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At least 955 records · Page 53Linked to original sources
PubMed1987

High intensity electrical stimulation effect on thigh musculature during immobilization for knee sprain. A case report.

We conducted high intensity electrical stimulation of the quadriceps femoris and hamstring muscle groups daily during a three-week period of lower extremity cast immobilization for an athlete who sustained Grade II medial collateral and anterior cruciate ligament sprains. Thigh muscle hypertrophy of the injured (stimulated) leg was suggested by an increase in girth measurement on the day of cast removal. Three weeks after cast removal, single-leg, vertical-leap height was 92% of that accomplished by the dominant, uninjured leg, and the patient was able to return to athletic competition. This case report documents the usefulness of high intensity electrical stimulation for maintaining limb motor function during cast immobilization. Limb stabilization during stimulation and simultaneous excitation of agonist-antagonist muscle pairs also are discussed.

Adolescent↗
PubMed2002

Clear cell myomelanocytic tumor of the thigh: report of a unique case.

The clear cell myomelanocytic tumor (CCMMT) is a recently reported and very rare member of the perivascular epithelioid cell family of tumors (PEComa). All CCMMTs reported to date have occurred in or immediately adjacent to the falciform ligament/ligamentum teres. We report a case of CCMMT that occurred in the right thigh of a 43-year-old woman. Histologic examination showed the classic features of CCMMT, and immunohistochemical studies confirmed co-expression of smooth muscle actin, HMB-45, and microphthalmia transcription factor.

Actins↗
PubMed1982

Closure of chronic wounds of the perineal and sacral regions using the gluteal thigh flap.

A new flap of the buttock and posterior thigh has been developed for closure of wounds of the perineal and postsacral regions. Flap anatomy and operation technique are described. Five patients with difficult wounds were selected to demonstrate the versatility and range of this flap. In 40 patients under 65 years of age with a variety of buttock and perineal wounds, there have been no appreciable wound-healing problems with use of this flap.

Adult↗
PubMed1986

Use of groin and mid-thigh flap in reconstruction of penis with penile and perineal urethra and a dorsal skin-lined socket for a removable prosthesis.

Absent or deformed genitalia give rise to profound psychological complexes. In such cases reconstruction of the phallus can help the patient return to leading a normal life. A reconstructed penis must have a normal appearance, feel, and function, which up to now has not been completely possible. Using the method described herein, the penis was reconstructed from a groin and mid-thigh flap. It has a skin-lined tube placed ventrally for urination and has a dorsal skin-lined socket for insertion of a removable prosthesis for artificial erection. Seven stages are required for reconstruction, including reconstruction of a perineal urethra. Appearance of the reconstructed organ is acceptable. The erection device is simple, stable, and not costly, and normal urination and procreation are possible. Part of this method is also applicable for loss of erection and in reconstruction of a perineal urethra only.

Adult↗
PubMed2002

Endoscope-assisted management of varicose veins in the posterior thigh, popliteal fossa, and calf area.

Varicose veins of the posterior thigh, popliteal fossa, and calf area were managed with the assistance of endoscopic surgery in 136 patients. Patients were divided into four types according to the normal veins involved in varicosities. With good illumination and magnified monitor viewing by means of a surgical endoscope, the main channel, tributaries of varicosities, incompetent perforating veins, and healthy veins could be clearly visualized and identified. Even though these varicosities had aberrant and tortuous courses, they could be completely dissected, divided, and then removed through one or more access incisions (2.5-3.0 cm in length). The incompetent perforating veins were also dissected and divided. The mean number of access incisions for each lower extremity was 2.2, 1.9, 1.3, and 1.0 for types I, II, III, and IV respectively. In all cases, the mean number of incisions was 1.6 in each lower limb. The most frequent morbidity was maceration of the access incision. Three wounds in 3 patients required debridement and resuturing, but the other wounds healed satisfactorily. Transient discoloration caused by bruising and numbness may present at the dissected area. There was no hematoma formation. Ischemic change with bleb formation of the dissected skin occurred in 1 patient. Subsequent secondary healing resulted in slight scarring in this area. With the assistance of endoscopic surgery, all the varicosities and the incompetent perforating veins could be completely dissected and removed. Accomplishment of removal of varicosities was double-checked between the preoperative skin marks of varicosities and the endoscopic findings. There is very little possibility for recurrence, because there were no residual varicosities or incompetent perforating veins after this operation. There was no recurrence in follow-up at least 2 months postoperatively. Patients were satisfied with the minimal surgical scarring and the complete absence of disfiguring varicosities.

