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At least 559 records · Page 31Linked to original sources
PubMed2002

Distraction lengthening by callotasis in the hand.

The clinical results of 26 digits (18 patients) lengthened by distraction callotasis were evaluated and the factors which influenced healing were analysed. There were 14 men and four women, with a mean age of 39 years. All digits had suffered traumatic amputation. There were eight thumbs and 18 fingers. The level of the site of the osteotomy was at the proximal metaphysis in ten, the middle diaphysis in 13 and the distal metaphysis in three. Although the proposed length was achieved in 23 of the 26 digits, five required additional bone grafts. The rate of healing was 96 days/cm in the digits without complications such as callus fracture or poor callus formation, and 158 days/cm in those with complications. Lengthening at the proximal metaphysis gave a better result than at the diaphysis or distal metaphysis.

Adolescent↗
PubMed1995

Operative treatment of bone overgrowth in children who have an acquired or congenital amputation.

Fifty-three children who were less than thirteen years old were followed for a median of seven years and ten months (range, two years and nine months to fourteen years and six months) after operative treatment for overgrowth of the tibia or humerus after amputation. During the thirty-one years in which these children were managed, three operative techniques were used in successive periods. Thus, the fifty-three children could be divided into three groups: thirty-one who had had a resection and revision, nine in whom the bone had been capped with a synthetic device, and thirteen in whom the bone had been capped with an autogenous tricortical bone graft from the iliac crest. A retrospective review was performed to determine the result and complications associated with each of these techniques. Survival analysis revealed that subsequent procedures were performed in twenty-six (84 per cent) of the thirty-one patients who had had a resection and revision, in seven of the nine in whom the bone had been capped with a synthetic device, and in four of the thirteen in whom the bone had been capped with an autogenous bone graft. The estimated mean survival time (that is, the time to a subsequent procedure) was five years in the group that had had the bone capped with an autogenous graft and three years and six months in the group that had had resection and revision; the difference is significant (p = 0.003).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

Biomechanical significance of the correct length of lower limb prostheses: a clinical and radiological study.

The length of the lower limb prosthesis was compared with the length of the contralateral lower extremity in 113 Finnish war-disabled amputees by a radiological weight bearing method developed by the author. Considering a shortening of 10 mm for above-knee prostheses and of 5 mm for below-knee prostheses as tolerance limits, the length of the prosthesis was acceptable only in 17 cases (15% of the total group). In 79 cases (70%) the prosthesis was up to 47 mm too short and in 17 cases (15%) up to 40 mm too long. Chronic pain symptoms of low back, hip and knee correlated significantly with the lateral asymmetry caused by incorrect length of the prosthesis. Independently of the side of amputation, the unilateral sciatica and chronic hip pain occurred mainly on the long leg side. Physical activity of the lower limb amputees seemed to correlate with the suitability of the length of the prosthesis, and was unrelated to the length of the amputation stump.

Aged↗
PubMed1996

Neurapraxia of the common peroneal nerve- a rare complication resulting from wearing a KBM prosthesis: a case report.

This clinical note describes a 47-year-old man who had a traumatic amputation of the left lower leg. Two months after wearing a Kondylen Bettung Münster (KMB) prosthesis, he developed a compression neuropathy of the common peroneal nerve of this right leg after sitting cross-legged. This troublesome complication can be avoided by giving accurate information to the patient.

Amputation Stumps↗
PubMed1993

Training for a patient with shoulder disarticulation.

This patient received 26 outpatient occupational therapy sessions for a total of 32.5 hr during an 18-week period. All treatment goals were achieved with the exception of psychosocial adjustment issues, which are ongoing. He made significant gains in right upper quadrant muscle isolation and demonstrated control and strength of the upper, middle, and lower trapezius fibers adequate for a myoelectric prosthetic. He also made improvement with left manual dexterity and unilateral coordination with regard to activities of daily living. He was discharged from outpatient occupational therapy services and referred to another medical center for prosthetic evaluation. Twenty weeks after discharge from our facility, he returned for a follow-up visit. He had been fitted with a shoulder cap and his tolerance for wearing it was approximately 10 hr per day. Thirteen weeks after the follow-up visit he resumed outpatient occupational therapy. We are evaluating his tolerance to the placement of a passive arm to the shoulder cap.

Activities of Daily Living↗
PubMed2006

Heterotopic ossification in the residual limbs of traumatic and combat-related amputees.

Reports on the occurrence and treatment of heterotopic ossification in amputees are rare. Heterotopic ossification in the residual limbs of amputees may cause pain and skin breakdown and complicate or prevent optimal prosthetic fitting and utilization. Basic science research has shed light on the cellular and molecular basis for this disease process, but many questions remain unanswered. The recent experience of the military amputee centers with traumatic and combat-related amputations has demonstrated a surprisingly high prevalence of heterotopic ossification in residual limbs. Primary prophylactic regimens, such as nonsteroidal anti-inflammatory drugs and local irradiation, which have proved to be effective in preventing and limiting heterotopic ossification in other patient populations, have not been studied in amputees and generally are not feasible in the setting of acute traumatic amputation. When nonsurgical measures such as activity and repeated prosthetic modifications fail to provide relief, surgical excision has provided good early clinical results, with low rates of recurrence and acceptable complication rates in military amputees.

Amputation Stumps↗
PubMed1999

Utilization of prostheses among US veterans with traumatic amputation: a pilot survey.

