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PubMedDate not supplied

MR imaging of pelvic and thigh muscles in congenital muscular dystrophy.

To define and compare the magnetic resonance (MR) imaging findings of pelvic and thigh muscles in merosin-deficient and merosin-positive congenital muscular dystrophy, 10 patients with merosin-positive and six patients with merosin-deficient muscular dystrophy were examined in a 0.5 T MR imaging unit. Intensity and atrophy scores were given to individual muscles by two radiologists and were calculated for three muscle groups (pelvic, anterior thigh and posterior thigh muscles). Rectus femoris was affected less than the vastus muscles in 40 percent of cases in merosin-positive patients, whereas there was no selective sparing in merosin-deficient patients. Sartorius and gracilis were relatively spared in both groups. The most consistently affected muscles were gluteus maximus, adductor magnus and brevis in merosin-positive patients. Atrophy was more prominent in the adductor muscles in the merosin-deficient group. Intensity scores of anterior thigh muscles of the merosin-positive group were significantly higher than those of the merosin-deficient group (U = 8, p = 0.016). When stepwise logistic regression model was applied, intensity score of the anterior thigh muscles was found to be the best differentiating variable. The regression analysis model formed was able to differentiate the two forms with a sensitivity of 80 percent and specificity of 83 percent.

Child↗
PubMed1999

Effect of the thigh-cuffs on the carotid artery diameter jugular vein section and facial skin edema: HDT study.

Thigh cuffs, currently named "bracelets", consist of 2 straps fixed to the upper part of each thigh, applying a pressure of approximately 30 mmHg. Initially the thigh cuffs were designed and used to improve th comfort of the cosmonauts during their stay in zero g. Except a reduction of the "puffy face" aspect no other morphological nor hemodynamic significant change was reported even when the cosmonauts weared these thigh cuffs inflight for 10h per day during several weeks or months. The objective was to evaluate the distal arterial, venous and skin changes in a group of 8 subjects in HDT for 7 days and using thigh cuffs 8h during daytime, and in a control group also in HDT for 7d but not using cuff.

Bed Rest↗
PubMed2001

[Applied anatomic study of the pudendal-thigh flap and establishment of flap model].

OBJECTIVE: To investigate the anatomic base of the pudendal-thigh flap and establish flap model. METHODS: Skin dissection of pudendal-thigh regions was performed on 10 cadavers (20 sides). All afferent and efferent vessels were measured and recorded. RESULTS: There exist multiple blood supplies of pudendal-thigh flap. Anterior cutaneous branches of obturator artery spread out on middle portion of flap. Piercing site of it is (3.0 +/- 0.5) cm apart from middle line of perineum, (1.7 +/- 0.4) cm from anterior margin of vaginal introitus, (0.6 +/- 0.2) cm from outer fringe of lower pubic rami and (0.8 +/- 0.1) mm in diameter. Posterior labial arteries mainly supply the major labia and constantly anastomose with superficial external pudendal arteries in direct vascular anastomosis in subcutis of major labia. The main stems send out 2-3 lateral branches of posterior labial arteries which distribute to posterior portion of the pudendal-thigh flap. CONCLUSION: The major vessels of pudendal-thigh flaps used to form a neovagina are lateral branches of posterior labial arteries and not the main stem itself. Flaps pedicled on the anterior cutaneous branches of obturator arteries may be elevated to repair rectovaginal fistula or small skin defects of perineum and not suited to reconstruct a neovagina as its piercing point of blood vessels is much higher and the location of pedicle is more fixed.

Female↗
PubMed1975

Thigh emphysema and hip pain secondary to gastrointestinal perforation.

A patient presenting with thigh emphysema and hip pain may suggest intra-abdominal pathology. Three new and 19 previously reported cases of thigh emphysema secondary to bowel disease are reviewed. The thigh and hip manifestations can obscure the primary intra-abdominal process either due to the obvious emphysema or to the obtunded abdominal signs secondary to associated neuropathy. Only one of 22 patients with thigh emphysema secondary to bowel perforation had gas gangrene. Early diagnosis of this clinical association is essential since eight of the 11 deaths occurred within a few days after admission. Right-sided thigh emphysema suggests appendicitis, whereas left-sided emphysema is more likely to be secondary to left colonic diverticulitis or carcinoma.

Appendicitis↗
PubMed2002

Thigh compartment syndrome after acute ischemia.

