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https://www.readbyqxmd.com/read/28938392/segmental-bone-loss-reconstruction-using-ring-fixation
#1
Stephen M Quinnan
Ring fixation is a powerful tool in the treatment of bone defects. The ability to create high-quality, biologically normal new bone of even massive proportions using distraction osteogenesis is a major reason for its success. In addition, ring fixation provides the ability to limit the risk of deep infection, improves flexibility in limb length control and alignment, and increases soft tissue coverage options. The drawbacks of ring fixation include long frame times, pin problems, risk of joint contractures, and difficult usage in areas with a large soft tissue envelope such as the thigh...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938362/muscle-versus-fasciocutaneous-free-flaps-in-lower-extremity-traumatic-reconstruction-a-multicenter-outcomes-analysis
#2
Eugenia H Cho, Ronnie L Shammas, Martin J Carney, Jason M Weissler, Andrew R Bauder, Adam D Glener, Stephen J Kovach, Scott T Hollenbeck, L Scott Levin
PURPOSE: Clinical indications are expanding for the use of fasciocutaneous free flaps in lower extremity traumatic reconstruction. We assessed the impact of muscle versus fasciocutaneous free flap coverage on reconstructive and functional outcomes. METHODS: A multicenter retrospective review was conducted on all lower extremity traumatic free flaps performed at Duke University (1997-2013) and the University of Pennsylvania (2002-2013). Muscle and fasciocutaneous flaps were compared in two subgroups (acute trauma and chronic traumatic sequelae), according to limb salvage, return to ambulation, flap outcomes, and secondary flap procedures...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28938286/optimizing-bone-defect-reconstruction-balanced-cable-transport-with-circular-external-fixation
#3
Stephen Matthew Quinnan, Charles Lawrie
Distraction osteogenesis has proven effective in the management of tibial bone loss from severe trauma and infection. Unfortunately, pain and scarring from wires and half pins dragging through the skin and the required prolonged time in the external fixator make treatment difficult. Cable bone transport has been shown to improve cosmesis and decrease pain during transport. However, the published methods have limitations in that they have poor control of transport segment alignment, do not allow for lengthening of the limb, and do not permit weight bearing during the treatment process...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28935331/modified-ravitch-procedure-for-left-poland-syndrome-combined-with-pectus-excavatum
#4
Gildardo Cortés-Julián, Hussein B Bushra-Nuritu, Renata Buenfil-Fuentes, José A Merino Rajme
Poland Syndrome is a rare disease with an incidence of 1 in 30,000. This disease is characterized by agenesis of the pectoralis major, hypoplasia of mammarian tissue and the nipple complex, and limb abnormalities. The severe form of this disease can be associated with rib and sternal malformations like pectus excavatum. A 19-year-old man with severe Poland syndrome with cardiac extrasystoles and restrictive ventilation as shown by a spirometry test is presented. A total sternal reconstruction with partial osteotomies and bilateral resection of cartilage was performed...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28932876/effective-patellofemoral-joint-stabilization-and-low-complication-rates-using-a-hardware-free-mpfl-reconstruction-technique-with-an-intra-operative-adjustment-of-the-graft-tension
#5
Lars V von Engelhardt, Torsten Fuchs, Pia Weskamp, Joerg Jerosch
PURPOSE: Even if medial patellofemoral ligament (MPFL) reconstruction is a proven method, complications such as implant loosening, patella fractures, recurrent luxations, knee pain or knee stiffness are frequently described. Besides a correct tunnel positioning and implant-specific complications, this might be caused by difficulties with an appropriate graft tensioning. The study presented here is a necessary first step in exploring our technique of a double-limbed, hardware-free MPFL reconstruction, which provides another way to test and adjust the graft tension before permanent fastening...
September 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28928818/the-value-of-computer-assisted-navigation-for-bone-reconstruction-after-tumor-resection
#6
Xuejun Peng, Fengping Wang, Jing Su
This study was designed to evaluate the use of computer-assisted navigation with computed tomography (CT) images for bone reconstruction after resection in malignant bone tumor treatment. Forty-five patients with malignant bone tumors were recruited for this study. CT scan images in a computer-assisted navigation system were used to assist during the osteotomy, the pairing with allografts, and the monitoring of the allograft and joint lines to perform joint reconstruction. Our results show that osteotomy and allograft pairing were successful in all patients...
