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The long-term venous function after postoperative thigh vein thrombosis according to the 125I-fibrinogen test was analysed. 50 patients with a positive fibrinogen test postoperatively were investigated with strain gauge plethysmography 74 (27--103) weeks after operation. In five patients (10%), all female and all hip operated, pathological plethysmograms were seen.
Granulo-cellular myoblastoma (MGC) is a rare disease, the nature of which is still discussed and uncertain. The authors describe a particular case with bilateral location at thigh in a patient suffering also from pigmental villonodular tenosynovitis (TSVNP) at the right thumb. This observation confirms the absolute benignancy, and supports the theory of the non-neoplastic histogenesis of MGC.
A clinical case of Wilms' tumor with primary metastasis to right thigh without pulmonary metastasis that would explain the dissemination to soft tissues is presented. Considerations on the mechanism of metastasis dissemination are made in regard to the question in this particular location. We have not found a similar case in medical literature.
Broiler chicks grown on litter or in cages at high bird density developed skin lesions on the thigh and hip. Changes in bird denisty markedly influenced lesion incidence (100% at 0.0185 sq m of floor space per bird). The dermatitis was characterized by crusted dry "scabs" at the base of feather follicles and between follicles. The lesions often coalesced to cover wide areas. The scab consisted of a mass of pyknotic nuclei and cellular debris, and when the epidermis was intact there was little inflammatory reaction in the dermis or subcutaneous tissue. The epidermis was destroyed in some lesions, with heterophils penetrating into the subcutaneous tissue. Colonies of gram-positive cocci were present in the lesions.
The authors report here their experiences with regard to reconstructive treatment of arteriosclerotic changes occurring in arteries of the thigh area. In the introduction the historic development of the blood vessels surgery has been given. Various operating methods and respective experiences, as well as the results obtained from this operating field have been described. It has been mentioned in the conclusion that the exact indication is responsible for successful reconstructive operation. Further factors playing the main role are: adequate operative technic, appropriate anesthesia, as well constant blood pressure in the course of operation.
The difficulties occuring in angiography of popliteal artery and its branches are here presented. The presentation of these arteries on angiogram is very important due to establishing operative andications on arteries of thigh and upper parts of leg. Successfully performed peripheral angiographies on 1000 patients are here presented.
The atrophy was evaluated by using muscle biopsies, computed tomography and measuring tape. Ten well functioning below-knee amputees with a mean age of 56 years participated. The amputees had 33 per cent type I fibres in the amputated leg compared to 38 per cent in the non-amputated leg, the difference not being significant. In the amputated leg there was less type IIA fibres (p less than 0.01), more type IIB (p less than 0.05) and type IIC fibres (p less than 0.01) than in the non-amputated leg. Atrophy (single fibres or groups of 4-5 small fibres) of both type I and type II fibres were seen in most patients. The mean muscle fibre area of the vastus lateralis of the amputated leg was 74 per cent of that of the non-amputated leg (p less than 0.05). In both legs the area of type II fibres was larger than that of type I fibres. The cross-sectional area of the whole thigh in the amputated leg was 86 per cent (p less than 0.05), of the quadriceps muscles 66 per cent (p less than 0.01) and of the hamstring muscles 80 per cent (p less than 0.05) of the area of the non-amputated leg. It was not possible to demonstrate if there was a reduction in the total number of muscle fibres. This indicates that the main cause for the reduction of muscle volume is the reduction in fibre sizes. There was no significant difference in circumference measurements when using computed tomography or measuring tape.
A surgical case is described of a 40-year-old hemophilia A patient with a potent factor VIII inhibitor (40 Bethesda units) suffering from a chronic cystic haematoma in the right thigh. Surgery was performed after extensive plasmapheresis and administration of a large amount of factor VIII concentrate (42,500 U on the day of operation). During the five post-operative days, the factor VIII level was maintained above 25%, which allowed control of hemorrhage. However, two serious problems, i.e., hemolytic anemia and anamnestic response of factor VIII inhibitor titer, occurred on the 6th post-operative day. The hemolytic anemia was circumvented by administering prothrombin complex concentrate every 8 hours for 12 days until the sutures were removed. There was no bleeding although the inhibitor titer rose to 460 Bethesda units.
An 87-year-old woman underwent surgery for a dermato-fibrosarcoma of the thigh, responsible for hypoglycaemic episodes. There was a high level of NSILP contrasting with a low level of NSILAs. This is the second case where such a finding has been made in a patient suffering from an extra-pancreatic tumour causing hypoglycaemia. The possible aetiological role of NSILP in extra-pancreatic tumours causing hypoglycaemia is discussed.
Two typical cases of this apparently rare condition usually observed in women are reported. 22 cases have been published since the first observation in 1974. Lesions are made of semi circular band-like, isolated, atrophy of the subcutaneous fatty tissue, involving half the circumference of anterolateral part of the thigh. No other clinical or biological abnormalities are noticed. Four stages may be histological considered. Ultrastructural investigation performed in our cases confirms histological findings: in the first case adipocyte's abnormalities, fibrillogenesis, and sclerosis are noticed, in the second case (persistent lipoatrophia) rarefaction of collagen's fibers appears to be the most important feature. Etiology remains unclear, but repeated external traumas seem the most plausible explanation in several cases of the literature and in our cases: case no. 1, related to leaning on bath's border for washing, was regressive after trauma's suppression, while the second case was not regressive since the patient did not discontinue wearing the responsible girdle.
