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[Reconstruction of facial contour in hemifacial atrophy (Romberg disease) using a free revascularized scapula-fat-fascia flap].

Presented is a case of progressive hemifacial atrophy. The reconstruction of the deficient left face-contour was performed by a free microsurgical transplanted fat-fascia flap from the scapular region. The position of the fascial layer of the inlay, facing skeletal and muscular structures, enables fixation of the transplanted tissue to zygomatic periosteum and fascia of the temporalis muscle. Thus we have advantage to avoid sagging of the transplanted tissue in upright position and to remove over-correcting applied amounts of fatty tissue during the first corrective operation.

Adipose Tissue↗

Electron microscopic study on the elastic and elastic related fibres in the human fascia transversalis at different ages.

An electron microscopic study of the elastic fibre and elastic related fibres of the fascia transversalis of the human inguinal triangle was performed in 20 male patients aged 13 to 81 a with right indirect inguinal hernia submitted to surgical repair. The 3 fibre types comprising the elastic system (oxytalan, elaunin, and elastic fibres) tend to be ordered in a precise manner and sequence among the fibrils, fibres, and collagen fibre bundles, respectively. The present findings show that with aging, there is a decrease in the oxytalan fibres and an increase in the amorphous substance of the elastic fibres. The authors concluded that the decrease in oxytalan fibres as a function of age may be responsible for alteration in the resistance of the transversalis fascia.

Actin Cytoskeleton↗

[Allogeneic lyophilized fascia lata "soft" as extra-articular stabilizer in simple and complex knee joint instability].

50 operative procedures in capsular-ligamentous apparatus of knee joint were done from 1.9.1988 until 31.12.1989 among 209 in charged treated sports injuries. The multiplicity in pattern of injuries is the reason for individual procedure in reconstructive joint-surgery and because of this various indications for auto- and allogenic eg. synthetic materials, static and dynamic procedures else free or vascularized grafts. The lyophylized fascia lata "soft" is used in case of anteromedial instability, isolated medial rupture of collateral ligament of the first degree else for augmentation after primary treated medial injury of collateral ligament. Early results are proving the histocompatibility, the healing without complications else timely stability and recommending the fascia lata-plasty in given indications.

Adolescent↗

[Several ultrastructural peculiarities of the fascia transversalis in direct inguinal hernias of senile men].

Fascia transversalis of the dorsal wall of the inguinal canal in direct hernias in senile men was studied by transmission electron microscopy. Collagen microfibrils (CMF) were unevenly arranged and rarely formed compact fibres. Dysplastic CMF with variable diameters and nonuniform profiles were also encountered. There was a marked collagenophagy: in some fibroblasts we observed collagen-containing vacuoles in different stages of microfibrillar degradation. Among CMF matrix vesicles were also detected. These ultrastructural findings are discussed as a morphological substrate leading to supportive and mechanical insufficiency of the fascia transversalis causing herniation. It is concluded also that because of the structural defects of the fascial sheath there is a need of alloplastic reconstruction where Bulgarian-made AMPOXEN tissue can successfully be applied.

Aged↗

Rupture of the plantar fascia in athletes.

Symptoms resembling those of plantar fasciitis were seen in six athletes who were thought to have a partial rupture of the plantar fascia. Treatment, which included the use of crutches, anti-inflammatory agents, strapping of the arch, and ice packs, was successful in all but one patient who had a painful mass in the area of the previous rupture. After surgical excision of the painful mass and release of the fascia, he recovered. Five of the six athletes had been previously treated with repeated local injections of steroid.

Adult↗

[Fibrous framework of human skeletal muscles, fasciae and tendons].

By means of scanning and transmissive electron microscopy, the construction of the fibrous framework of the human skeletal muscles, fasciae and tendons has been investigated and its morphofunctional analysis has been performed. The fibrous framework of the endomysium is presented as a complexly organized system of anastomosing fibers of the connective tissue, forming a net-like construction. The fibrous structures of the framework are united into a whole construction by connecting fibers and fibrils. Different types of structural interconnection of collagenous fibers with sarcolemma are revealed. The structure of the fibrous framework both in different muscles and within one muscle has certain peculiarities. The main constructive element of the fascial fibrous framework make large anastomosing collagenous fibers, their architectonics is stabilized by connective fibers and fibrils. The construction of the tendinous fibrous framework is characterized by a pronounced anisotropia of the largest collagenous fibers and a developed network of connective structures both on the surface and inside the collagenous fibers. Structural mechanisms, interconnecting muscles and tendons, are demonstrated. Presence of anastomoses between the fibrils in the composition of the collagenous fibers in the fascia and Achilles tendon are stated. Together with the peculiarities existing, the general principle of the structural organization of the fibrous framework of the muscle system is the net-like constructure dependent on presence of anastomoses and elements of the connective system between the fibrous structures. Depending on the organ's function, the construction of the network acquires certain specific morphological forms.

