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At least 775 records · Page 43Linked to original sources
PubMed1986

Repeated skin expansion to resurface a massive thigh wound.

We report here a patient who sustained posttraumatic skin and soft-tissue loss of the right thigh. Replacement of approximately 750 cm2 of split-thickness skin graft with adjacent skin serially expanded and advanced demonstrates the applicability of this technique to cover large tissue defects. Despite infection and exposure, we believe that expansion can proceed safely on an outpatient basis, providing that systemic toxicity does not develop and the exposure does not mechanically preclude expansion.

Child↗
PubMed1998

Reconstruction of a large abdominal wall defect using combined free tensor fasciae latae musculocutaneous flap and anterolateral thigh flap.

A large abdominal wall defect was reconstructed with the use of a flap combining the tensor fasciae latae musculocutaneous flap and the anterolateral thigh flap in four individuals who had undergone extensive abdominal wall resection because of cancer. The flap was harvested as a single combined composite flap and was transferred to the recipient site by means of microvascular surgery. Morbidity was minimal and the outcome was satisfactory in all instances.

Abdominal Muscles↗
PubMed1997

Perforated cecal adenocarcinoma presenting as a thigh abscess.

Complicated colorectal carcinoma has several symptoms, the most common being bleeding and obstruction. Occasionally it will cause perforation, which carries a worse prognosis. We report a case of perforated adenocarcinoma of the cecum that presented as an abscess of the thigh. We also present a review of the literature on this subject.

Abscess↗
PubMed2006

Thigh muscle weakness in ACL-deficient knees persists without structured rehabilitation.

UNLABELLED: We evaluated whether quadriceps and hamstrings weakness depended on chronicity in amateur athletes with anterior cruciate ligament deficiencies. We hypothesized that the weakness would not recover to the level of healthy control subjects without structured rehabilitation. Secondarily, we asked whether quadriceps and hamstrings side-to-side percent asymmetry in strength was consistent at different stages of chronicity. Thirty-six male amateur athletes forming equal groups of short, intermediate, and long chronicity (mean, 4, 12, and 56 months, respectively) were tested isokinetically against control subjects at 60 degrees per second. Weakness was substantial in both muscle groups and at all times ranging from 32% to 21% compared with the control subjects. However, side-to-side deficits revealed a linear trend of lessening with time. The quadriceps had greater side-to-side asymmetry that ranged from 23% to 10%, whereas the hamstrings asymmetry ranged from 14% to almost 0%. Acquiring symmetric strength earlier than 1 year after injury only occurred in the hamstrings. It can be inferred that participation in organized rehabilitation would minimize the detrimental effects of anterior cruciate ligament rupture on thigh muscle strength. LEVEL OF EVIDENCE: Prognostic Study, Level II.

Anterior Cruciate Ligament Injuries↗
PubMed2007

Case report: a thigh mass resulting from polyethylene wear of a revision total hip arthroplasty.

The case of a 60-year-old man who had an enlarging thigh mass seen during a routine 12-year examination of a cementless revision total hip arthroplasty is presented. Aspiration of the mass yielded more than 200 cc of thick yellow fluid. Cytopathologic examination disclosed material consistent with polyethylene wear debris. The porous titanium acetabular and femoral components were not loose. Reoperation was recommended despite minimal symptoms, because the fluid-filled mass recurred after aspiration. At the time of reoperation, the components appeared well fixed and a linerhead exchange was performed. One year after surgery, the mass had not recurred and the patient had minimal symptoms.

Arthroplasty, Replacement, Hip↗
PubMedDate not supplied

Acute compartment syndrome of the thigh in a football athlete: a case report and the role of the vacuum-assisted wound closure dressing.

We present a case of compartment syndrome of the thigh due to blunt injury in a Division I American football player managed with fasciotomy and vacuum-assisted wound closure. This case report discusses the vacuum-assisted wound closure dressing as an alternative to more traditional closure techniques such as suture retention devices and split-thickness skin grafting. We feel that any surgeon involved in performing fasciotomies should be familiar with this increasingly used closure device and its potential complications.

Adult↗
PubMedDate not supplied

Solitary cysticercosis in the intermuscular area of the thigh: a rare and unusual pseudotumor with characteristic imaging findings.

A 33-year-old woman with cysticercosis presenting as a solitary tumor between the adductor muscle groups of the thigh is reported. Although such solitary soft tissue cysticercosis is rare and there are no sporadic reports in the literature with an intermuscular presentation, the typical appearance of the larvae within the mass made the diagnosis in this case easier compared with other cases of solitary soft tissue cysticercosis reported in the literature.

Adult↗
PubMed2003

New anterolateral thigh perforator flap with a short pedicle for reconstruction of defects in the upper extremities.

