Closure of the femoral medullary canal after retrograde nailing using an in-situ osteochondral autograft – Technical trick and a case series

Injury ◽  
2021 ◽  
Author(s):  
Şahin Çepni ◽  
Enejd Veizi ◽  
Yasin Erdoğan ◽  
Ali Şahin ◽  
Ahmet Fırat ◽  
...  
2021 ◽  
Vol 10 (11) ◽  
pp. 2478
Author(s):  
Majid Moshirfar ◽  
David G. West ◽  
Chase M Miller ◽  
William B. West ◽  
Shannon E. McCabe ◽  
...  

Although the use of femtosecond lasers instead of mechanical devices has decreased the incidence of flap complications following laser-assisted in situ keratomileusis (LASIK), dislocations and striae still occur. Flap repositioning is an effective intervention to improve visual outcomes after acute flap complications in both microkeratome-assisted and femtosecond-assisted LASIK. This retrospective case series included patients undergoing flap repositioning secondary to acute flap dislocation and/or visually significant striae within the first two weeks following femtosecond LASIK (FS-LASIK) from 2015 to 2020 at a single institution. Preoperative, intraoperative, and postoperative de-identified data were analyzed for incidence, risk factors, and visual acuity outcomes. The incidence of flap repositioning was 0.35% in 21,536 eyes (n = 70). Indications for repositioning included acute flap dislocation (35.7%) and visually significant striae (64.3%). High myopia (OR = 3.04, p = 0.001) and patient age over 50 years (OR = 3.69, p = 0.001) were the strongest risk factors for these complications. Prior to flap repositioning, uncorrected distance visual acuity (UDVA) of 20/20 or better and 20/40 or better occurred in 19% and 57% of eyes, respectively. After repositioning, a final UDVA of 20/20 or better and 20/40 or better occurred in 78% and 98% of eyes, respectively. After repositioning, one line of UDVA was lost in two eyes (2.8%) and two lines were lost in one eye (1.4%). Risk factors for acute flap dislocation included high myopia and age over 50 years. Flap repositioning was effective in salvaging visual outcomes.


2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Moritz Bünger ◽  
Rene Brunthaler ◽  
Christine Unterweger ◽  
Igor Loncaric ◽  
Maximiliane Dippel ◽  
...  

Abstract Background Mycoplasma hyorhinis is an invader of the upper respiratory tract in swine that is considered to have ubiquitous distribution. It is mainly known for causing polyserositis and polyarthritis in weaned piglets, even though the mechanisms of systemic spread are not fully understood. Mycoplasma hyorhinis has also been associated with other diseases in pigs such as pneumonia or otitis media, but so far has not been known to cause central nervous disorders. This case series reports the isolation of Mycoplasma hyorhinis from cerebrospinal fluid and/ or meningeal swabs from piglets originating from four different piglet producing farms in Austria. Case presentation On farm 1, coughing, stiff movement and central nervous signs occurred in nursery piglets. Mycoplasma hyorhinis was the only pathogen isolated from meningeal swabs from two piglets showing central nervous signs. Fibrinopurulent leptomeningitis was only observed in one piglet. Only one of two nursery piglets from farm 2 showed mild central nervous signs but no histologic lesions; Mycoplasma hyorhinis was isolated from cerebrospinal fluid of the piglet with neurologic signs. Mycoplasma hyorhinis was isolated from cerebrospinal fluid of all three investigated piglets from farm 3, all of which showed central nervous signs and purulent leptomeningitis. Further, Streptococcus suis was isolated from the cerebrospinal fluid of one piglet. Fibrinopurulent leptomeningitis was detected in two piglets from farm 4 that had died overnight without showing any clinical signs and Mycoplasma hyorhinis was isolated from meningeal swabs from both piglets. Conclusion While causality has yet to be proven by experimental infection and in situ detection of the pathogen in histologic sections, the findings of this study and the absence of other pathogens suggest Mycoplasma hyorhinis as a potential causative agent of meningitis in swine.


2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Wilfried Engelke ◽  
Marcio Lazzarini ◽  
Víctor Beltrán

Background. Maintenance of hard tissue in the case of impacted third molars (M3M) with close relationship to the mandibular canal is still a surgical challenge which may be overcome using the inward fragmentation technique. Methods. A consecutive case series of 12 patients required the extraction of 13 impacted M3M with a close relationship to the inferior alveolar nerve (IAN). Via occlusal miniflaps, M3M were exposed occlusal under endoscopic vision and removed by inward fragmentation. All patients received socket preservation with resorbable in situ hardening TCP particles to reduce the risk of pocket formation at the second molar. Results. All 13 sites healed uneventfully. Bone height was assessed using CBCT cross-sectional reformats pre- and 3 months postoperatively. The bone height was reduced by 1.54 mm lingual (SD 0.88), 2.91 mm central (SD 0.93), and 2.08 mm buccal (SD 1.09). Differences were significant at a 0.05% level. No tissue invagination at the extraction sites was observed. Conclusions. Major bone defects can be avoided safely using inward fragmentation surgery. The self-hardening bone filler appears to enhance the mineralization of the intrabony defect.


