Commentary on: A 3-Level Impaction Technique for Dorsal Reshaping and Reduction Without Dorsal Soft Tissue Envelope Dissection

2021 ◽  
Author(s):  
Aaron M Kosins
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Envelope

scholarly journals Redefining Knee Balance in a Medially Stabilized Prosthesis: An In-Vitro Study

2017 ◽  
Vol 11 (1) ◽  
pp. 1165-1172
Author(s):  
Philippe Van Overschelde ◽  
Vera Pinskerova ◽  
Peter P. Koch ◽  
Christophe Fornasieri ◽  
Sandro Fucentese
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
In Vitro Study ◽  
Lateral Release ◽  
Soft Tissue Release ◽  
Iliotibial Band ◽  
Soft Tissue Envelope ◽  
Medial Side ◽  
Fresh Frozen

Background: To date, there is still no consensus on what soft tissues must be preserved and what structures can be safely released during total knee arthroplasty (TKA) with a medially stabilized implant. Objective: The aim of this study was to analyze the effect of a progressive selective release of the medial and lateral soft tissues in a knee implanted with a medially stabilized prosthesis. Method: Six cadaveric fresh-frozen full leg specimens were tested. In each case, kinematic pattern and mediolateral laxity were measured in three stages: firstly, prior to implantation; secondly, after the implantation of the trial components, but before any soft tissue release; and thirdly, progressively as soft tissue was released with the trial implant in place. The incremental impact of each selective release on knee balance was then analyzed. Results: In all cases sagittal stability was not affected by the progressive release of the lateral soft tissue envelope. It was possible to perform progressive lateral release provided the anterior one-third of the iliotibial band (ITB) remained intact. Progressive medial release could be performed on the medial side provided the anterior fibers of the superficial medial collateral ligament (sMCL) remained intact. Conclusion: The medially conforming implant remains stable provided the anterior fibers of sMCL and the anterior fibers of the ITB remain intact. The implant’s sagittal stability is mainly dependent on its medial ball-in-socket design.

scholarly journals What is a balanced knee replacement?

2018 ◽  
Vol 3 (12) ◽  
pp. 614-619 ◽  
Author(s):  
Lucy C. Walker ◽  
Nick D. Clement ◽  
Kanishka M. Ghosh ◽  
David J. Deehan
Keyword(s):  
Total Knee Arthroplasty ◽  
Soft Tissue ◽  
Knee Replacement ◽  
Knee Arthroplasty ◽  
Current Evidence ◽  
Soft Tissue Envelope ◽  
Total Knee ◽  
Uneven Wear ◽  
Definition Of ◽  
Revision Tka

For multifactorial reasons an estimated 20% of patients remain unsatisfied after total knee arthroplasty (TKA). Appropriate tension of the soft tissue envelope encompassing the knee is important in total knee arthroplasty and soft tissue imbalance contributes to several of the foremost reasons for revision TKA, including instability, stiffness and aseptic loosening. There is debate in the literature surrounding the optimum way to achieve balancing of a total knee arthroplasty and there is also a lack of an accepted definition of what a balanced knee replacement is. It may be intuitive to use the native knee as a model for balancing; however, there are many difficulties with translating this into a successful prosthesis. One of the foundations of TKA, as described by Insall, was that although the native knee has more weight transmitted through the medial compartment this was to be avoided in a TKA as it would lead to uneven wear and early failure. There is a focus on achieving symmetrical tension and pressure and subsequent ‘balance’ in TKA, but the evidence from cadaveric studies is that the native knee is not symmetrically balanced. As we are currently trying to design an implant that is not based on its anatomical counterpart, is it possible to create a truly balanced prosthesis or to even to define what that balance is? The authors have reviewed the current evidence surrounding TKA balancing and its relationship with the native knee. Cite this article: EFORT Open Rev 2018;3:614-619. DOI: 10.1302/2058-5241.3.180008.

scholarly journals Internal and External Radiofrequency Assisted Lipo-Coagulation (RFAL) in the Control of Soft Tissue Contraction during Liposuction: Part 2 “Outside In” RFAL Thermal Tissue Tightening

2021 ◽  
Author(s):  
Robert Stephen Mulholland
Keyword(s):  
Soft Tissue ◽  
Invasive Procedure ◽  
Thermal Stimulation ◽  
Thermal Coagulation ◽  
Soft Tissue Envelope ◽  
Non Invasive ◽  
Tissue Contraction ◽  
Contraction Effect ◽  
Positively Charged ◽  
Coated Electrodes

The new Morpheus8 is a novel external RFAL device that uses the proven soft tissue contraction of BodyTite in an external, non-invasive procedure. This external RF applicator, which is also powered by BodyTite, inserts up to 40 positively charged, coated electrodes 8 mm into the subcutaneous, soft tissue envelope. A monopolar ablative lesion is generated from the tip of the electrode, stimulating contraction of the FSN and adipose coagulation. The RF then flows up to the distant negative, return electrodes on the surface of the skin, providing a non-ablative thermal stimulation to the papillary dermis. The “burst” feature of the Morpheus8, delivers simultaneous multiple levels of internal coagulation in a single one second pulse, amplifying the adipose ablation and contraction effect. Studies, show, that the combination of BodyTite internal thermal coagulation and external Morpheus8 at the time of liposuction can result in 60–70% area skin contraction, greatly improving the soft tissue contours and Body shaping outcomes following lipo-contouring procedures.