Adult↗
PubMed2002

Thin anterolateral thigh free flap.

The need for a thin flap has increased for contour or coverage of the shallow defects caused by trauma, tumor ablative surgery, or defects created after the release of contractures. The authors describe their experience with the use of an extremely thin anterolateral thigh free flap for covering such defects in a series of 12 patients. Extreme thinning of the flap (4-5 mm) was achieved by removal of deep fascia and subcutaneous fat except for a 3- to 4-cm area around the entry of the perforator into the flap. Subdermal fat and immediate underlying superficial veins should be preserved during the thinning procedure for venous drainage of the flap. Their clinical experiences with 12 patients indicate that an extremely thin, long flap can survive on a single perforator.

Adolescent↗
PubMed2002

V-Y fasciocutaneous pudendal thigh flap for repair of perineum and genital region after necrotizing fasciitis: modification and new indication.

Necrotizing fasciitis is an aggressive, deep-seated infection of the fascia and subcutaneous fat with necrosis of the overlying skin, and it is a toxin-mediated disease. The aim of this study was to review 13 cases of necrotizing fasciitis of the perineum and the external genitalia region with regard to the diagnosis, treatment, and methods of reconstruction of secondary defects. The study was performed from June 1997 to May 2001 and involved 11 men and 2 women who ranged in age from 35 to 67 years (mean age, 53 years). All patients presented to the plastic surgery unit with huge secondary defects of the urogenital region, upper thigh, and lower abdomen after being excised initially by general surgeons. Eight patients were treated with bilateral flaps, and the unilateral flap was used in 2 patients. The V-Y island fasciocutaneous flap, used to resurface the urogenital region after necrotizing fasciitis, is considered a new indication. The V-Y axial-pattern design of the flap is also considered a new modification, which enabled the flap to be advanced and tailored nicely in the midline. The idea of using the V-Y-plasty design is raised because the perineum has a pair of symmetrical anatomic structures. In addition, this procedure conserves tissue and the flap donor site is closed primarily without tension. Both aesthetic and functional results were satisfactory.

Adult↗
PubMed2002

Free anterolateral thigh fasciocutaneous flap with a fat/fascia extension for reconstruction of tendon gliding surface in severe bursitis of the dorsal hand.

A 72-year-old man had severe bursitis in his left dorsal hand after resection of a ganglion twisted around the extensor tendons. After resection of the bursa, a free anterolateral thigh fascial flap with a skin island was used to fill the dead space and to reconstruct a two-layer gliding surface of the extensor tendons. The extensor tendons were wrapped in the fascial flap with the fat layer inside. The flap took completely and the patient was free of bursitis without loss of range of finger motion.

Aged↗
PubMed1995

A new musculocutaneous island flap from the distal thigh for recurrent ischial and perineal pressure sores.

In the paraplegic patient who has had previous surgeries for pressure sores, local tissue is frequently unavailable for further use. The posterolateral aspect of the thigh, however, is almost always available and provides an excellent reconstructive alternative for this difficult problem. In 1983, Baek described the skin territory supplied by the third perforator of the profunda femoris artery. A musculocutaneous flap can be raised consisting of the same skin territory and a portion of the biceps femoris muscle (short head) through which the third perforator courses. In addition, the distal part of the vastus lateralis muscle, which is supplied by a muscular branch of the same perforator, can be included in the flap. The flap is elevated as an island based on the profunda femoris artery and accompanying venae comitantes. A substantial soft-tissue mass can be transposed easily to the perineum. Standard latex injection techniques were used in 12 fresh cadaver dissections prior to use of this flap in 16 clinical cases. Selective india ink injections into the third perforator of the profunda femoris artery in 6 cadavers confirmed the perfusion of the overlying skin territory. Recurrent ischial and perineal wounds were closed successfully with this musculocutaneous flap in all 16 clinical cases.

Adult↗
PubMed2000

Anterolateral thigh fasciocutaneous flap in the difficult perineogenital reconstruction.

A pedicled anterolateral thigh fasciocutaneous flap that was used to cover a complicated perineogenital defect after bilateral gracilis myocutaneous flap for perineal reconstruction is presented. The indications and advantages of this approach are outlined. This technique offers to the plastic surgeon and gynecologic oncologist a new option in the armamentarium for reconstruction of the perineum, and it offers the patient reduced donor-site morbidity.

Aged↗
PubMed2000

Facial contour restoration in Barraquer-Simons syndrome using two free anterolateral thigh flaps.

