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At least 271 records · Page 15Linked to original sources
PubMed1994

Desepiphysiodesis--elimination of partial premature epiphyseal closure. Experience of 17 cases.

Between 1975 and 1990, 17 growth plates have been operated on by epiphyseal bridge resection. The children were from 4 years and 10 months to 13 years and 10 months old. The etiology of partial closure was traumatic (10 times), caused by therapeutic mistakes (3 times), septic osteomyelitis (1 case), purpura fulminans (1 case), unknown (2 cases). There was always length discrepancy or deformity of bone. The regions that have been subjected to treatment were distal femur, proximal tibia, distal tibia, distal radius. Evaluation of the bone bridge was made by tomoscintigraphies and recently by MR imaging and computed tomoscintigraphy. The bone bridge size was from 2.5% to 60% of the growth plate surface; surgical technique consists of resection of bone bridge connecting epiphysis and metaphysis which is replaced by methyl metacrylate. In 16 cases simultaneous corrective osteotomy was performed. Results are poor, there were only two good results and 8 failures; seven results were medium. The failures can all be explained by mistakes in technique or indication, except one. Indications are post-traumatic narrow bridges in young children. It would be useful to know the vitality of the residual growth plate.

Adolescent↗
PubMed1983

Strains and sprains in athletes.

Although often considered "minor" injuries, strains and sprains are the leading cause of time lost from athletics due to injury. Trainers, coaches, and physicians other than orthopedic surgeons are usually called on to manage these injuries and thus need to be aware of proper methods of diagnosis and treatment. Because of the tendency of these injuries to recur, treatment must be followed by adequate rehabilitation. Muscle sprains, in particular, require strengthening exercises to prevent recurrences.

Acromioclavicular Joint↗
PubMed2004

The effect of tibial curvature and fibular loading on the tibia index.

The tibia index (TI) is commonly used to predict leg injury based on measurements taken by an anthropomorphic test device (ATD). The TI consists of an interaction formula that combines axial loading and bending plus a supplemental compressive force criterion. Current ATD lower limbs lack geometric biofidelity with regard to tibial curvature and fibular load-sharing. Due to differences in tibial curvature, the midshaft moments induced by axial loading are different in humans and ATDs. Midshaft tibial loading in the human is also reduced by load-sharing through the fibula, which is not replicated in current ATDs. In this study, tibial curvature and fibular load-sharing are quantified through CT imaging and biomechanical testing, and equations are presented to correct ATD measurements to reflect the loading that would be experienced by a human tibia.

Adult↗
PubMed1981

The management of lower extremity degloving injuries.

Successful treatment of massive degloving lower extremity requires a flexible approach with adherence to basic surgical principles. There should be aggressive therapy with extensive debridement guided by direct observation and fluorescein vital dye staining. Wound closure, either primary or delayed, should be carried out using autogenous tissues when local and systemic tissue conditions permit.

Adolescent↗
PubMed1990

The lateral genicular artery flap.

A method for reconstruction of skin defects around the knee using the lateral genicular artery flap is presented. This flap is supplied mainly by the cutaneous perforator of the superior lateral genicular artery. On the basis of ten cadaver dissections, we found that the nutrient artery is reliable, penetrates the deep fascia at a small triangular area surrounded by the lateral femoral condyle, the vastus lateralis, and the short head of the biceps femoris, and anastomoses predominantly with the lateral perforators of the profunda femoris artery in the midlayer of the subcutaneous fatty tissue. This flap can be safely extended to the midpoint between the lateral femoral condyle and the greater trochanter.

Adult↗
PubMed1984

Wounding potential of the Russian AK-74 assault rifle.

The Russian contribution to the new generation of smaller caliber assault rifles is the AK-74, whose 5.61-mm (diameter), 3.4-gm (weight), 2.5-cm (length) aerodynamically shaped bullet has a muzzle velocity of 900 m/s. Our tests show that in living swine soft tissues and gelatin tissue simulant the AK-74's copper-plated steel jacket resists fragmentation or deformation. Since the bullet does not fragment, the tissue disruption surrounding the bullet pathway is limited to the stretching effect of temporary cavitation. We present evidence indicating that the energy used during temporary cavity formation causes limited permanent tissue disruption in the more elastic soft tissues (muscle, bowel wall, lung); the same insult in the relatively nonelastic liver, however, causes multiple fractures and massive permanent disruption. We conclude that the AK-74, despite its rather high velocity and marked tendency to yaw soon after penetration, causes relatively nondramatic wounds due to its nonfragmenting behavior.