September 2017: Oncology Letters
https://www.readbyqxmd.com/read/28926380/osseointegrated-transtibial-implants-in-patients-with-peripheral-vascular-disease-a-multicenter-case-series-of-5-patients-with-1-year-follow-up
#7
MULTICENTER STUDY
Robin Atallah, Jiao Jiao Li, William Lu, Ruud Leijendekkers, Jan Paul Frölke, Munjed Al Muderis
BACKGROUND: Osseointegration is an alternative treatment for amputees who are unable to wear or have difficulty wearing a socket prosthesis. Although the majority of limb amputations are due to vascular disease, such amputations have been perceived as a contraindication to osseointegration surgery. We report the outcomes of osseointegrated reconstruction in a series of 5 patients with limb amputation due to peripheral vascular disease. METHODS: Five patients with transtibial amputation and a history of peripheral vascular disease who received an osseointegration implant from 2014 to 2015 were followed for 12 months...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#8
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28919498/accelerated-return-to-sport-after-acl-reconstruction-and-early-knee-osteoarthritis-features-at-1-year-an-exploratory-study
#9
Adam G Culvenor, Brooke E Patterson, Ali Guermazi, Hayden G Morris, Timothy S Whitehead, Kay M Crossley
BACKGROUND: A timely return to competitive sport is a primary goal of anterior cruciate ligament reconstruction (ACLR). It is not known if an accelerated return-to-sport increases the risk of early-onset knee osteoarthritis (KOA). OBJECTIVE: To determine whether an accelerated return-to-sport post-ACLR (i.e., <10 months) is associated with increased odds of early KOA features on MRI 1-year post-surgery, and to evaluate the relationship between an accelerated return-to-sport and early KOA features stratified by type of ACL injury (isolated or concurrent chondral/meniscal injury) and lower-limb function (good or poor)...
September 14, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28918506/young-athletes-after-acl-reconstruction-with-quadriceps-strength-asymmetry-at-the-time-of-return-to-sport-demonstrate-decreased-knee-function-1%C3%A2-year-later
#10
Matthew P Ithurburn, Alex R Altenburger, Staci Thomas, Timothy E Hewett, Mark V Paterno, Laura C Schmitt
PURPOSE: Quadriceps femoris (QF) strength deficits at return-to-sport (RTS) after ACL reconstruction (ACLR) contribute to decreased knee function at the same time point. However, the impact of QF strength at RTS on longitudinal function has not been examined. The purpose of this study was to test the hypothesis that young athletes after ACLR with QF strength asymmetry at RTS would demonstrate decreased knee-related function and lower proportions of functional recovery at 1 year post-RTS compared to young athletes following ACLR with nearly symmetric QF strength at RTS...
September 16, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28918266/nanomedicine-for-safe-healing-of-bone-trauma-opportunities-and-challenges
#11
REVIEW
Shahed Behzadi, Gaurav A Luther, Mitchel B Harris, Omid C Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing...
September 4, 2017: Biomaterials
https://www.readbyqxmd.com/read/28916871/strength-and-functional-symmetry-is-associated-with-post-operative-rehabilitation-in-patients-following-anterior-cruciate-ligament-reconstruction
#12
Jay R Ebert, Peter Edwards, Luke Yi, Brendan Joss, Timothy Ackland, Richard Carey-Smith, Jens-Ulrich Buelow, Ben Hewitt
PURPOSE: To investigate strength and functional symmetry during common tests in patients after anterior cruciate ligament reconstruction (ACLR), and its association with post-operative rehabilitation. METHODS: At a median 11.0 months post-surgery (range 10-14), 111 ACLR patients were assessed. A rehabilitation grading tool was employed to evaluate the duration and supervision of rehabilitation, as well as whether structured jumping, landing and agility exercises were undertaken...
September 15, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28902825/-treatment-of-patients-with-critical-lower-limb-ischaemia-endovascular-methods-or-reconstructive-operations
#13
A V Gavrilenko, A A Kravchenko, A É Kotov, D V Shatalova
Presented herein is a review of the literature related to endovascular methods of treatment of patients with critical lower limb ischaemia. This is followed by comparative assessment of the outcomes of endovascular and open surgical interventions. Also covered are problems concerning appropriate therapeutic decision making, taking into consideration peculiarities of lower limb ischaemia and the state at the expense of insufficiency of inflow/outflow.
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28893848/a-review-of-10-years-of-scapula-injuries-sustained-by-uk-military-personnel-on-operations
#14
Darren C Roberts, D M Power, S A Stapley
BACKGROUND: Scapula fractures are relatively uncommon injuries, mostly occurring due to the effects of high-energy trauma. Rates of scapula fractures are unknown in the military setting. The aim of this study is to analyse the incidence, aetiology, associated injuries, treatment and complications of these fractures occurring in deployed military personnel. METHODS: All UK military personnel returning with upper limb injuries from Afghanistan and Iraq were retrospectively reviewed using the Royal Centre for Defence Medicine database and case notes (2004-2014)...