Thigh compartment syndrome (TCS) is a poorly recognized clinical condition that may follow reperfusion of acutely ischemic thigh muscles. The anterior muscle group appears to be at greatest risk because of its layered arrangement. Intense pain, swelling, and elevated compartment pressures characterize the early presentation in the affected muscle group. If untreated myonecrosis, myoglobinuria, and renal failure may result. TCS was observed in a patient who was treated for a gunshot wound to the left thigh. The superficial femoral and profunda femoris veins as well as the profunda femoris artery were disrupted. The superficial femoral vein and profunda femoris artery injuries were repaired but the mangled branches of the profunda femoris vein were ligated. Postoperatively he developed intense thigh pain, swelling, and elevated compartment pressures. Lateral thigh fasciotomy, extensive debridement of necrotic muscle, and delayed wound closure resulted in a full recovery. Physicians should recognize the numerous clinical circumstances that could lead to TCS--particularly those associated with trauma or physical activity. Timely recognition and intervention may be both limb and life saving. Associated irreparable injury to the profunda femoris vein may aggravate this condition.

Adult↗
PubMed2004

The descending branch of the superficial circumflex artery supplying anteromedial thigh skin.

This report presents an extended groin flap design that consists of a conventional skin paddle in the groin region and a vertical extension in the anteromedial thigh region, based on the superficial iliac circumflex artery and an unnamed descending branch, respectively. The inferior branch of the superficial iliac circumflex artery that supplies the thigh extension of the flap, spanning approximately the upper half of the thigh region, was found to originate approximately 2 cm from the origin of the superficial iliac circumflex artery. A total of six free and four local flaps were used in 10 patients with ages ranging from 10 to 60 years (average, 45 years). There were six male and four female patients. The free flaps were required for total facial resurfacing, through-and-through cheek defect, and burn scar contractures and traumatic defects of the lower extremity. The local flaps were used for reconstruction of scrotum defect, trochanteric decubitus ulcer, and lower abdominal skin and fascia defects. All 10 flaps survived completely. The groin flap with anteromedial thigh extension offers the following advantages: (1) it is very easy and quick to elevate; (2) a significantly increased volume of tissue is available for reconstruction, based on one axial vessel and being completely reliable; (3) the flap offers two skin paddles that are independently mobile; (4) there is no need for positional change and a two-team approach is possible; and (5) it can be raised as a vertical skin island only. The authors conclude that the groin flap with anteromedial thigh extension is a useful modification for reconstruction of both distant and local defects.

Adolescent↗
PubMed2006

Correlation of weight estimation in large and small fetuses with three-dimensional ultrasonographic volume measurements of the fetal upper-arm and thigh: A preliminary report.

OBJECTIVE: To determine the correlation of measuring fetal upper-arm and thigh volume using three-dimensional ultrasonography with weight estimation in large and small fetuses. MATERIAL AND METHOD: The authors included 46 pregnant women admitted for delivery in the Labor Room at Srinagarind Hospital, Khon Kaen University, between February 1 and September 30, 2004. Inclusion criteria were: 1) singleton pregnancy; 2) delivery within 48 hours after study; 3) estimation birthweight < 2,500 g (small fetuses group: n = 22) or > 3,500 g (large fetus group: n = 24). All patients received two- and three-dimensional ultrasound examinations by an experienced practitioner The upper-arm and thigh volume were assessed using a three-dimensional ultrasound scanner. RESULTS: In the large fetus group, upper-arm and thigh volume measurements by three-dimensional ultrasound strongly correlated with birthweight, r = 0.805 (95%CI = 0.594-0.912) and r = 0. 739 (95%CI = 0.478-0.880), respectively. In the small fetuses group, the upper-arm and thigh volume measurements, by three-dimensional ultrasound, strongly correlated with birthweight, r = 0.868 (95%CI = 0.689-0.946) and r = 0.835 (95%CI = 0.638-0.929), respectively. CONCLUSION: Upper-arm and thigh volumes measured by three-dimensional ultrasound highly correlates with weight estimation in large and small fetuses and can be used as a new modality for estimating fetal weight.

Adult↗
PubMed2006

Effect of controlled volumetric tissue heating with radiofrequency on cellulite and the subcutaneous tissue of the buttocks and thighs.