No random surveys have been done to determine how effectively veterans with amputation can utilize their prostheses, and only one limited survey has been done of Scandinavians' use of lower-limb prostheses. A pilot survey of prosthetic problems was sent to all 170 US veteran soldiers who had traumatic amputations over the last 10 years, whose addresses could be supplied by the VA, and whose medical synopses showed them to be otherwise healthy when leaving the military. This subpopulation was selected as a "best case" group: those most likely to be active, young, and healthy enough to use their prostheses, as well as close enough to the military and veterans medical systems to get adequate treatment. If they have problems, the rest of the veterans with amputation, relatively older and more debilitated, are very likely to have far worse problems. Although only 45 responded (26%), all had significant problems using their prostheses for work. Most problems were related to the attachment method. Even if all nonrespondents were problem free, at least a quarter had very significant problems using their prostheses. This means that there are significant problems with current methods for attaching prostheses that need to be addressed. The first step should be a large survey of veterans with amputation to get an accurate assessment of the extent of prosthesis-related problems.

Amputation Stumps↗
PubMed1975

Syme's amputation. Follow-up study of weight-bearing in sixty-eight patients.

Sixty-eight patients with Syme amputations resulting from industrial injuries were reviewed. The amount of end-weight-bearing was measured with a capacitance transducer. The majority of patients required fitting with a prosthesis designed to relieve end-weight-bearing. The old-fashioned prosthesis with a leather corset was the most effective in achieving reduction of end-weight-bearing.

Accidents, Occupational↗
PubMed2001

Sympathetic blockade for the relief of chronic pain.

The sympathetic blocks are useful in many ways for relief of chronic pain. The sympathetic block can be caused at pre- and paravertebral sympathetic ganglia eg, stellate ganglia, coeliac plexus and lumbar sympathetic ganglia. Indications for sympathetic blockade are: Complex regional pain syndrome, phantom limb pain, central pain, acute pancreatitis, pancreatic cancer and cancer pain from upper abdominal viscera. Stellate ganglion blockade is required for the diagnosis, prognosis and therapy for painful and other conditions associated with sympathetic dysfunctions of head, neck and upper extremity. Coeliac plexus block is indicated in pain due to intra-abdominal cancer, stemming from organs innervated by coeliac plexus. Lumbar sympathetic block is indicated for diagnosis, prognosis and therapy for painful and other conditions associated with sympathetic dysfunctions like complex regional pain syndrome I and II, herpes zoster, amputation stump pain and inoperable peripheral vascular vasospastic diseases of the lower limb. Indications for superior hypogastric block are the prognostic and therapeutic purposes of cancer pelvic organs--uterus, cervix, bladder, prostate, urethra, testes and ovaries.

Anesthetics, Local↗
PubMed1975

[A new case of reticular hyperplasia connected with volatile oils].

An additional case of "reticular hyperplasia" is described. The clinical picture is trimorphic with grouped nodules, spinulosismus-like and parapsoriasiform lesions. Histologically there are dense lymphoreticular, partly eosinophilic infiltrates with leucocytoclastic cell aggregates, which, however, do not resemble mycosis fungoides nor a reticulosis. The causative agent was most likely the external use of remedy for an amputation stump containing ethereal oils, which had been used over decades. Positive provocation tests confirmed the diagnosis.

Aged↗
PubMed1992

Neurosensory free flaps to the hand. Indications and donor selection.

When used in properly selected cases, a neurosensory free flap provides sensibility, vascularity, and soft-tissue coverage to an injured hand. Appropriate selection of donor flaps based on the need for fine discriminatory or protective sensation is important for optimal results. Because of its thin, glabrous skin and a constant vascular and neural anatomy, the first web-space flap of the foot or its variants provide the best reconstructive choice for restoration of critical sensibility to digital tips or anesthetic amputation stumps. Protective sensibility can be restored with other neurosensory free flaps, but more clinical experience is needed to fully evaluate the reconstructive potential of many described flaps. A distinction must be made between the anatomic description of a free flap with neurosensory potential and the report of long-term sensory ability after clinical transfer.

Foot↗
PubMedDate not supplied

An experience with free scapular flap for reconstruction of lower extremity defects at Aga Khan University Hospital Karachi.

BACKGROUND: Reconstruction of large composite tissue defects with exposed vital structures and weight bearing surfaces are extremely difficult for reconstructive surgeons. Coverage of such difficult defects can be achieved with free tissue transfer provided microsurgical expertise is available. This study was carried out to determine the outcome of free scapular flaps performed for lower extremity defects. METHODS: Clinical records of the patients were reviewed and important variables included demographic data, etiology of soft tissue defects, site and size of defect, complications and percentage of wound coverage by flap. Patient satisfaction and objective assessment of flap coverage and motion of involved joints was made. RESULTS: There were 13 male patients with mean age of 30.46 years. The causes of tissue defects were road traffic accident in 8 cases, industrial accidents in 2 and 3 cases had bomb blast, gunshot and gas gangrene one in each case respectively. Nine scapular flaps were performed to reconstruct the defects around the foot, ankle and lower leg; two flaps for amputation stumps and two flaps for defects around the knee and popliteal fossa. Post flap surgery, 3 cases had vascular compromise which required urgent exploration of anastomosis. Two cases were revived and one flap did not survive. With respect to cosmetic appearance, coverage of required defect, performance of activities of daily living and functional range of motion of involved joints, 6 cases were graded excellent and 7 cases were good. CONCLUSION: In our cases of lower extremities defects, scapular flap helped to salvage the limb. In conclusion scapular flap is a versatile flap which can be used for lower extremity defects.

Accidents, Occupational↗