Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “FASCIA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

Fascia iliaca compartment block for femoral bone fractures in prehospital care.

BACKGROUND AND OBJECTIVES: The fascia iliaca compartment block provides a faster and more consistent simultaneous blockade of the lateral cutaneous and femoral nerves than the "3 in 1" block. We studied the effectiveness of this technique for analgesia after a femoral bone fracture in pre-hospital care. METHODS: Patients with an isolated femoral shaft fracture were included. A fascia iliaca compartment block was performed on all of them. Twenty milliliters of lidocaine 1.5 % with epinephrine were injected under the fascia iliaca. The intensity of pain was measured using a simplified verbal scale (SVS) from 0 (no pain) to 4 (extreme pain). The SVS was noted before the block was performed, 10 minutes later, and then on admission to the trauma care center. Sensory blockade was evaluated using cold perception in the lateral, medial, and internal part of the thigh 10 minutes after block performance and on arrival at the trauma care center. RESULTS: Twenty-seven patients were enrolled in this study. The SVS was 3 (3-4) before the block, 1 (0-2) 10 minutes after the block, and 0 (0-1) when arriving at the trauma care center (P <.05). The SVS was lower when the internal part of the thigh was blocked. CONCLUSION: The fascia iliaca compartment block is a simple, inexpensive, and effective method of prehospital analgesia for femoral shaft fracture. A sensory block of the internal part of the thigh is an early predictive sign of optimal pain relief.

Adult↗
PubMed1994

Microneurovascular transfer of the tensor fascia lata musculocutaneous flap for reconstruction of the tongue.

The tensor fascia lata musculocutaneous flap has been successfully transferred for coverage of the groin, abdomen, and thigh regions. After free transfer, it has demonstrated both muscle reinnervation and sensibility. The current study presents anatomical dissections and five clinical cases of innervated tensor fascia lata musculocutaneous flap transfer for immediate reconstruction of subtotal glossectomy defects after carcinoma extirpation. Clinical evaluation 10 to 24 months postoperatively with oral pressure measurement, electromyography, cineradiography, and speech analysis demonstrated adequate bulk and both sensory and motor function. Speech and swallowing were superior to those in patients whose defects were repaired by primary closure and pectoralis major musculocutaneous flaps. Tensor fascia lata reconstructions showed superior tongue-palate and tongue-pharynx contact and improved oral functional rehabilitation. We believe the tensor fascia lata musculocutaneous flap is ideal for reconstruction of total or partial glossectomy defects because of its appropriate bulk and reinnervation.

Adult↗
PubMed1997

Effect of cutting the plantar fascia on mechanical properties of the foot.

A biomechanical model was used to calculate the loadbearing characteristics of the plantar fascia and to determine the effect of cutting the plantar fascia on the stiffness of the foot. With a load of 683 N applied to the foot, the model predicted a 17% increase in vertical displacement and a 15% increase in horizontal elongation when the plantar fascia was cut, compared with the corresponding value when the plantar fascia was intact. Plantar fasciotomy, although clinically satisfactory in cases of recalcitrant heel pain, decreases the stiffness of the foot and creates a less rigid and more deformable arch. The biomechanical model described can help to evaluate the possible outcome of such a procedure.

Elasticity↗
PubMed1997

Human fascia dentata anatomy and hippocampal neuron densities differ depending on the epileptic syndrome and age at first seizure.