BACKGROUND: Regardless of diet and exercise, genetics plays an important part in creating puckering skin or dimples, which are difficult to hide at any age. The demand for a nonsurgical, noninvasive treatment of cellulite has inspired some manufacturers to invest in a new age of sophisticated devices and treatment therapies to repair the skin and improve contours. Although many of these new choices have demonstrated a smoothing effect (following a multitude of treatments), the objective documentation has in most cases been limited to biopsies, circumference measurements, and photographic evidence. HYPOTHESIS: We believe that the application of noninvasive high-energy radiofrequency (RF) to the skin of the thigh and buttocks heats the subcutaneous adipose tissue, causing collagen fibers to contract. The resulting impact to the subcutaneous tissue and collagen is expected to improve the skin's external architecture. Given that the subcutaneous tissue and adipose tissue are difficult to evaluate through histological methods, this investigation seeks to demonstrate the changes that occur when applying 2 treatments of high-energy RF on the subcutaneous tissue of thighs and buttocks utilizing real-time ultrasound image scanning. MATERIALS AND METHODS: Twenty-six healthy female patients (ages 18 to 50) with visible bilateral cellulite (grade 1 to 3) on either the buttocks and/or thighs received 2 treatment sessions (15 days apart) of unipolar RF using the Accent RF System (Alma Lasers Inc). The system utilizes a unipolar RF applicator that is electrically cooled to aid in patient comfort during the treatment. Appropriate energy was set and the treatment was delivered in 3 passes of 30 seconds each. Evaluation of the thickness of the subcutaneous tissue on buttocks and thighs took place before the first treatment, second treatment, and 15 days following the second treatment with a with real-time scanning image ultrasound (Philips Medical Systems). Clinical improvement was objectively evaluated through comparative pre- and post-treatment measurements of the distance between the stratum corneum to the Camper's fascia and from the stratum corneum to the muscle. The study also evaluated the structure and changes of the collagen (thickening and realignment of septae) resulting from 2 treatments of RE Photography was used to document contour and superficial changes. RESULTS: From the measurements of the distance between the stratum corneum to the Camper's fascia and from the stratum corneum to the muscle we were able to demonstrate that 68% of the patients presented a contraction of the volume of approximately 20%. CONCLUSIONS: Based on the demonstrated results with real-time ultrasound scanning, we have observed that 2 RF treatments on the subcutaneous tissue of the buttocks and thighs provide a volumetric contraction effect in the majority of patients. This validates the primary hypothesis of our protocol and establishes that the RF energy works on the connective tissue of the subcutaneous adipose tissue. This effect should be the same on any other body part.

Adolescent↗
PubMedDate not supplied

Evaluation of arm and thigh circumference in screening low birth weight newborns.

The present cross-sectional study collected data regarding birth weight along with arm and thigh circumference of 174 consecutive newborns delivered at Maternity Hospital, Tasgaon during 2003. To compare & evaluate utility of arm & thigh circumferences for the detection of LBW newborns. Assessment of the best suitable measurement for identification of low birth weight newborns was made by comparison of Coefficient of Determinants (R(2)), Sensitivity and Specificity values and Kappa Statistics. The estimated cut off points of arm and thigh circumference for given value of birth weight 2.5 kg. were 9.1 cm and 14.2 cm. respectively. Although both measurements are highly sensitive, present study established supiriority of arm circumference over thigh circumference in predicting low birth weight newborns. Thigh circumference is more reliable. Advantages of these measurements are their simplicity & low cost.

Arm↗
PubMed1989

Ischaemic mouse thigh model for evaluation of pathogenicity of non-clostridial anaerobes.

A mouse thigh model has been devised in which the growing culture of non-clostridial anaerobe in the ischaemic tissue produces inflammatory swelling and death. The swelling of the right thigh served as an index of pathogenicity of the test strain in comparison to the negatively reacting left thigh which received injection of the control strain of Bifidobacterium infantis. Actinomyces naeslundii exceptionally caused death in all animals within 24 h. Mortality and thigh swelling were pronounced (greater than 75%) in case of Fusobacterium gonidiaformans and Propionibacterium acnes but less (less than 50%) in Acidaminococcus fermentans. High (less than 75%) rate of thigh swelling was also encountered in case of Bacteroides oralis, Bacteroides corrodens, Fusobacterium necrophorum, Fusobacterium prausnitzii, Fusobacterium plauti, Peptococcus prevotii, Streptococcus intermedius, Eubacterium lentum and Propionibacterium freudenreichii ss. shermanii.

Animals↗
PubMed1993

Thigh pain in cementless total hip replacement.

The incidence of thigh pain was investigated in 51 joints implanted with model Y or YII cementless total hip system. The 51 patients were followed for one or more years after surgery. Twenty-six out of 51 implanted with the model Y, and the other 25 with the model YII. Thigh pain appeared in 11 out of 26 patients (43%) replaced by model Y and in only 2 out of 25 (8%) replaced by model Y II. The difference in the incidence of thigh pain was attributed to the difference in the extent of the press fit of the stem, stress distribution and postoperative activity. To prevent thigh pain, a favorable press fit must be achieved during surgery, and the excessive weight-bearing must be restricted in postoperative course. In our improved stem design, stress is distributed uniformly on the interface between the bone and the stem resulting in reduction of thigh pain.