Utilization of Alexandrite Laser for Hair Removal in Pediatric Auricular Reconstruction

2021 ◽  
pp. 019459982110419
Author(s):  
Peng You ◽  
Tara L. Rosenberg ◽  
Yi-Chun Carol Liu
Keyword(s):  
Soft Tissue ◽  
Chart Review ◽  
Laser System ◽  
Retrospective Chart Review ◽  
Hair Removal ◽  
Procedural Sedation ◽  
Alexandrite Laser ◽  
Auricular Reconstruction ◽  
Laser Hair Removal ◽  
Soft Tissue Envelope

Auricular reconstruction with autologous rib cartilage involves using a soft tissue envelope to cover the cartilage framework. In patients with a low hairline, hair-bearing skin may be incorporated on the reconstructed ear, creating a difficult and conspicuous aesthetic problem. A retrospective chart review was conducted to summarize and share the experience of using the Candela GentleMax Pro 755-nm alexandrite laser system (Candela Corp) in children following auricular reconstruction. Nine patients received laser hair removal via the alexandrite laser system with good results. The number of completed sessions ranged from 1 to 5. The procedures were completed without the need for premedication or procedural sedation. Laser hair removal with an alexandrite laser system was safe, fast, and effective. With multistage auricular reconstruction, it was feasible to incorporate laser hair removal between the stages.

scholarly journals A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Radwane Faroug ◽  
Paul Stirling ◽  
Farhan Ali
Keyword(s):  
Soft Tissue ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Calcaneal Fracture ◽  
Fracture Dislocation ◽  
Bony Union ◽  
Calcaneal Fractures ◽  
Simultaneous Application ◽  
Soft Tissue Envelope ◽  
Good Functional Outcome

Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF). Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome.

Comprehensive Diagnosis and Planning for the Difficult Rhinoplasty Patient: Applications in Ultrasonography and Treatment of the Soft-Tissue Envelope

2017 ◽  
Vol 33 (05) ◽  
pp. 509-518 ◽  
Author(s):  
Aaron Kosins
Keyword(s):  
Soft Tissue ◽  
Preoperative Planning ◽  
Early History ◽  
Diagnosis And Treatment ◽  
Open Approach ◽  
Secondary Surgery ◽  
Soft Tissue Envelope ◽  
Comprehensive Diagnosis ◽  
History Of ◽  
Closed Approach

AbstractRhinoplasty is one of the most complicated operations that a plastic surgeon will encounter. In the early history of rhinoplasty, operations were done with a closed approach, and the structures were shrouded in mystery while surgeons relied on surface aesthetics for diagnosis and treatment. Finally, with the advent of the extended open approach, power tools, and piezosurgery, the whole bony pyramid can be directly visualized, shaped, and sculpted. Osteotomies can be done under direct vision with high precision. Using this approach, every part of the osseocartilaginous vault and nasal tip can now be directly observed, diagnosed, and surgically treated. However, this only occurs once the patient is in the operating room. This article will detail the diagnosis and treatment of the difficult soft-tissue envelope of the nose. It will also describe the use of ultrasonography for preoperative planning as well as postoperatively for diagnosis and treatment during the healing period and for planning possible revision and secondary surgery.

Soft Tissue Thickness Variations of the Nose: A Radiological Study

2020 ◽  
Vol 40 (7) ◽  
pp. 711-718
Author(s):  
Melekber Çavuş Özkan ◽  
Fatma Yeşil ◽  
İnci Bayramiçli ◽  
Mehmet Bayramiçli
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Soft Tissue Coverage ◽  
Limited Information ◽  
Tissue Thickness ◽  
Level Of Evidence ◽  
Age And Gender ◽  
Soft Tissue Envelope ◽  
Soft Tissue Thickness ◽  
And Gender

Abstract Background Soft tissue thickness (STT) is a major factor affecting the outcome in rhinoplasty. However, limited information is found in the literature on the age- and gender-related variations of the nasal STT. Objectives The purpose of this study was to measure STT at various landmarks over the nasal framework and compare the age- and gender-related differences. Methods STT measurements were made at 11 landmarks in 325 patients by employing magnetic resonance imaging. Patients were divided into subgroups to compare the STT differences between female and male and between the age groups as young, middle age, and elderly. Results Soft tissue was thickest at the nasion and thinnest at the rhinion. The soft tissue coverage was significantly thicker in the male population at the supratip, tip, nasal bones, upper lateral cartilages, and alar lobules, whereas it is thicker in females at the rhinion. Average thickness of the soft tissues over the entire nasal framework increases with age except the rhinion. Conclusions The STT is variable over different parts of the osteocartilaginous framework. Gender and age influence the STT. The soft tissue is thicker at the distal half of the nose in male patients, and these areas become gradually thicker with age, whereas the soft tissue over the midvault becomes thinner. Increasing age presents a particular challenge to achieve predictable results in rhinoplasty, and an understanding of the soft tissue envelope allows for improved aesthetic outcome. Level of Evidence 2

scholarly journals Commentary on: Managing the Difficult Soft Tissue Envelope in Facial and Rhinoplasty Surgery

2017 ◽  
Vol 37 (2) ◽  
pp. 158-160 ◽  
Author(s):  
Ronald P. Gruber ◽  
Hubert B. Shih ◽  
Walter C. Lin
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Envelope

Tibial plafond fractures

2011 ◽  
Author(s):  
J.L. Marsh
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Preoperative Planning ◽  
Distal Tibia ◽  
Soft Tissue Envelope ◽  
Tibial Plafond ◽  
Tibial Plafond Fractures

♦ Tibial plafond fractures demand respect, largely due to the fragile soft tissue envelope that surrounds the distal tibia♦ Careful preoperative planning followed by meticulous operative handling of the soft tissues is required to avoid devastating complications.

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