This study determined fascia dentata anatomy and hippocampal neuron densities in patients with different epileptic syndromes. Based on presurgical data, patients were classified into: (a) pediatric patients (n=19); (b) temporal mass lesion cases (n=14); and (c) hippocampal sclerosis patients (n=31). Surgically removed hippocampi and autopsies (n=34) were studied for: (a) hippocampal neuron densities; (b) stratum granulosum (SG) widths and lengths; and (c) hilar areas. The number of granule cells and hilar neurons per tissue section were estimated from the neuron densities and fascia dentata area measurements. Results showed that compared with autopsies (p<0.05): (a) pediatric patients had similar SG and hilar areas; granule cell density was lower (but not hilar neuron density); and the estimated number of granule cells was lower (but not the number of hilar neurons); (b) the widths of SG and hilar areas were greater in mass lesion cases; the density of granule cells and hilar neurons was lower; and the total estimated numbers of granule cells and hilar neurons were similar to those of the autopsies; and (c) hippocampal sclerosis patients had wider, yet shorter SG; hilar areas were smaller; granule cell and hilar densities were lower; and the total estimated numbers of granule cells and hilar neurons were lower than those of the autopsy cases. The duration of the seizures did not correlate with lower fascia dentata neuron densities or estimates of total granule cell and hilar neurons. Furthermore, greater SG widths correlated with lower hilar and CA4 neuron densities, but not with age at first seizure or duration of epilepsy. These results indicate that the size of the fascia dentata SG and hilus along with hippocampal neuron densities differ between surgical patients with different epileptic syndromes, and a wider SG was associated with a lower density of end folium neurons. These findings support the hypothesis that hippocampal sclerosis and granule cell dispersion are not the consequence of repetitive seizures beginning at an early developmental age, but seem to differ depending on the type of epileptic syndrome.

Adolescent↗
PubMed1998

Island V-Y tensor fasciae latae fasciocutaneous flap for coverage of trochanteric pressure sores.

The distal fasciocutaneous portion of the lateral thigh is supplied by the direct cutaneous branch of the lateral descending branch of the lateral circumflex femoral artery and the third perforating artery of the deep femoral artery. This consistent vascular anatomy allows raising a distal skin island based on both arteries on the lateral thigh, and this flap can be advanced into a trochanteric defect according to the V-Y technique. Based on anatomic and clinical study, a new design has been developed of the tensor fasciae latae fasciocutaneous flap, which is supplied by two pedicles. Seven island V-Y tensor fasciae latae fasciocutaneous flaps have been used for the coverage of trochanteric pressure sores in six patients. It is believed that the island V-Y tensor fasciae latae fasciocutaneous flap could overcome the traditional drawbacks of the conventional tensor fasciae latae flap and its modifications, and this is an ideal flap for covering trochanteric pressure sores without any donor site deformity and morbidity, which greatly improves the aesthetic result.

Adult↗
PubMed2003

Transvaginal radio frequency treatment of the endopelvic fascia: a prospective evaluation for the treatment of genuine stress urinary incontinence.

PURPOSE: We evaluate the safety and efficacy of a new treatment modality for genuine stress urinary incontinence which was a transvaginal radio frequency applicator to deliver radio frequency energy to the endopelvic fascia. The purported mechanism of effect for this therapy is shrinkage of the collagenated tissue which composes the endopelvic fascia that supports the bladder neck and proximal urethra, thus stabilizing the proximal urethra and bladder neck. In prior animal trials and early pilot studies this therapy was shown to cause a reproducible thermal effect manifested by fascial shrinkage. Preliminary human trials indicated a therapeutic benefit of this therapy for women with genuine stress urinary incontinence. MATERIALS AND METHODS: To our knowledge this is the first multicenter study of a transvaginal approach for radio frequency of the endopelvic fascia for treatment of genuine stress incontinence. Between June 1999 and June 2000, 120 consecutive women (mean age 49.9 years) at 10 sites underwent transvaginal radio frequency treatment in a prospective trial to evaluate the overall efficacy and safety profile of this therapy. All patients had preoperative urethral hypermobility (average cotton swab change 38 degrees). Detrusor instability was excluded by cystometry. In all procedures precisely controlled radio frequency energy was applied to the endopelvic fascia to heat and shrink the tissue. The patients were evaluated postoperatively at 1 week and at 1, 3, 6 and 12 months using objective and subjective measures. Primary end points consisted of physician assessment of continence, patient reported pad use and the number of patient reported episodes. Safety was determined for acute (immediate postoperative) and chronic time frames. RESULTS: Of the 120 patients 96 completed 1-year evaluation. Average operative time was less than 30 minutes, and all patients were treated as outpatients. Preoperatively 101 patients (84%) averaged 1 or more episodes of urinary incontinence per day. At 3, 6 and 12 months 57%, 66% and 59% of patients, respectively, averaged 1 or no daily episodes of urinary incontinence. At 12-month followup 79 of 109 patients (73%) reported being continent or improved. Preoperatively, 43% of patients reported using 1 or no pads daily. At 3, 6 and 12 months 69%, 70% and 72% of patients, respectively, required 1 or no pads daily. On urodynamic evaluation at 12-month followup 76.0% of the patients did not leak with a Valsalva maneuver. A total of 30 cases were classified as failures and 11 women were lost to followup. There were no intraoperative complications, 3 (4%) minor postoperative complications which resolved, and no device related complications. CONCLUSIONS: The transvaginal radio frequency applicator demonstrated good efficacy and excellent safety at 1-year followup. Ongoing analysis of the data has indicated opportunities for improvement of this new surgical technique that could result in higher efficacy rates without compromising safety. Further long-term evaluation is being conducted to assess chronic durability of the procedure.

