B aortic dissection after thoracic endovascular aortic repair (TEVAR). CASE REPORT: A 46-year-old man post TEVAR for type B aortic dissection was admitted with persistent back pain and a rapidly expanding residual dissection. The celiac and left renal arteries arose from the FL and the superior mesenteric artery from both lumens, with the FL as its main supply...
November 17, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27863500/simultaneous-reconstruction-of-the-bone-and-vessels-for-complex-femoral-defect
#17
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/27861256/nonmodifiable-risk-factors-for-anterior-cruciate-ligament-injury
#18
Meghan J Price, Maria Tuca, Frank A Cordasco, Daniel W Green
PURPOSE OF REVIEW: As anterior cruciate ligament (ACL) injury is becoming increasingly prevalent in the population of active children and young adolescents, it is crucial to be aware of both the modifiable and nonmodifiable factors that place this population at increased ACL injury risk. Historically, there has not been a definitive consensus on all of these risk factors-particularly the nonmodifiable ones. RECENT FINDINGS: The present review has accumulated the most recent evidence for the nonmodifiable risk factors in ACL injury focusing particularly on female gender, generalized joint laxity, knee recurvatum, increased lateral tibial slope, decreased intercondylar notch width, structural lower extremity valgus, limb length discrepancy, family history, and history of contralateral knee ACL injury...
November 16, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27858399/a-modified-chemical-protocol-of-decellularization-of-rat-sciatic-nerve-and-its-recellularization-with-mesenchimal-differentiated-schwann-like-cells-morphological-and-functional-assessments
#19
M M García-Pérez, H G Martínez-Rodríguez, G G López-Guerra, A Soto-Domínguez, S L Said-Fernández, R Morales-Avalos, R E Elizondo-Omaña, R Montes-de-Oca-Luna, S Guzmán-López, M L Castillo-Galván, O F Mendoza-Lemus, F Vílchez-Cavazos
The functional reconstruction of large neural defects usually requires the use of peripheral nerve autografts, though these have certain limitations. As a result, interest in new alternatives for autograft development has risen. The acellular peripheral nerve graft is an alternative for peripheral nerve injury repair, but to date there is not a standardized chemical decellularization method widely accepted. The objective of this study was to propose a modified chemical protocol of decellularization of rat sciatic nerve and its recellularization in vitro with mesenchimal differentiated Schwann-like cells...
November 18, 2016: Histology and Histopathology
https://www.readbyqxmd.com/read/27856964/neonatal-satellite-cells-form-small-myotubes-in-vitro
#20
P L Carvajal Monroy, S Grefte, A M Kuijpers-Jagtman, J W Von den Hoff, F A D T G Wagener
Although palatal muscle reconstruction in patients with cleft palate takes place during early childhood, normal speech development is often not achieved. We hypothesized that the intrinsic properties of head satellite cells (SCs) and the young age of these patients contribute to the poor muscle regeneration after surgery. First, we studied the fiber type distribution and the expression of SC markers in ex vivo muscle tissue from head (branchiomeric) and limb (somite-derived) muscles from neonatal (2-wk-old) and young (9-wk-old) rats...
November 16, 2016: Journal of Dental Research
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