Abdominal Injuries↗
PubMed1993

Rehabilitation of patients after lower limb replantations by the bone distraction method.

The length of the lower extremities was equalized by the bone distraction method in four patients after replantation of lower legs. A Volkov-Oganesian or Ilizarov distraction apparatus was applied on the replanted lower leg after corticotomy of the tibia and osteotomy of the fibula, and distraction was carried out over 6 to 11 months in small, measured doses. The lower extremities were lengthened from 4 to 8 cm. The lengths of the lower extremities were fully equalized in two patients; they were partially equalized in the other two patients. This made it possible to achieve successful rehabilitation of the patients after lower limb replantation.

Adolescent↗
PubMed1979

Management of compound injuries of the lower extremity.

The reconstructive surgeon experienced in the use of rotated or free muscle and myocutaneous flaps, skilled in microvascular surgery, and interested in lower extremity trauma, may favorably alter the course of management of these historically difficult problems. It can be of great advantage to the patient if this surgeon is involved in the primary evaluation, so that all initial therapy can be performed with the future reconstructive goals in mind.

Adolescent↗
PubMed1979

Tropical ulcers.

We present 87 cases of chronic leg ulcers. The ages and sexes of the patients, and the symptomatology and complications, are described. The term "tropical ulcer" is inappropriate for these cases--though the term may be appropriate for certain rare acute ulcers colonized by Vincent's bacilli. For most persistent leg ulcers in the tropics, however, a general term of chronic ulcer is better--because it stimulates one to look for the cause and to treat the patient accordingly.

Adolescent↗
PubMed1979

The free latissimus dorsi myocutaneous flap.

The general anatomy and the detailed vascular anatomy of the latissimus dorsi myocutaneous flap is described, and its use as a free flap is illustrated. The speed and ease with which it can be raised, its long vascular pedicle, the large diameter of the donor vessels, and the potentially large size of the flap are emphasized.

Adult↗
PubMed1982

Bipedicle gastrocnemius musculocutaneous flap for defects of the distal one-third of the leg.

A bipedicle gastrocnemius musculocutaneous flap has been designed to cover soft-tissue defects over the lower one-third of the tibia. The flap, which consists of the entire medial or lateral half of the posterior leg skin and the underlying gastrocnemius muscle, combines the advantages of the axial-pattern blood supply of a musculocutaneous flap and the dual blood supply to a bipedicle flap. The augmented circulation from the proximal end of the flap allows the distal pedicle to be narrowed and advanced anteriorly in one stage without jeopardizing the blood supply. Bipedicle gastrocnemius musculocutaneous flaps are best suited for moderate-sized defects over the anterior lower one-third of the leg. Indications for use of the flap are presented.

Adult↗
PubMed1989

Free-flap coverage of the exposed Achilles tendon.

Posterior skin loss of the distal lower leg enhances the risk of exposure of the Achilles tendon. Most commonly, these wounds are a sequela to peripheral vascular insufficiency or else posttraumatic in origin. As a consequence, local flaps or skin grafts frequently are inadequate options for achieving coverage. Free-tissue transfers have proven to be a reasonable alternative in these situations for preservation of tendon function or even limb salvage. In this series of 12 patients, small defects were best covered with fasciocutaneous flaps, whereas the larger and usually chronic, concomitantly suppurating wounds required muscle flaps. Eighty-three percent (10 of 12) of patients remained ambulatory with healed wounds, obviating the need for extremity amputation.

Adolescent↗
PubMed1992

Use of a calf prosthesis and tissue expansion in aesthetic reconstruction of the leg.

We present a technique for reconstruction of the legs in patients with soft-tissue loss and formation of large scars with retraction of this tissue in the pretibial region. In such patients, a subcutaneous tissue expander is placed in the region adjacent to the scar tissue. With expansion, we obtained sufficient skin for use in the reconstruction, and the resulting asymmetry in leg diameter was compensated for by means of one or two calf prostheses, depending on the patient.

Adult↗
PubMed1995

Versatility of a cross-leg free rectus abdominis flap for leg reconstruction under difficult and unfavorable conditions.

A cross-leg free rectus abdominis flap, anastomosing to utilized "carrier" vessels of the contralateral noninjured leg, was used for reconstruction in six cases of extensive traumatic defects and deformities of a lower extremity. This method provides great advantages in free-flap reconstruction of complicated and unfavorable cases in which utilization of what would be suitable recipient vessels in the injured leg is most difficult, but there is good blood circulation of the leg.

Adult↗