Catheter Ablation↗
PubMed2005

Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques.

PURPOSE: Anatomical nerve sparing radical prostatectomy provides excellent cancer control, although the recovery of sexual function is variable. We recently described a technique to preserve the prostatic fascia (veil of Aphrodite) that appears to enhance the quality of nerve preservation during robotic prostatectomy. In January 2003 we initiated a prospective study comparing patients undergoing prostatic fascia preservation with those undergoing conventional nerve sparing robotic radical prostatectomy. We report results at 12 months of followup MATERIALS AND METHODS: From January to August 2003, 58 potent men with a Sexual Health Inventory for Men score (SHIM) of greater than 21 without phosphodiesterase 5 inhibitors underwent Vattikuti Institute prostatectomy, including 35 with preservation of the prostatic fascia (study) and 23 with conventional nerve sparing (control). Potency was assessed with self-administered SHIM questionnaires 12 months after surgery. The primary end point was achievement of erections strong enough for penetration with or without oral medications. The secondary end point was the ability to achieve normal erections (SHIM greater than 21) with and without medications. RESULTS: At 12 months of followup 17 of 23 control (74%) and 34 of 35 study (97%) patients achieved erections strong enough for intercourse (p = 0.002). Four control (17%) and 18 study (51%) patients achieved normal erections (SHIM greater than 21) without medication (p <0.0001). Six control (26%) and 30 study (86%) patients achieved normal erections with or without phosphodiesterase 5 inhibitors (p <0.0001). CONCLUSIONS: Potency rates after radical prostatectomy vary with the measure used to define potency. Irrespective of the definition used patients undergoing prostatic fascia preserving radical prostatectomy have significantly better potency outcomes than patients undergoing conventional nerve sparing robotic prostatectomy at 12 months of followup.

Aged↗
PubMed2006

Articaine: an effective adjunctive local anesthetic for painless surgery at the depth of the muscular fascia.

BACKGROUND: Articaine is a unique amide anesthetic that contains a thiophene ring and an additional ester group. The rapid diffusion and enhanced tissue-penetrating properties of articaine enable its use for infiltrative anesthesia. OBJECTIVE: To describe the effective use of articaine as an adjuvant local anesthetic for surgical excisions requiring dissection at the level of the muscular fascia. METHODS AND MATERIALS: We discuss the successful adjunctive use of articaine to provide effective infiltrative anesthesia of muscular fascia. We review the composition, the pharmacologic properties, and the safety profile of articaine. RESULTS: Adjuvant local anesthesia using articaine results in painless surgery at the level of the muscular fascia without any perioperative complications. CONCLUSION: Articaine is not only well tolerated but also rapidly effective for anesthesia in the fascial plane of the trunk and extremities. We recommend it be considered as an adjunctive local anesthetic for consistently painless cutaneous surgery near the muscular fascia.