September 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28892671/kinematic-and-kinetic-gait-deviations-in-males-long-after-anterior-cruciate-ligament-reconstruction
#15
Giovanni Milandri, Mike Posthumus, T J Small, Adam Bothma, Willem van der Merwe, Reshma Kassanjee, Sudesh Sivarasu
BACKGROUND: Biomechanical deviations long (approx. 5years) after anterior cruciate ligament reconstruction have not been quantified in males, despite their distinct risk profile as compared to females. These deviations can indicate altered joint loading during chronic, repetitive motions. METHODS: Cross-sectional study, comparing kinematic and kinetic variables between 15 male anterior cruciate ligament reconstructed patients and 15 healthy controls. During walking and running gait, measurements were taken of impact dynamics, knee and hip sagittal plane angles and moments, and knee varus angles and adduction moments...
July 29, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28890311/pancreatoduodenectomy-after-roux-en-y-gastric-bypass-technical-considerations-and-outcomes
#16
June S Peng, Ricard Corcelles, Kevin Choong, Matthew Poturalski, Namita Gandhi, R Matthew Walsh, Jeffrey M Hardacre, Stacy A Brethauer, Gareth Morris-Stiff
BACKGROUND: Patients with altered anatomy due to Roux-en-Y gastric bypass (RYGB) present unique diagnostic and therapeutic challenges when they present with periampullary pathology. We describe a series of patients who underwent pancreatoduodenectomy (PD) after gastric surgery with Roux-en-Y reconstruction and review the literature to highlight technical considerations and outcomes. METHODS: Patients from two institutions were identified and data regarding preoperative workup, operative conduct, and pathologic and clinical outcomes were collected...
September 7, 2017: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/28890027/cryopreserved-cadaveric-arterial-allograft-for-arterial-reconstruction-in-patients-with-prosthetic-infection
#17
Anne Lejay, Charline Delay, Elie Girsowicz, Bettina Chenesseau, Emilie Bonnin, Mohamed-Zied Ghariani, Fabien Thaveau, Yannick Georg, Bernard Geny, Nabil Chakfe
OBJECTIVE: The aim of this study was to report outcomes of cryopreserved arterial allografts used as a vascular substitute in the setting of prosthetic material infection. METHODS: A retrospective analysis of prospectively collected data was conducted including all consecutive interventions performed with cryopreserved arterial allografts used for vascular reconstruction in the setting of prosthetic material infection between January 2005 and December 2014. Five year outcomes included allograft related re-interventions, survival, primary patency, and limb salvage rates...
September 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28888305/tissue-rearrangements-the-power-of-the-z-plasty
#18
REVIEW
Gabriel Hundeshagen, Ramón Zapata-Sirvent, Jeremy Goverman, Ludwik K Branski
The z-plasty is a highly versatile standard technique of reconstructive burn surgery. Variations of the classic z-plasty with limbs of equal length at 60° angles can accommodate specific reconstruction needs. Opposing z-plasties can be used when available tissue is limited; series of z-plasties can be linked to elongate tissue over a longer distance with smaller individual incisions, and a z-plasty with varying limb angles and lengths can provide tissue coverage in areas with special distributions of scarred and normal skin...
October 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28887648/evaluation-of-donor-site-morbidity-after-medial-triceps-brachii-free-flap-for-lower-limb-reconstruction
#19
A Delgove, R Weigert, V Casoli
INTRODUCTION: The medial head of the triceps brachii muscle (MTB)-free flap is an attractive solution to cover small-to-medium defects of the lower limb. This muscular head has no well-identified function, suggesting minimal impact of its removal on elbow mobility. The aim of this study was to evaluate the safety and reliability of the harvest procedure and the functional and cosmetic morbidity of this donor site. MATERIALS AND METHODS: Twenty-four consecutive MTB-free flaps were performed for reconstructive surgery of the lower limb between 2011 and 2015...
September 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28886390/vascularized-fibular-graft-as-a-surgical-option-for-osteosarcoma-of-distal-humerus-a-case-report
#20
Achmad Fauzi Kamal, Anggaditya Putra, Wahyu Widodo
INTRODUCTION: Distal humerus is a very rare predilection site of osteosarcoma. Limb salvage surgery has widely replaced amputation for surgical treatment of most types of malignant bone sarcomas. PRESENTATION OF CASE: We presented a 42 years old male with rapidly growing osteosarcoma on his right distal humerus. After induction chemotherapy, wide excision and reconstruction using free vascularized fibular graft followed with interpositional elbow arthroplasty technique was done...
August 23, 2017: International Journal of Surgery Case Reports
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