Adult↗
PubMed1993

Thigh pain in cementless total hip arthroplasty. A comparison of two systems at 2 years' follow-up.

Cementless total hip arthroplasties using 110 porous-coated anatomic (PCA) and 105 consecutive Mallory-Head (MH) prostheses were reviewed using prospectively gathered clinical data and a detailed radiographic analysis. In an earlier experience with the PCA, 13% of patients experienced thigh pain at 1 year and 23% at 2 years. Positive radiographic correlates with thigh pain included subsidence, distal cortical hypertrophy, a tight diaphyseal fit, and stem tip sclerosis. In the current MH study group, the incidence of thigh pain was 7% at 1 year and 3% at 2 years. No radiographic findings correlated positively with thigh pain. The results of this short-term clinical comparison suggest that a long, straight, tapered design offered better initial stability than its anatomic counterpart as reflected in the much lower incidence of thigh pain. These results may translate into improved osseous integration and long-term success.

Adult↗
PubMed2000

Gelation of chicken breast and thigh muscle homogenates: effect of pH and time of aging.

Gelation properties of chicken breast and thigh muscle homogenates were studied at various pH values. Breast muscle homogenates showed a greater protein extractability at pH 5.8-6.6 and gel strength at pH 6.3-6.6 than thigh muscle homogenates. At pH 5.8-6.0 breast muscle homogenate gels were weaker than thigh muscle homogenate. The pH for optimum gelation, indicated by the highest stress at failure was 6.3 for breast and 6.0 for thigh muscle homogenates. The pH dependence of chicken breast and thigh muscle homogenate gel strengths, influenced by the muscle fibre type, probably was due to altered protein-protein and other meat component interactions and changes in protein extractability.

Animals↗
PubMed2004

Randomized clinical trial of low molecular weight heparin with thigh-length or knee-length antiembolism stockings for patients undergoing surgery.

BACKGROUND: This was a randomized clinical trial to determine the efficacy and safety of a 'blanket' protocol of low molecular weight heparin (LMWH) and the best length of antiembolism stocking, for every patient requiring surgery under general anaesthesia. METHODS: Of 426 patients interviewed, 376 agreed to be randomized to receive one of three types of stocking: thigh-length Medi thrombexin climax (Medi UK, Hereford, UK), knee-length thrombexin climax and thigh-length Kendall T.E.D. (Tyco Healthcare UK, Redruth, UK). All patients received LMWH thromboprophylaxis. Duplex ultrasonography was used to assess the incidence of postoperative deep vein thrombosis (DVT). RESULTS: No postoperative DVT occurred in 85 patients at low or moderate risk. Nineteen DVTs occurred, all in the 291 high-risk patients: two with the Medi thigh-length stockings, 11 with the Medi knee-length stockings (odds ratio 0.18 (95 per cent confidence interval 0.04 to 0.82); P = 0.026) and six with the Kendall T.E.D. thigh-length stockings. No patient developed a pulmonary embolism. Stocking groups were similar for age, sex, thromboembolic risk, type of operation and compliance. One significant bleeding complication occurred. CONCLUSION: A single protocol comprising LMWH and thigh-length stockings abolished DVT in low- and moderate-risk patients, and reduced the rate of DVT to 2 per cent in high-risk patients.

Adolescent↗
PubMed1996

Isokinetic and isometric strength of the thigh muscles in below-knee amputees.

OBJECTIVE: The strength of the quadriceps and hamstring muscles of the amputated limb in below-knee amputees was evaluated. DESIGN: A descriptive study based on clinical measurements of muscle strength. BACKGROUND: The residual limb of below-knee amputees is less active in daily functions. As a result, atrophy of the thigh muscles in the affected limb is a common finding. Quality of standing and gait performances depend on the strength of these muscles, which activate the knee of the amputated limb. METHODS: Isokinetic concentric and eccentric, as well as isometric, strength of thigh muscles was measured by means of a dynamometer. Parameters of peak torque and maximal average torque of the quadriceps and hamstring muscles were considered. RESULTS: Significant decreases (P < 0.01) in strength of the quadriceps and hamstrings were observed in the amputated limb. Thigh muscle strength in amputees over 7 years was not significantly weaker when compared with amputees where amputation had been performed more recently. CONCLUSIONS: In below-knee amputees, the thigh muscle strength of the amputated limb decreases significantly during the first years after amputation. RELEVANCE: In so far as the ultimate goal in rehabilitation of amputees is to return the patient to an acceptable level of function, it is recommended that the amputee should be trained and encouraged in self-strengthening exercises for the thigh muscles of the amputated limb.

