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PubMed2006

Diffuse-type giant cell tumor of the subcutaneous thigh.

Diffuse-type giant cell tumor is an extra-articular form of pigmented villonodular synovitis. The localized form of this lesion (tenosynovial giant cell tumor) is frequent, representing the most common subset arising from the synovium of a joint, bursa or tendon sheath, with 85% of cases occurring in the fingers. The less frequent diffuse-type giant cell tumors are commonly located in the periarticular soft tissues, but on rare occasions these lesions can be purely intramuscular or subcutaneous We report the case of a 26-year-old female with diffuse-type giant cell tumor of the subcutaneous thigh, remote from a joint, bursa or tendon sheath. A review of the literature did not reveal any similar description of a diffuse-type giant cell tumor completely within the subcutaneous thigh, remote from a joint, bursa or tendon sheath. These lesions were initially regarded as inflammatory or reactive processes, but since the identification of clonal abnormalities in these patients, and in view of their capacity for autonomous growth, they are now widely considered to represent benign neoplasms.

Adult↗

PubMed1997

Morel-Lavallée effusions in the thigh.

OBJECTIVE: To assess the radiological features of Morel-Lavallée effusion in the thigh. DESIGN AND PATIENTS: A retrospective study of clinical records and radiological studies was carried out on three patients with Morel-Lavallée effusion. RESULTS AND CONCLUSIONS: Ultrasound and computed tomography (CT) were able to locate the effusion in the three patients. CT demonstrated a capsule around the lesion. A fluid-fluid level was visible with both techniques. Ultrasound and CT are good methods for assessing patients with Morel-Lavallée effusion of the thigh. CT can be used to distinguish patients requiring surgical treatment from those who could be treated by conservative measures.

Adult↗

PubMed2000

Angiomyolipoma arising in the thigh.

A 41-year-old man presented with an asymptomatic mass in the right medial thigh. Magnetic resonance imaging (MRI) revealed a well-demarcated, 10-cm mass in the right adductor muscles. The margins of the mass exhibited high signal intensity and the rest showed low or iso signal intensity on T1-weighted MR images. However, the high signal intensity was decreased on T2-weighted images with fat suppression. The central part of the tumor was of inhomogeneous high signal intensity on T2-weighted images; after Gd-DTPA injection it enhanced in homogeneously on T1-weighted images with fat suppression. On dynamic computed tomography (CT) in the arterial phase, there were strongly enhancing spotty areas in the tumor. At surgery, a yellow-whitish tumor was resected and a pathological diagnosis of angiomyolipoma (AML) in the thigh was made.

Adipose Tissue↗

PubMedDate not supplied

Circular lipectomy with lateral thigh-buttock lift.

Patients with body contour deformities amongst the challenges that plastic surgeons most frequently face. Through the years, many surgical procedures have been developed that attempt to solve many forms of body contour deformities while optimizing the number of surgical stages within safety limits. In one stage, circular lipectomy with lateral thigh and buttock lift and trochanteric liposuction corrects deformities of the abdomen, the lateral thighs, the buttocks, the supra-gluteal area, the lateral supra-gluteal area, leaving only one circular scar that can be covered with a thong. It is performed under epidural anesthesia, requires one or two units of autologous blood, one night in a hospital, and two or three weeks off work. Thirty-nine patients were operated on without any major complications. Results were consistently good and superior to patients' expectations.

Abdomen↗

PubMed2004

The concentric medial thigh lift.

Plastic surgeons often are asked to perform horizontal medial thigh lifts because the skin of this area has poor elasticity, inducing excess skin, and also because there is upper fat deposit. This excess skin and fat lead to irritation and even functional problems. But surgeons dislike this operation because of its justified bad reputation. Obviously, this area is difficult to manage because of the many possible side effects (e.g., healing difficulty, scar migration, necrosis, effusions, pain) and unreliable results. A new way of thinking is proposed to lighten this operation and make its more frequent use possible. This horizontal technique presents several innovating points: -A new incision line located along the labia major in the perineal crease remains at the same height backward. The incision never descends into the buttock fold. -No undermining whatsoever occurs even in the resection area. Liposuction is the key to avoidance of any undermining. It is performed everywhere in the thigh, but most importantly under the resection area where all the fat must be eliminated to lighten the flap and favor its lifting. -The resection removes only the skin layers (epidermis and dermis) and not the liposucted tissue, which is very thin. Consequently, all lymphatic and other vessels are preserved, and the healing process is much easier. Moreover, there is no dead space after ascension of the flap and no risk of effusion. -The resection is realized on demand, depending on the excess of skin brought on the incision line by each anchor suture. Therefore, any tension on the skin closure is avoided. -The direction of the skin stretching is concentric toward the labia minor. Consequently, the length of the scar is shortened at both the front and the rear. -Anchor sutures pull a nonundermined skin, thus drastically decreasing the risk of necrosis. In the past 2 years, 25 patients, most of them as outpatients, have undergone surgery using this technique, with a real improvement in the quality of the result, as compared with the results from the standard technique.