Abdominal Muscles↗

[Effect of hypodynamia on the hemomicrocirculatory bed of the triceps muscle and brachial fascia in the rat].

By means of amputation of the forearm (the place of the brachial musculus attachment is kept intact) in 30 male rats certain conditions are produced for decreasing force activity in the m. triceps brachii. Anatomical changes in structure and in distribution of links of the hemomicrocirculatory bed (HMCB) are followed in the medial head of the muscle and in the fascia covering it. Time of observations - 1-60 days. The sections of the muscles and some parts of the fascia are impregnated with silver nitrate solution. The greatest changes are observed to occur in the capillary-venular links of the HMCB during the interval of 1.14-4.5 days and are manifested as initial congestion of venous blood in these links. Later (4.5-15.3 and further 60 days) together with stable dilatation of all venous components of the blood bed certain qualitative changes take place in the arteriolar links of the HMCB.

Amputation Stumps↗

Further experience with the tensor fascia lata musculocutaneous flap.

We have found the tensor fascia lata myocutaneous flap to be exceedingly reliable with a consistent vascular pedicle; it can be elevated easily and rapidly in its subfascial plane. It is a useful flap in the paraplegic patient for colsure of ischial, trochanteric, and sacral pressure sores, and may also be used as a free flap with little donor morbidity. At present, we recommend this as the flap of choice for closure of trochanteric pressure sores. Additionally, it appears to have further applications in defects of the groin, perineum, abdominal wall, and lower chest wall. Eleven tensor fascia lata musculocutaneous flaps, utilized for soft tissue coverage for varying defects in 9 patients, are discussed.

Fascia Lata↗

Regression of mouse sarcoma M(52)B treated with bovine fascia lata extract from animals previously inoculated with Babesia bovis and B. bigemina.

Mice with induced tumours of mouse sarcoma M(52)B were treated by injections of extract of bovine fascia lata from two animals which had been inoculated with a mixture of Babesia bovis and B. bigemina--in one case 6 weeks previously and in the second case 8 weeks previously. As a control a further series of mice was injected with an extract of bovine fascia lata taken from a splenectomized animals reared in the laboratory to ensure that it had not come into contact with ticks and was free of Babesia.

Animals↗

[Importance of damage to the medial fascia of the external lateral ligament (radial collateral ligament) in the mechanisms of luxations of the elbow. Study on the cadaver (author's transl)].

A study of 18 elbows in the cadaver allowed the medial fascia of the radial collateral ligament of the articular capsule to be clearly separated. Section of this ligament associated with that of the anterior fascia, without section of the ulnar collateral ligament always produces luxation of the elbow if it is in flexion. The integrity of the insertion surface of the epicondyles does not stop this luxation. This therefore confirms the arthrographic and operative observations recently published.

Cadaver↗

[The mesorectum in females. Evolution of the fascia pelvis parietalis in pelvic dissection].

The authors used dissections of adult and fetal female cadavers to describe the meso uro-genito-rectum or visceral pelvic fascia, visceral prolongation of the parietal pelvic fascia. This meso uro-genito-rectum consists of two parts: 1 The anterior part: formerly the umbilico-prevesical aponeurosis, called the meso-bladder in this text. 2 The posterior part: the meso recto-vagina. While the meso-rectum was already well described using the term "rectal wing" or para-rectum, knowledge of the meso-vagina under the meso-cervix (or paracervix or Mackenrodt's cardinal ligament) was poorly defined, and concerning the following in particular: * its posterior prolongation by the meso-rectum, * its relations with the middle rectal pedicle (formerly the middle hemorrhoidal pedicle),* its helicoidal appearance when in anatomical position.

Adult↗

Mersilene mesh and fascia lata in brow suspension: a comparative study.