Barraquer-Simons syndrome, or cephalothoracic lipodystrophy, is characterized by fat atrophy of an obscure pathogenesis involving the face and, eventually, the thoracic region. Simultaneously, fat hypertrophy of the lower extremities, a nephropathy, and complement anomalies may be observed. We presented two patients with the typical features of this disease, as well as a previously undescribed vascular and perivascular inflammation of the facial arteries and veins that caused problems with microvascular anastomosis. Both patients were treated with a bilateral transfer of the anterolateral thigh flap, which has not been reported previously. In contrast to other transfers previously reported, the fat tissue of this flap is never affected by the disease and is redundantly present. Placing the fascia of the flaps toward the skin allows for strong fixation to the temporal region and guarantees a stable result with a smooth facial contour.

Facial Asymmetry↗
PubMed2007

The anterolateral thigh flap is highly effective for reconstruction of complex lower extremity trauma.

BACKGROUND: Trauma patients with high-energy injuries often present with severe tissue damage that extends beyond the immediate zone of injury and requires recruitment of vascularized tissues from distant sites. The objective of this study was to evaluate the utility of the anterolateral thigh (ALT) flap for reconstruction of the traumatically injured lower extremity. METHODS: Prospective data were collected on all patients who underwent lower extremity reconstruction with an ALT flap during a 3.5-year period at a primary adult resource center (PARC). Demographics captured included age, gender, Injury Severity Score, mechanism of injury, and size of defect and complications. RESULTS: Fifty-six patients underwent a total of 59 ALT flap harvests during the study period. The majority of patients were male (75%) and sustained blunt injury (95%). The mean age was 37 +/- 14 years with a mean Injury Severity Score of 17.9 +/- 8. The mean flap size was 20.7 x 8.4 cm, with 64% harvested from the injured limb. Total flap success rate was 91.5%, with four total (6.7%) and one partial flap failure (1.7%). CONCLUSION: The ALT flap is a useful tool for trauma reconstruction in lower extremity salvage. We have shown that the ALT flap can be performed successfully in the traumatically injured patient even when harvested from the ipsilateral lower extremity.

Adult↗
PubMed2006

Posterolateral thigh perforator varicosities in 12 patients: a normal deep venous system and successful treatment with ultrasound-guided sclerotherapy.

OBJECTIVES: To determine whether in patients with posterolateral thigh perforator (PLTP) varicosities ultrasound-guided sclerotherapy (USGS) is successful and to determine any deep venous anomaly. PATIENTS: Twelve consecutive patients with PLTP varicosities were investigated and treated. DESIGN: In this prospective intervention study USGS of the PLTP with polidocanol microfoam 1-2% was performed with a maximal number of three treatments. Clinical pictures and Duplex imaging were performed before and after treatment. Ascending phlebography was performed in 9 patients. RESULTS: Ten patients showed a marked success, defined as no PLTP varicosities visible and no reflux detectable. In 2 patients there was moderate success. The mean number of treatments was 1.58, the mean diameter of the PLTP vein was reduced from 4.06 (range, 2.2-6.1) to 1.97 (range, 0-3.3) mm (p=0.003, Wilcoxon signed rank test). No serious side effects were noted. No deep venous anomaly was found in the phlebographic study. CONCLUSION: In patients with PLTP varicosities, USGS is very successful, with very few side effects. No deep venous anomalies were found in our study, which conforms to the literature.

Humans↗
PubMed2004

Synovial fluid from an African spur-thighed tortoise (Geochelone sulcata).

A 4.5-year old, male African spur-thighed tortoise (Geochelone sulcata) was presented to the University of Florida Veterinary Teaching Hospital with a 2-week history of lethargy, anorexia, constipation, dyspnea, and coughing up fluid or vomiting. Laboratory results included an inflammatory leukogram and a marked increase in plasma uric acid concentration. Synovial fluid from multiple joints was thick, chalky white, and opaque, with a grainy consistency. Microscopically, the fluid contained numerous brown, needle-like crystals consistent with urates (gout). Gross necropsy findings and histopathology confirmed a diagnosis of systemic gout, with urate deposition, gout tophi, and underlying necrosis in multiple organs, including kidneys, lung, and liver. Dehydration with concurrent renal insufficiency may have impaired urate excretion and led to a build-up of urates in the blood and tissues of this tortoise. A high protein diet also may have contributed to the development of gout. Cytologic evaluation of synovial fluid can be used as a quick and definitive tool to diagnose gout in tortoises.

Animals↗