Adipose Tissue↗

PubMedDate not supplied

Medial thigh lift and DE.C.LI.VE.

Vertical dermocrurolipectomy is a technique that in Italy has been named "DECLIVE," (which in Latin means something that moves downward). The first medial thigh lift with the DECLIVE technique was done in 1993. Since then, based on its excellent results 50 patients have been operated on, following DECLIVE. Therefore, DECLIVE should be considered just a variant in the medial thigh lift, because resecting a triangular portion from the perivulvar skin, it stops the displacement of the scar downward. Special acknowledgment goes to Ted Lockwood's studies for his role in the development of this technique.

Cicatrix↗

PubMed1998

MR and CT findings in a case of hibernoma of the thigh extending into the pelvis.

Review of the literature shows no report of hibernoma of the thigh extending into the pelvis. Herein we report a case of hibernoma which appeared on CT and MR as a well-defined pelvic mass with contrast enhancement extending through the obturator foramen into the thigh. Fat was demonstrated by CT, whereas MR, using multiplanar sections, better analyzes the extension of the mass. This case demonstrates that hibernoma as liposarcoma can extend through the obturator foramen. However, no definite diagnosis could be made by CT or MR and the tumor must be considered as a "potential" malignant liposarcoma.

Adipose Tissue↗

PubMed1997

Exercise performance and magnetic resonance imaging-determined thigh muscle volume in children.

This study examined the relationships between thigh muscle volume (TMV) and aerobic and anaerobic performance in children. A total of 32 children, 16 boys and 16 girls, aged 9.9 (0.3) years completed a treadmill running test to exhaustion for the determination of peak oxygen uptake (peak VO2) and a Wingate Anaerobic Test (WAnT) for the determination of peak power (PP) and mean power (MP). The volume of the right thigh muscle was determined using magnetic resonance imaging. TMV was not significantly different in boys and girls [2.39 (0.29) l vs 2.18 (0.38) l, P > 0.05]. Peak VO2 and MP were significantly higher in boys than girls (P < 0.01) whether expressed in absolute, mass-related or allometrically scaled terms. Absolute PP was not significantly different in boys and girls but mass-related and allometrically scaled values were higher in boys (P < 0.01). TMV was correlated with absolute peak VO2, PP and MP in both sexes (r = 0.52-0.89, P < 0.01). In boys, mass-related PP was correlated with TMV (r = 0.53, P < 0.01), and in girls mass-related peak VO2 was correlated with TMV (r = -0.61, P < 0.01). However, in neither sex were allometrically scaled peak VO2, PP or MP correlated with TMV (P > 0.05). There were no significant differences between boys and girls in terms of peak VO2, PP or MP when expressed in a ratio to TMV or allometrically scaled TMV. In conclusion, this study has demonstrated that, when body size is appropriately accounted for using allometric scaling, TMV is unrelated to indices of aerobic and anaerobic power in 10-year-old children. Furthermore, there appear to be no qualitative differences in the muscle function of boys and girls in respect of aerobic and anaerobic function.

Child↗

PubMed2005

Solitary fibrous tumor in the thigh: review of the literature.

Solitary fibrous tumors (SFT) of extremities, especially the thighs are very rare. Despite SFTs are generally benign, well-circumscribed soft tissue tumors new cases should be presented and followed up carefully to monitor their biological behavior. In general for tumor classification a biopsy is state of the art. Histological including immunohistochemical patterns for SFTs are defined. MRI and ultrasound are not sufficient for differential diagnosis. Once property identified and defined by size and location, resection with intact tumor capsule may result in full recovery of the patient. Reviewing the literature there are no validated reasons for a wider resection. The current patient was a 41-year-old male. Four years after an arthroscopy of the left knee the patient has been suffering an ongoing swelling of the lateral thigh. Because MRI scan data suggested a synovial sarcoma a biopsy was performed. The tumor was classified as a benign SFT. The diagnosis based on histological findings and the presence of the positive immunohistochemical markers Vimentin, CD34, and CD99. The complete tumor resection with intact capsule was achieved in a final operation. Clinical and in MRI after 54-month outcome period there were no local recurrences.