2013 ◽  
Vol 65 (2) ◽  
pp. 429-437 ◽  
Author(s):  
M. Jurisic ◽  
Milica Manojlovic-Stojanoski ◽  
M. Andric ◽  
V. Kokovic ◽  
Vesna Danilovic ◽  
...  

Biphasic calcium phosphates (BCP) are widely used in alveolar ridge regeneration as a porous scaffold for new bone formation. The aim of this case series was to evaluate the regenerative effect of the combination of BCP and polylactide-co-glycolide (PLGA) which can serve as a barrier membrane during bone regeneration. The study included five patients. Four months into the healing period, bone samples were collected for histological and morphometric analyses. The results of morphometric analysis showed that newly formed bone represented 32.2 ? 6.8% of the tissue, 31.9 ? 8.9% was occupied by residual graft and 35.9 ? 13.5% by soft tissue. Active osteogenesis was seen around the particles of the graft. The particles were occupied mostly by immature woven bone and connective tissue. The quality and quantity of newly formed bone, after the use of BCP/PLGA for ridge preservation, can be adequate for successful implant therapy after tooth extraction.


2019 ◽  
Vol 40 (1) ◽  
pp. 213-225 ◽  
Author(s):  
Jihong Zhou ◽  
Wei Gu ◽  
Shaowei Li ◽  
Lijuan Wu ◽  
Yan Gao ◽  
...  

Abstract Purpose To investigate the predictive factors of postoperative myopic regression among subjects who have undergone laser-assisted subepithelial keratomileusis (LASEK), laser-assisted in situ keratomileusis (LASIK) flap created with a mechanical microkeratome (MM), and LASIK flap created with a femtosecond laser (FS). All recruited patients had a manifest spherical equivalence (SE) from − 6.0D to − 10.0D myopia. Methods This retrospective, observational case series study analyzed outcomes of refraction at 1 day, 1 week, and 1, 3, 6, and 12 months postoperatively. Predictors affecting myopic regression and other covariates were estimated with the Cox proportional hazards model for the three types of surgeries. Results The study enrolled 496 eyes in the LASEK group, 1054 eyes in the FS-LASIK group, and 910 eyes in the MM-LASIK group. At 12 months, from − 6.0D to − 10.0D myopia showed that the survival rates (no myopic regression) were 52.19%, 59.12%, and 58.79% in the MM-LASIK, FS-LASIK, and LASEK groups, respectively. Risk factors for myopic regression included thicker postoperative central corneal thickness (P ≦ 0.01), older age (P ≦ 0.01), aspherical ablation (P = 0.02), and larger transitional zone (TZ) (P = 0.03). Steeper corneal curvature (Kmax) (P = 0.01), thicker preoperative central corneal thickness (P < 0.01), smaller preoperative myopia (P < 0.01), longer duration of myopia (P = 0.02), with contact lens (P < 0.01), and larger optical zone (OZ) (P = 0.02) were protective factors. Among the three groups, the MM-LASIK had the highest risk of postoperative myopic regression (P < 0.01). Conclusions The MM-LASIK group experienced the highest myopic regression, followed by the FS-LASIK and LASEK groups. Older age, aspheric ablation used, thicker postoperative central corneal thickness, and enlarging TZ contribute to myopic regression; steeper preoperative corneal curvature (Kmax), longer duration of myopia, with contact lens, thicker preoperative central corneal thickness, lower manifest refraction SE, and enlarging OZ prevent postoperative myopic regression in myopia from − 6.0D to − 10.0D.