Adjuvants, Anesthesia↗
PubMed1994

Spatiotemporal relation between gap junctions and fascia adherens junctions during postnatal development of human ventricular myocardium.

BACKGROUND: The growing postnatal human heart maintains electromechanical function while undergoing substantial changes of cellular topology and myocardial architecture. The capacity for growth and remodeling of ventricular myocardium in adaptation to the hemodynamic changes of early infancy later declines. This decline is associated with changes in electromechanical properties of the myocardium, which suggest that the electrical and mechanical interactions between the myocytes may change in an age-dependent manner. Thus, reduction in the capacity for myocardial growth and adaptability may relate to age-dependent alterations in the patterns of the intercellular junctions that mediate electrical and mechanical coupling. We therefore examined the hypotheses that (1) age-dependent changes in the distribution patterns of gap junctions and fasciae adherentes, the intercellular junctions responsible, respectively, for electrical and mechanical coupling, accompany postnatal development in the human heart and that (2) such changes continue into the first few years of childhood. Further, the spatial relation between the two types of junction, for which a close association has been hypothesized as necessary, was explored. METHODS AND RESULTS: Ventricular myocardial gap-junction distribution was investigated in 23 pediatric surgical patients (4 weeks to 15 years old) by quantitative immunohistochemical localization of the principal cardiac gap-junctional protein, connexin43, using confocal microscopy. Immunolocalization of fascia adherens junctions by labeling N-cadherin, and correlative immunogold and standard electron microscopy, were performed in parallel. In the neonate, connexin43 gap junctions have a punctate distribution over the entire surface of the ventricular myocytes. With advancing age, gap junctions become progressively confined to the transverse terminals of the cell, ie, toward the distribution within the intercalated disk characteristic of the adult ventricle. The transversely arrayed proportion of gap-junctional label showed a linear increase with age (R = .88, P < .001), reaching the adult pattern at about 6 years, and the fascia adherens junctions showed a similar progression. Electron microscopy confirmed the changing pattern of junctional contacts and demonstrated that initially gap junctions and adhering junctions are frequently not closely adjacent but become increasingly so with maturation of the intercalated disk. CONCLUSIONS: Changes in the spatiotemporal patterns of the intercellular junctions responsible for electrical and mechanical coupling are closely coordinated in postnatal human ventricular myocardium and continue to about 6 years of age. Over this period there is a close and increasing association between the gap junctions and fascia adherens junctions. These changes in the distribution of intercellular electrical and adhering junctions may parallel the changing functional requirements of the ventricle, from a distribution that facilitates the remodeling necessitated by rapid growth and changing hemodynamics to that of the relatively stable and rapidly conducting adult myocardium. These age-related changes may also diminish the ability for appropriate myocardial remodeling in response to physiological, pathological, or surgical hemodynamic alterations.

Adolescent↗
PubMedDate not supplied

Use of the fascia sheath coverage and exogenous fibrin clot in the treatment of complex meniscal tears.

In a previous series, complex meniscal tears, including double flap, double longitudinal, and radial tears, there was reported a high failure rate (14 of 58 repairs, 24%) when treated by conventional arthroscopic repair techniques. There was only one tear in the anterior middle one-third of the lateral meniscus in this group. The use of a fascia sheath to cover the repaired area improves healing rates an additional 17% (from 75% to 92%) with these tear classifications, with the exception of radial split tears in the middle one-third of the lateral meniscus. The present repair technique includes rasp abrasion of the parameniscal synovium, peripheral white rim, and tear surface of the handle fragment. The meniscus is sutured with fully diverged sutures. A rectangle of fascia from the distal anterolateral thigh, trimmed to 25 x 35 to 40 mm, is prepared with the double-armed meniscus suture run along opposite sides. One or two "hold-down" sutures are tied to the superior and inferior main sutures. The four hold-down sutures from the corners and the previously placed hold-down sutures are pulled through the capsule with previously placed pull-through sutures to pull the fascia over the meniscal repair. The exogenous blood clot is injected in the tear under the sheath. This preliminary report suggests that improved healing rates can be obtained with most complex tears by meticulous meniscal repair followed by coverage with the fascia sheath and then exogenous clot injection. Repairs of tears in the middle one-third of the lateral meniscus still show a high failure rate.