The author has had experience with ulcers of venous origin on the toes, knee and thigh, and demonstrates some of them. They are rare, and as a general rule are the result of a traumatism (shoes or seating). The author attaches little importance to cosmetic treatment and is strongly opposed to foot baths with Permanganate of K, since they require that the edematous leg remain in a vertical position in the warm water. In addition to elastocompression of the leg, well applied and only for walking, he insists on the efficacy of posture treatment reasonably and conscientiously practiced. The absence of posture treatment is, together with hemopathies and calcinosis, the root cause of so-called long-term ulcers.
Using three soft-tissue analogs of variable compliances, four custom functional knee orthoses were evaluated for their abilities to control anterior tibial displacement (ATD) using an anterior cruciate ligament (ACL)-deficient surrogate knee model with applied forces from 25 to 250 N. These analogs had stiffnesses (compliance) ranging from 2.18 N/mm to 4.6 N/mm, simulating the range in the thigh soft-tissue compliances found in subjects ranging from sedentary individuals to competitive athletes. Significant differences in the ATDs allowed were observed between the soft-tissue analogs, orthoses, and the force applied. At low forces, soft-tissue compliance did not play an important role in the reduction of ATD; however, at high forces ATD was directly related to the soft-tissue compliance.
100 anterior branches of the lateral cutaneous nerve of the thigh were dissected and measured in 50 adult cadavers. The results show that this nerve is present in all sides. The average length from the point of the nerve piercing fascia lata to the point of its first branch is about 79mm, the average width is 2.25 mm, and the average thickness is 0.79 mm respectively. It is found that the course of the nerve is approximately along the line between the anterior superior iliac spine and the midpoint of the patella. This study is benifit to the facial nerve grafting in clinic by providing data of the nerve.
Only a few cases of rupture of the symphysis pubis have been reported but the condition could become more frequent with epidural anesthesia. Conservative management is emphasized. Rupture is caused by desensitization to the labor process due to epidural anesthesia and excessive abduction of the thighs to increase anterior-posterior diameter during the birth process. Greater use of labor epidural anesthesia could increase the frequency of this event.
Hydatid cyst has been reported in various unusual anatomical sites. Primary limb and muscular hydatid cyst remains extremely rare. We report a case of hydatid cyst in the thigh presenting with referred hip pain 40 years after leaving an endemic region, and review the literature.
Early failure caused by wear of the polyethylene bearing surface of a metal-backed tibial platform or a metal-backed patellar component in a total knee prosthesis has been a recognized complication; patients with these problems initially have pain and instability. A patient who had a cystic mass in the distal thigh was evaluated, and osteolysis of the distal femur was detected. Polyethylene debris and reactive synovium were confirmed surgically and histologically, indicating a cause-effect relationship of polyethylene wear debris and failure of the total knee arthroplasty. Regular and long-term patient follow-up evaluation after total joint arthroplasty is essential for the detection of early evidence of occult polyethylene wear.
A case of Hemangiopericytoma at the thigh is reported. The Hemangiopericytoma is a rare tumour made with pericyties. This neoplasia is usually benign and it is located in the soft tissues. Tumour is profusely irrigated. The most common locations of the Hemangiopericytoma are the lower limbs and the abdominal cavity. The Hemangiopericytoma is difficult to be recognized by histological criteria. The high number of relapses and metastasis involve to an extent surgical ablation of the tumour and its borders. Present literature is reviewed and the different diagnostic and therapeutic options are discussed.
A previous investigation suggested that striation patterns spanning individual muscles in longitudinally oriented MR images may represent the orientation of its fascicles. In this study, we confirmed that these striation patterns could be used to infer fascicle orientation and to compute other architectural features of muscles from MR images. The volumes of 14 muscles within a cadaveric thigh were shown to be estimated accurately from cross-sectional MR images by comparison with direct measures from muscle mass. The angles of striations were measured at several positions within vastus medialis and semimembranosus from sagittal and frontal-plane MR images. Mathematical techniques were developed to infer the 3-dimensional orientation of fascicles based on these striation angles. The angle of striations in a 3rd oblique plane was shown to agree with mathematical predictions based on these computed orientations. The pennation angle, defined as the angle between the fascicles and the line of action of the muscle, predicted from the MR images, was similar to directly measured values. Interestingly, the pennation angle of these fascicles varied along the length of the muscle; in vastus medialis, pennation angle ranged from 5 degrees to 50 degrees in a proximodistal direction. Procedures were developed and validated to compute fascicle length by projection of fascicle orientation across the 3D shape of the muscles. The use of MR images to estimate muscle morphometry could improve greatly the predictive capabilities of musculoskeletal modelling by reducing the number of unknown model parameters.