Three cases of successful transfer of a new free anterolateral thigh (ALT) perforator flap for coverage of soft-tissue defects in the hand and upper arm are described. This new flap has a thin superficial fatty layer, no fascial component, and is vascularized with a perforator of the descending branch of the lateral circumflex femoral system. The free flap is nourished by anastomosing of the perforator or the proximal small segment of the descending branch. The advantages of this flap are no need for deep dissection, minimal time for flap elevation, minimal donor site morbidity, preservation of the main trunk of the lateral circumflex femoral system, possible thinning of the flap with primary defatting, possible application as a flow-through flap, and a concealed donor scar. This flap is suitable for coverage of defects in the fingers, hands, and arms.

Adult↗
PubMed2006

Use of the anterolateral thigh flap as an alternative to the rectus flap in obese and overweight patients.

INTRODUCTION: Oncologic reconstruction in obese patients can be challenging. Donor tissues, such as the rectus flap, can be excessively bulky and result in significant cosmetic and functional deformities. Although the use of the anterolateral thigh (ALT) flap as an alternative to the radial forearm flap has been extensively described, few studies have evaluated the use of the ALT flap as an alternative to the rectus flap. The purpose of this study was to evaluate our experience with the ALT flap in overweight or obese patients. METHODS: A retrospective review was conducted of all ALT flaps performed over a 2-year period at Memorial Sloan-Kettering Cancer Center. All patients with a body mass index (BMI) >25 kg/m2 were identified and evaluated. RESULTS: Twenty-seven patients underwent ALT flap reconstruction during the study period. Of these, 11 patients were overweight (BMI, 25.1-30 kg/m2) or obese (BMI, >30 kg/m2). Reconstructions were performed for a variety of oncologic defects, including head and neck (n = 7), extremity (n = 2), chest wall (n = 1), and abdominal wall (n = 1). Complications were, in general, mild and infrequent. One patient experienced a minor infection, 1 patient had partial flap loss, and 2 patients had partial skin graft loss at the donor site. There were no flap losses. CONCLUSIONS: The ALT flap is a safe and reliable flap for reconstruction of diverse defects in overweight or obese patients. Large flaps can be designed and tailored to the defect by harvesting variable amounts of skin, subcutaneous tissues, fascia, and muscle. The ALT flap may be a good alternative to the rectus flap in overweight or obese patients.

Adult↗
PubMed1992

Angiosarcoma of the thigh with thrombosis in the femoral artery.

We report a case of angiosarcoma with some peculiar clinical features developing on the left thigh of a 63-year-old man. The early primary lesion was erythematous with necrotic areas. The initial biopsy specimen of the lesion indicated a benign angioproliferative process. However, the necrotic area enlarged rapidly, ulcerated with severe pain, and thus was widely excised. The excised specimen had a malignant histologic appearance, particularly in the fascia, and was diagnosed as angiosarcoma. Following local recurrence, the lesion was complicated by thrombosis of the femoral artery at the affected site. A similar cutaneous lesion subsequently arose on the right lower leg, and thrombosis developed in the right femoral artery. Both legs had to be amputated. There were no distant metastases.

Amputation, Surgical↗
PubMed1985

Effects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients.

Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. In the general anaesthesia group, there was a rise in either systolic or diastolic arterial pressure of over 30% of the control value in 8/15 patients. In the spinal anaesthesia patients, there was a transient rise above 30% in only one patient out of 15 and no rise in the 15 epidural group patients. On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.

Adult↗
PubMed1987

Spinal block, after dantrolene pretreatment, for resection of a thigh muscle herniation in a young malignant hyperthermia susceptible man.

We describe a young man who experienced malignant hyperpyrexia, probably triggered by suxamethonium and/or enflurane during his second operation for an epigastric hernia. His malignant hyperthermia susceptibility was later verified using the caffeine/halothane contracture test in vitro. Subsequently, a tumorous mass, consisting of herniated and hypertrophied muscle grew in his thigh, and was resected under spinal anaesthesia. Whereas dantrolene (2.5 mg/kg i.v.) pretreatment produced impaired swallowing, the subsequent high spinal block, in addition, resulted in laboured breathing. It is stressed that respiratory power should be monitored when patients pretreated with dantrolene are given spinal anaesthesia. The muscular symptoms and test results in the patient's relatives are also discussed.

Adolescent↗
PubMed1992

Percutaneous drainage of a thigh haematoma: case report of an unusual radiographic appearance.

We present a case of fat necrosis in the thigh of a ten year old girl, resulting in unusual multiple, ovoid filling defects seen in the residual cavity following drainage of a subcutaneous haematoma. No similar cases have been found on review of the literature. The appearance is described to aid diagnosis at the time of initial cavity drainage, avoiding the need for further investigation.

Child↗
PubMed2006

Long-standing Morel-Lavallée lesion in the proximal thigh: ultrasound and MR findings with surgical and histopathological correlation.