Anterior Cruciate Ligament↗
PubMed2003

The effect of plantar fascia release on strain in the spring and long plantar ligaments.

The effect of plantar fascia release on strain in the spring and long plantar ligaments was investigated in 11 cadaveric feet. Strain gauges were placed in the spring and long plantar ligaments of each specimen, and cyclic axial loading was applied until reproducible hysteresis curves were observed in the ligaments before and after plantar fascia release. After release of the plantar fascia, the average strain observed in the spring ligaments at 920N of axial load increased by 52% (p < .001) and in the long plantar ligaments by 94% (p = .04). Longer resting lengths of the ligaments were also observed. Release of the plantar fascia significantly changed force distributions in the foot which may explain the development of deformities and symptoms observed clinically following this procedure.

Cadaver↗
PubMed1998

Biomechanical consequences of sequential plantar fascia release.

Plantar fascia release has long been a mainstay in the surgical treatment of persistent heel pain, although its effects on the biomechanics of the foot are not well understood. With the use of cadaver specimens and digitized computer programs, the changes in the medial and lateral columns of the foot and in the transverse arch were evaluated after sequential sectioning of the plantar fascia. Complete release of the plantar fascia caused a severe drop in the medial and lateral columns of the foot, compared with release of only the medial third. Equinus rotation of the calcaneus and a drop in the cuboid indicate that strain of the plantar calcaneocuboid joint capsule and ligament is a likely cause of lateral midfoot pain after complete plantar fascia release.

Biomechanical Phenomena↗
PubMed2004

Successful removal of a knotted fascia iliaca catheter: principles of patient positioning for peripheral nerve catheter extraction.

Peripheral nerve catheters are typically advanced a substantial distance into a perineural sheath, theoretically increasing the risk of catheter knotting and kinking. In this case report, we describe successful removal of a knotted fascia iliaca catheter and discuss principles of nonsurgical catheter extraction. A 64-yr-old woman with bilateral coxarthrosis presented for total hip arthroplasty under combined general/regional anesthesia. A 20-gauge fascia iliaca catheter was inserted before surgery by using a loss-of-resistance "double pop" technique. The catheter was uneventfully advanced 10 cm past the needle tip. After injection of 30 mL of 0.5% bupivacaine with 1:200,000 epinephrine and 100 microg of clonidine, general anesthesia was induced. An infusion of 0.1% bupivacaine at 20 mL/h was initiated in the recovery room for postoperative analgesia. Approximately 48 h later, resistance was encountered during catheter removal. Catheter extraction was attempted by altering patient positioning, including the supine position during which the catheter placement had occurred. Successful catheter removal was achieved by decreasing tension on the fascia lata and fascia iliaca through flexion of the hip joint and by applying firm, steady traction. The catheter was removed intact with a knot approximately 2 cm from the distal tip. We conclude that the principles for removal of entrapped peripheral catheters are not well known and may differ from those for neuraxial catheters. Patient positioning to minimize pressure and tension on the perineural soft tissues may facilitate catheter removal.

Arthroplasty, Replacement, Hip↗
PubMed1977

[Development from skin- to fascia- and to cartilage tympanoplasty (epitympanon-antrum-mastoidplasty) (author's transl)].

Experiences with 8029 endaural tympanoplastes show interruption of the self-cleaning process of the endaural epithelium after 366 tympanoplasties with skin grafts. The self-cleaning process may be preserved after fascia temporalis (2325) and cartilage (5338) plasties, because of overgrowth with local epithelium. 16 years after combined fascia temporalis and cartilage tympanoplasty the pieces of cartilage are almost unchanged but the fascia temporalis is more or less thinned to atrophic scars and according to tubal function it shows adhesive retraction pockets or bulging. For 7 years we have not been using fascia any more, but ear cartilage for the tympano-epitympano-antrum-mastoidplasty. Cartilage material not used is kept in a cartilage bank. Recurrence of cholesteatoma will press the cartilage plasty into the external auditory canal, whereas after osteoplasty of the endaural canal wall the patient runs to an uncertain percentage the same risk as before the operation.