I retrospectively compared 34 brow suspension procedures: 17 using Mersilene mesh and 17 using stored, irradiated fascia lata. Good results were obtained with both materials. Since Mersilene mesh is inexpensive, easy to prepare and work with, and can be sterilized and guaranteed free of infectious diseases, it is an acceptable alternative if fascia lata is unavailable.

Child↗

[Biomechanical changes in the hip, femur and knee joint after removal of a tensor fasciae latae flap].

The TFI-musculofasciocutaneous flap has become a standard procedure in recent years. Donor-site problems of this method, especially the biomechanical changes of the hip, the proximal femur and the knee joint are evaluated, employing biomechanical techniques. Harvesting of a TFL-flap leads to functional loss of the M. tensor fasciae latae and the iliotibial tract and band. This might lead to a weakening of active and passive stabilising structures of the hip and the knee joint. Loss of the iliotibial tract causes a loss of the lateral tension-band of the proximal femur and leads to a significant increase of shear forces on the proximal femoral shaft. The functionally important structures of the iliotibial tract for knee biomechanics are not influenced by harvesting of the TFL flap. Loss of the M. tensor fasciae latae leads to a mild reduction of hip flexion and internal rotation. The indication for a TFL-flap should consider the patient's activity to prevent overload damage of the proximal femoral shaft. In childhood, harvesting of the TFL flap is likely to influence the growing axial skeleton due to the loss of the iliotibial tract.

Biomechanical Phenomena↗

Tensile strength of fascia lata sutures following gamma radiation.

Gamma radiation (Co-60) is used to sterilize biological sutures. We wished to compare the effect of gamma-radiation in doses of 2.7 and 4.0 Mrads on the tensile strength of human fascia lata sutures obtained from the same cadaver. Five variables of tensile strength viz. Breaking Elongation, Breaking Load, Yield Point Load, Work of Rupture and Elastic Stiffness were determined for each suture. For Breaking Elongation the mean strength for the 4.0 Mrad dose was 3% less than for 2.7 Mrad dose (P less than 0.05); for Breaking Load 11% less (P less than 0.01); for Yield Point Load 9% less (P less than 0.02); for Work of Rupture 14% less (P less than 0.01); and for Elastic Stiffness 8% less (P less than 0.02). Irradiation with 4.0 Mrads, does not greatly change the tensile strength characteristics of fascia lata sutures.

Adult↗

[Maintenance of the cranial cruciate ligament rupture in the dog using an intra-articular ("over-the-top") and an extra-articular ("fascia-doubling") method].

The present study compares the results of an intraarticular ("over-the-top") and an extraarticular (fascia lata imbrication) surgical method to treat the rupture of the cranial cruciate ligament in dogs. In a period of 18 months, 132 stifle joints of 125 dogs with a partial or complete rupture of the cranial cruciate ligament were examined according to a systematic protocol at the Clinic for Small Animals of the Hannover School of Veterinary Medicine, Hannover, Germany. Surgery was performed with either one or the other of the two surgical techniques. In all cases a " cleaning up " was carried out. If the medial meniscus was damaged, it was resected and the lesion was investigated. The imbrication technique of the lateral aspect of the fascia lata was easier and faster to perform. Using the "over-the-top" method, there were difficulties to guide the fascial strip through the intercondylar notch. After six months 88 patients were re-examined clinically and radiologically according to the same protocol as mentioned above. In the present study it was demonstrated that patients treated with the extraarticular method showed a higher rate (76.5%) of normal limb function after six months and walked earlier without lameness compared with dogs operated with the "over-the-top" technique (41.5%). The same results were valid for patients of giant breeds. Patients operated with the imbrication technique showed more arthrosis of the patellar tip. After six months stability, evaluated with the cranial drawer test and the tibia compression test was satisfying with both techniques.

Animals↗

[A case of Poland's syndrome with giant bulla resected by using autologous fascia lata].

We reported a case of giant bulla with Poland's syndrome, only left pectoral major and minor muscles defect. A 58-year-old man was admitted to our hospital with shortness of breath on exertion. Computed tomographic scan revealed right giant bulla in emphysematous lung. The giant bulla was resected by linear stapler with autologous fascia lata. Though minor air leakage persisted for 5 postoperative days, the postoperative course was uneventful. It could be effective to reinforce staple line by using autologous fascia lata in emphysematous bulla without any infectious problem.

Fascia Lata↗