Journal Article↗
PubMed1998

The lateral thigh V-Y flap for the repair of ischial defects.

The lateral thigh fasciocutaneous flap described by Maruyama et al in 1984 is a useful method for the repair of ischial and trochanteric defects. We clinically re-evaluated the potential vascular territory of the nutrient artery for this flap, i.e., the first profunda perforator, and have newly designed the postero-lateral thigh V-Y flap in the area including the proximal two-thirds of the posterior thigh. This flap was applied to five difficult or recurrent ischial defects, and satisfactory results were obtained in all cases. For the reconstruction of ischial defects, the postero-lateral thigh V-Y flap has the following advantages; the proximal and well-vascularised portion of the flap is inserted into the area of the previously excised pressure sore, and this flap can potentially be readvanced if a recurrent pressure sore should develop. A Z-plasty can be performed to prevent excessive tension on the skin closure at the junction of the V-Y advancement flap. The postero-lateral thigh V-Y flap can be considered one of the first-line options for both primary and recurrent ischial pressure sores.

Adult↗
PubMed2003

Anterolateral thigh flap: ideal free flap choice for lower extremity soft-tissue reconstruction.

This article presents the authors' experience with the anterolateral thigh free flap for lower extremity reconstruction. Twenty-one consecutive anterolateral thigh flaps were transferred for reconstruction of soft-tissue defects of the lower extremity from March 2000 to May 2002. Total flap survival was 90.5 percent, with two partial failures. Venous congestion was observed in one flap (4.7 percent) and the venous anastomosis was revised immediately in the postoperative second hour. The mean follow-up time was 13.4 months (range: 5 to 26 months). The cutaneous perforators were consistently found and presented as musculocutaneous in 19 patients (90.5 percent) or septocutaneous in two other patients (9.5 percent). A thinned anterolateral thigh flap was used in 11 patients. Sensate flaps were used in four patients (19.05 percent) for the reconstruction of amputation stumps. Five flaps (23.8 percent) were used also as flow-through flaps. All patients were satisfied with the cosmetic and functional results. The anterolateral thigh flap has many advantages over other free flap donors in lower extremity reconstruction. These include a long and large caliber vascular pedicle, large and pliable skin paddle, good color and texture matching, and minimal donor-site morbidity. Moreover, the flap can be used successfully and safely as a sensate, thin, or flow-through flap. The anterolateral thigh flap can be accepted as an ideal free flap choice for lower extremity reconstruction because it has maximal reconstructive capacity and produces minimal donor-site morbidity.

Adolescent↗
PubMed2002

Anterolateral thigh flap for postmastectomy breast reconstruction.

Most postmastectomy defects are reconstructed by use of lower abdominal-wall tissue either as a pedicled or free flap. However, there are some contraindications for using lower abdominal flaps in breast reconstruction, such as inadequate soft-tissue volume, previous abdominoplasty, lower paramedian or multiple abdominal scars, and plans for future pregnancy. In such situations, a gluteal flap has often been the second choice. However, the quality of the adipose tissue of gluteal flaps is inferior to that of lower abdominal flaps, the pedicle is short, and a two-team approach is not possible because creation of the gluteal flap requires that the patient's position be changed during the operation. In 2000, five cases of breast reconstructions were performed with anterolateral thigh flaps in the authors' institution. Two of them were secondary and three were immediate unilateral breast reconstructions. The mean weight of the specimen removed was 350 g in the three patients who underwent immediate reconstruction, and the mean weight of the entire anterolateral thigh flap was 410 g. Skin islands ranged in size from 4 x 8 cm to 7 x 22 cm, with the underlying fat pad ranging in size from 10 x 12 cm to 14 x 22 cm. The mean pedicle length was 11 cm (range, 7 to 15 cm). All flaps were completely successful, except for one that involved some fat necrosis. The quality of the skin and underlying fat and the pliability of the anterolateral thigh flap are much superior to those of gluteal flaps and are similar to those of lower abdominal flaps. In thin patients, more subcutaneous fat can be harvested by extending the flap under the skin. Use of a thigh flap allows a two-team approach with the patient in a supine position, and no change of patient position is required during the operation. However, the position of the scar may not be acceptable to some patients. Therefore, when an abdominal flap is unavailable or contraindicated, the creation of an anterolateral thigh flap for primary and secondary breast reconstruction is an alternative to the use of lower abdominal and gluteal tissues.

Adult↗