2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
John S. M. Chang ◽  
Jack C. M. Ng ◽  
Vincent K. C. Chan ◽  
Antony K. P. Law

Purpose. To report visual performance and quality of life after implantation of a bifocal diffractive multifocal intraocular lens (MIOL) in postmyopic laser in situ keratomileusis (LASIK) patients.Methods. Prospective, observational case series. Patients with prior myopic LASIK who had implantation of Tecnis ZMA00/ZMB00 MIOL (Abbott Medical Optics) at Hong Kong Sanatorium and Hospital were included. Postoperative examinations included monocular and binocular distance, intermediate and near visual acuity (VA), and contrast sensitivity; visual symptoms (0–5); satisfaction (1–5); spectacle independence rate; and quality of life.Results. Twenty-three patients (27 eyes) were included. No intraoperative complications developed. Mean monocular uncorrected VA at distance, intermediate, and near were0.13±0.15(standard deviation),0.22±0.15, and0.16±0.15, respectively. Corresponding mean values for binocular uncorrected VA were0.00±0.10,0.08±0.13, and0.13±0.10, respectively. No eyes lost >1 line of corrected distance VA. Contrast sensitivity at different spatial frequencies between operated and unoperated eyes did not differ significantly (allP>0.05). Mean score for halos, night glare, starbursts, and satisfaction were1.46±1.62,1.85±1.69,0.78±1.31, and3.50±1.02, respectively. Eighteen patients (78%) reported complete spectacle independence. Mean composite score of the quality-of-life questionnaire was90.31±8.50out of 100.Conclusions. Implantation of the MIOL after myopic LASIK was safe and achieved good visual performance.


Hand ◽  
2018 ◽  
Vol 14 (4) ◽  
pp. 477-482
Author(s):  
Nicholas Kim ◽  
Ryan Stehr ◽  
Hani S. Matloub ◽  
James R. Sanger

Background: Cubital tunnel syndrome is a common compressive neuropathy of the upper extremity. The anconeus epitrochlearis muscle is an unusual but occasional contributor. We review our experience with this anomalous muscle in elbows with cubital tunnel syndrome. Methods: We retrospectively reviewed charts of 13 patients noted to have an anconeus epitrochlearis muscle associated with cubital tunnel syndrome. Results: Ten patients had unilateral ulnar neuropathy supported by nerve conduction studies. Three had bilateral cubital tunnel syndrome symptoms with 1 of those having normal nerve conduction studies for both elbows. Eight elbows were treated with myotomy of the anconeus epitrochlearis muscle and submuscular transposition of the ulnar nerve. The other 8 elbows were treated with myotomy of the anconeus epitrochlearis muscle and in situ decompression of the ulnar nerve only. All but 1 patient had either clinical resolution or improvement of symptoms at follow-up ranging from 2 weeks to 1 year after surgery. The 1 patient who had persistent symptoms had received myotomy and in situ decompression of the ulnar nerve only. Conclusions: An anomalous anconeus epitrochlearis occasionally results in compression of the ulnar nerve but is usually an incidental finding. Its contribution to compression neuropathy can be tested intraoperatively by passively ranging the elbow while observing the change in vector and tension of its muscle fibers over the ulnar nerve. Regardless of findings, we recommend myotomy of the muscle and in situ decompression of the ulnar nerve. Submuscular transposition of the ulnar nerve may be necessary if there is subluxation.


2019 ◽  
Vol 30 (6) ◽  
pp. 1238-1245
Author(s):  
Ana B Plaza-Puche ◽  
Verónica Vargas ◽  
Pilar Yébana ◽  
Samuel Arba ◽  
Jorge L Alio

Purpose: The aim of this study is to analyze the long-term stability of the corneal topography, the functional optical zone, and the refractive stability throughout 3 years following laser in situ keratomileusis surgery for hyperopia using a 500-Hz excimer laser system. Methods: This retrospective consecutive observational case series study comprised 66 eyes that underwent laser in situ keratomileusis to correct hyperopia with a postoperative follow-up of 3 years. Laser in situ keratomileusis procedures were performed using the SCHWIND Amaris 500-Hz excimer laser. Main outcomes measured were stability of the functional optical zone at corneal topography and corneal aberrometry. Results: Statistically significant differences were found in simulated keratometry (K2 (steep meridian) and Km (mean keratometry)) between 3 and 36 months postoperatively ( p ⩽ 0.01); these differences disappeared at 12 and 36 months ( p ⩾ 0.18). No statistically significant changes were observed in the horizontal and vertical diameter of the functional optical zone throughout the whole follow-up ( p ⩾ 0.07). A statistically significant difference was found in the spherical aberration between 3 and 36 months ( p = 0.02); this difference disappeared when compared between 12 and 36 months ( p = 0.72). Statistically significant correlations were detected between the vertical functional optical zone and coma root mean square ( r = –0.510, p < 0.01) and between the vertical functional optical zone and spherical aberration ( r = 0.441, p = 0.02) 36 months after surgery. Conclusion: Following 3 years of hyperopic laser in situ keratomileusis with a 500-Hz Amaris excimer laser, keratometry, functional optical zone, and corneal aberrations remain stable from 1 year after surgery. Topographical regression is not observed in hyperopic laser in situ keratomileusis with this excimer laser technology from 1 year after surgery.


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