12E7 Antigen↗

PubMed1996

Thigh ischemia complicating femoral vessel cannulation for cardiopulmonary bypass.

Compartment syndrome of the lower leg is an occasional complication of prolonged ischemia and reperfusion. Compartment syndrome of the thigh is a less well-recognized complication. We present 2 patients with compartment syndrome of the ipsilateral thigh after femoral arterial and venous cannulation for cardiopulmonary bypass. Early diagnosis and urgent decompressive fasciotomy may limit the extent of local tissue damage and subsequent myonephropathic syndrome.

Aged↗

PubMed1984

The lateral thigh fascio-cutaneous flap in the repair of ischial and trochanteric defects.

We have recently designed and developed a lateral thigh fascio-cutaneous flap based on the first perforating artery. This artery supplies the distal part of the gluteus maximus muscle and continues to supply the fascia, subcutaneous tissues and skin over the lateral aspect of the thigh. We describe the use of this fascio-cutaneous flap in the repair of ischial and trochanteric defects.

Adult↗

PubMed1985

A supero-medial thigh flap for urethral reconstruction in epispadias and hypospadias.

A reliable axial flap from the adductor region has been used for many years to repair a series of urethral defects formerly regarded as difficult problems. In particular the flap has proved invaluable in the treatment of epispadias "cripples". Suggestions are also made for correcting the reverse chordee deformity due to the shortage of skin on the dorsum which, if untreated, spoils the functional result. The use of a supero-medial thigh flap was reported by Hirshowitz et al. (1980, 1982) for repair of the scrotum and vulva. The same flap had been discovered independently in 1978 in this department and used for the repair of epispadias and hypospadias "cripples". Its reliability was soon recognised and the presence of axial vessels from the medial femoral circumflex artery and vein were demonstrated by transillumination at the time of surgery and by study in the post-mortem room. Some patients with epispadias are referred at puberty with an unrepaired scarred penis and a reverse chordee deformity. The defect cannot be repaired with local tissue alone and the same difficulty is encountered with some hypospadias "cripples". Occasionally untreated cases of perineal hypospadias are seen with a marked shortage of local tissue. In our experience scrotal flaps may fail to heal and orthodox groin flaps may have difficulty in reaching the target. Although the superomedial thigh flap will require at least two stages it is a reliable technique and it provides a generous amount of tissue with which to solve what may at first sight seem to be an insuperable problem.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1988

The use of the anteromedial thigh fasciocutaneous flap in the reconstruction of the lower abdomen and inguinal region; a report of two cases.

The use of the anteromedial thigh fasciocutaneous flap in the reconstruction of the lower abdomen and inguinal region is described. If there is a dominant vessel supplying the anteromedial thigh flap, it can be raised as an island or a free flap. When there are only slender vessels in this area, a random pattern fasciocutaneous flap can safely be created with a fasciosubcutaneous pedicle.

Abdomen↗

PubMed1995

Lateral cutaneous nerve of the thigh blockade as primary anaesthesia for harvesting skin grafts.

The lateral cutaneous nerve of the thigh (LCNT) supplies a large area of skin in an ideal site for harvesting a split skin graft. LCNT block was used as primary local anaesthesia for harvesting split skin grafts in 23 patients with a variety of injuries. Their ages ranged from 26 to 99 years. The mean age was 69 years. The onset of full anaesthesia took between 15 and 20 min. The area anaesthetised ranged from 250 cm2 to 1020 cm2 with a mean of 569 cm2. There were 17 successful blocks and 6 failures. Most of the 6 failures occurred during the early phase of the study. We have found that, with experience, LCNT block is a safe, simple and reliable method for achieving adequate anaesthesia for harvesting split skin graft from the thigh and that it provided excellent postoperative analgesia.

Adult↗

PubMed1991

The threshold for thermally significant cavitation in dog's thigh muscle in vivo.