Cartilage↗
PubMed2005

The effect of epidermal growth factor on anastomosis, fascia, and skin wound healing.

BACKGROUND: The effect of epidermal growth factor (EGF) on gastrojejunostomy (anastomosis), fascia, and skin wound healing in rats was investigated. METHODS: The animals (rats) were separated into two main groups. In the first group (control group n: 23), rats were fed on standard diet and tap water without administration of EGF. In the second group (EGF group, n: 19), EGF was added to the diet. Skin, fascia, and anastomosis wounds were created on three different locations via laparotomy and gastrojejunostomy in all rats. In both groups, the rats divided into three subgroups were sacrificed on the 3rd, 7th, and 21st days post operatively. Tensile strength of skin and fascia and bursting pressure strength were measured for wound healing in both groups on 3rd, 7th, and 21st days. RESULTS: Anastomosis tensile strength of EGF group on the 3rd day of postoperation was found to be significantly higher than that of the control group and when we compared anastomosis bursting pressure, fascia tensile strength, and skin tensile strength in both groups, we did not find any significant differences. CONCLUSION: The measurements indicated that on the 3rd day EGF administered group, which had a more remarkable fibroblastic activity at gastrojejunostomy site, was superior to the control group only in terms of anastomosis breaking tensile strength.

Abdominal Wall↗
PubMed1983

Stabilization of ileostomy position with fascia.

An ileostomy that maintains its protrusion in a stable manner can be fashioned by the technique of Brooke. However, in a significant number of patients, recession or prolapse of the ileostomy occurs, tending to displace an appliance. A safe and effective technique is described whereby the ileostomy is stabilized without danger. A ribbon of fascia, obtained from the abdominal wall, is passed through the mesentery adjacent to the bowel between vessels, at its point of exit from the peritoneum. It is neither wrapped around the bowel nor sutured to it. The ends of the fascia are securely sutured to the peritoneum and transversalis fascia. This secures the position of the ileostomy without the danger of fistula from suturing the bowel wall. It may be used for recession or prolapse. It may be supplemented by passing additional fascia or suture elsewhere in the mesentery or into other available tissue.

Adult↗
PubMed1995

Two-layer repair of the transversalis fascia is sufficient for inguinal hernia repair.

The Shouldice four-layer repair is considered to be the gold standard procedure for repair of inguinal hernia with low recurrence rates around 1%. Tension-free two-layer repair of the transversalis fascia may be all that is required to avoid recurrence. We compared the early recurrence rate after two-layer repair of the transversalis fascia or the standard four-layer Shouldice technique in a randomised study of elective inguinal herniorrhaphy. In 48 patients (53 repairs) who had a two-layer transversalis fascia repair, there was one recurrence (2%) in the first 12 months after operation, though there was one more recurrence within 36 months (total 4%). In 39 patients who had a four-layer Shouldice repair (42 repairs), there was no recurrence at 12 months but at 36 months two recurrences (5%) were found. We conclude that a two-layer repair of the transversalis fascia is anatomically correct, physiologically sound and can provide equivalent results to the standard Shouldice repair for inguinal hernia.

Adult↗
PubMed1983

Host tolerance of homologous fascia lata in retinal detachment surgery.

The use of homologous fascia lata in ocular surgery has been frequently questioned in regard to its host tolerance. Our electron microscopic examination of homologous fascia lata grafts up to 19 years old, which had been implanted as scleral buckling elements, showed no gross or microscopic histologic changes. Late infection, migration, and erosion were virtually nonexistent in comparison with other series using synthetic buckling materials. Therefore, homologous fascia lata is ideally tolerated and the most perfect scleral buckling material currently available.

Fascia↗