A 65-year-old man presented with a soft mass in his proximal right thigh. Ultrasonography showed a well-defined anechoic lesion with slightly internal echoes. On MRI, the mass was hypointense and minimally hyperintense compared with muscle at T1 and hyperintense at T2, with a hypointense peripheral rim on both sequences. No signal loss was observed on T1-weighted fat-suppression MRI. The clinical setting, imaging findings and histopathological features were consistent with a long-standing Morel-Lavallée lesion.

Aged↗
PubMed1988

Merkel cell tumor of the thigh.

This case of a Merkel cell carcinoma is unusual due to the occurrence of the tumor on the thigh; most Merkel cell tumors have been found on the sun-exposed region of the head and neck. Histologically, the nodule was composed of sheets of uniform, poorly differentiated cells with a high nuclear to cytoplasmic ratio. Electron microscopy revealed perinuclear filaments, scattered dense core granules, and complex, interdigitating processes within cytoplasmic membranes. Treatment consisted of surgical excision of the tumor with a wide margin.

Aged↗
PubMed1988

Liposuction surgery of the lateral thigh.

We report our experience in 50 patients who underwent liposuction surgery of the lateral thighs with or without concomitant liposuction surgery of the hip and buttock areas. This procedure has proven to be a remarkably safe and effective method for removal of fat in properly selected individuals. The operation avoids the problems of blood loss and scarring associated with other operations used to remove fat and makes for extremely satisfied patients.

Adult↗
PubMed1993

Focal myositis of the thigh: report of two cases.

Focal myositis is a benign inflammatory pseudotumor of skeletal muscle, presenting as a localized painful swelling within the soft tissue of an extremity. Histological examination reveals lymphocytic infiltration, scattered muscle fiber necrosis and regeneration, and interstitial fibrosis. Complete recovery follows surgical removal of the lesion. Two cases are presented of young active males with a localized painful swelling of the thigh. Clinical examination, standard laboratory tests, electromyography (EMG), magnetic resonance imaging (MRI) and surgical biopsies were performed. Surgical biopsies were formalin-fixed, paraffin-embedded and sections were stained with hematoxylin and eosin, van Gieson, modified Gomori trichrome and Mallory's method for iron. Clinical examination in both cases revealed an indolent lump in the quadriceps femoris muscle. Standard laboratory tests and electromyography were normal. MRI prior to surgery visualized the focal nature of the lesions. Histological examination of repeated surgical biopsies showed scattered muscle fiber necrosis, regeneration, and interstitial fibrosis but few lymphocytes. Both patients recovered after surgical removal of the lesion. Two years after surgery there was no recurrence of the lesions and repeated EMGs were normal.

Adolescent↗
PubMed2003

Inhibition of alpha-adrenergic vasoconstriction in exercising human thigh muscles.

The mechanisms underlying metabolic inhibition of sympathetic responses within exercising skeletal muscle remain incompletely understood. The aim of the present study was to test whether alpha(2)-adrenoreceptor-mediated vasoconstriction was more sensitive to metabolic inhibition than alpha(1)-vasoconstriction during dynamic knee-extensor exercise. We studied healthy volunteers using two protocols: (1) wide dose ranges of the alpha-adrenoreceptor agonists phenylephrine (PE, alpha(1) selective) and BHT-933 (BHT, alpha(2) selective) were administered intra-arterially at rest and during 27 W knee-extensor exercise (n= 13); (2) flow-adjusted doses of PE (0.3 microg kg(-1) l(-1)) and BHT (15 microg kg(-1) l(-1)) were administered at rest and during ramped exercise (7 W to 37 W; n= 10). Ultrasound Doppler and thermodilution techniques provided direct measurements of femoral blood flow (FBF). PE (0.8 microg kg(-1)) and BHT (40 microg kg(-1)) produced comparable maximal reductions in FBF at rest (-58 +/- 6 versus-64 +/- 4%). Despite increasing the doses, PE (1.6 microg kg(-1) min(-1)) and BHT (80 microg kg(-1) min(-1)) caused significantly smaller changes in FBF during 27 W exercise (-13 +/- 4 versus-3 +/- 5%). During ramped exercise, significant vasoconstriction at lower intensities (7 and 17 W) was seen following PE (-16 +/- 5 and -16 +/- 4%), but not BHT (-2 +/- 4 and -4 +/- 5%). At the highest intensity (37 W), FBF was not significantly changed by either drug. Collectively, these data demonstrate metabolic inhibition of alpha-adrenergic vasoconstriction in large postural muscles of healthy humans. Both alpha(1)- and alpha(2)-adrenoreceptor agonists produce comparable vasoconstriction in the resting leg, and dynamic thigh exercise attenuates alpha(1)- and alpha(2)-mediated vasoconstriction similarly. However, alpha(2)-mediated vasoconstriction appears more sensitive to metabolic inhibition, because alpha(2) is completely inhibited even at low workloads, whereas alpha(1) becomes progressively inhibited with increasing workloads.

Adrenergic alpha-1 Receptor Agonists↗