In this study the threshold of thermally significant transient cavitation in vivo in dog's thigh muscle was investigated as a function of frequency from 0.246 MHz to 1.68 MHz. Cavitation, evidenced by strong emission of wide band noise monitored by a hydrophone, appeared to increase the energy absorption in tissue at the focal zone of a focused ultrasound beam as measured with an embedded thermocouple. This was indicated by a significant increase in the temperature, a loss of smooth temperature rise during the 1 s sound pulse and a significant reduction in the acoustic power transmitted through the thigh. This thermal phenomenon was associated with a strong emission of wide band noise which was monitored by a hydrophone. In addition, strong echoes appeared in ultrasound images during the pulses that caused the noise emission and the thermal effect. These echoes appeared preferentially at locations where there was acoustic heterogeneity. The measured cavitation pressure amplitude threshold was found to depend almost linearly on frequency with a slope of about 5.3 MPa MHz-1. (The extrapolated static pressure threshold was 0.6 MPa). When these measured levels are compared to those typical of clinical application, it appears that the transient cavitation can be avoided when perfusion independent high temperature hyperthermia is induced with focused and pulsed ultrasound fields. However, intensities required during scanned focused ultrasound hyperthermia, where sharply focused transducers are used to heat large tumors at low frequencies (1 MHz or below), could rise above the threshold. Thus, care should be taken when focused ultrasound systems are designed so that the maximum peak pressure is below the threshold in order to avoid unpredictable biological effects induced by transient cavitation. Finally it is unlikely that the present diagnostic ultrasound units which operate at higher frequencies and in pulsed mode could cause transient cavitation in vivo.

Acoustics↗

PubMed2005

Waist-to-thigh ratio can also be a better indicator associated with type 2 diabetes than traditional anthropometrical measurements in Taiwan population.

PURPOSE: Using three-dimensional (3D) scanning data along with other existing subject's medical profiles to search for better anthropometric markers in association with type 2 Diabetes Mellitus (DM). METHODS: In this cross-sectional study with 6007 subjects undergoing health examination in a period of 3 years, the authors adopted data from 3D scanning with hundreds of body measures and conducted factor analysis to search for practical indicators better associated with type 2 DM. A multiple logistic regression model was used to analyze strength of association between indicators and presence of type 2 DM. RESULTS: The trunk component derived from factor analysis was positively associated with type 2 DM, regardless of obesity status. However, lower limbs component was found to be negatively associated with type 2 DM in the same stratifications. Waist was thus found as the strongest indicator among practical measures of trunk component. The strength of association between thigh and type 2 DM was found to be the highest among practical measures of lower limbs component. A marker from taking the ratio of waist to thigh (WTR) was derived from the approach which was found to be the best indicator for association with type 2 DM while comparing to body-mass index, waist circumference, or waist-hip ratio. CONCLUSION: This study offers a low-cost, noninvasive practical marker that is better associated with the presence of type 2 DM. WTR, with further study, may be used in clinical practice, epidemiological study, and preventive medicine in the future.

Abdomen↗

PubMed2004

Body contouring by combined abdominoplasty and medial vertical thigh reduction: experience of 14 cases.

The common perception of beauty in the human body has shown a dramatic change over the past few decades culminating in a preoccupation not only with body weight, but also with body image. Obesity is becoming prevalent in our society, and yet generalised redundancy of skin following massive weight reduction can also be an affliction. Localised fat deposits in one or more regions of the trunk, upper arms and thighs are common and are virtually impossible to correct by diet, weight loss or exercise. Excision of the excess pendulous skin and/or the localised fat deposits are able to reduce or even eliminate the physical problems associated with the condition and contribute significantly to patient self-esteem. These procedures are usually multiple and extensive. Combining and reducing the number of such procedures while obtaining optimal results would be most beneficial to both the surgeon and the patient. We report our experience of 14 patients who underwent body contouring operations using combined abdominoplasty and medial thigh reduction with analysis of the results and discussion of the requirements and the advantages of the technique.

Abdomen↗

PubMed2006

A new phalloplasty technique: the free anterolateral thigh flap phalloplasty.

After a 10-year experience with phalloplasty in female to male gender reassignment surgery and with more than one hundred cases treated, we have introduced a new technique for creation of the neo-phallus. Between 1993 and 2002, phalloplasties were performed in our department using the free radial forearm flap or the pre-expanded suprapubic flap (modified Pryor technique). The study of long-term results and complications of these cases, as well as patient requests for a new donor site, induced us to look for an alternative flap for phalloplasty. The versatility and the low donor site morbidity of anterolateral thigh flap persuaded us to use it for phalloplasty. Since March 2003, six phalloplasties with free anterolateral thigh (ALT) flap have been performed. The results have been encouraging. The shape and the consistency of the neo-phallus are suitable, the flap can be sensate and an erectile prosthesis can easily be implanted. Penile urethral reconstruction is possible in the same operative stage. Patient satisfaction is high. The anatomy and harvesting techniques of ALT flap have already been exhaustively described by several authors and only the operative technique of phalloplasty with free ALT flap, donor site management, preliminary results and complications are reported in this paper.

Adult↗