Bowing of the right lower leg in a 6-month-old infant

Abstract Background We present a case of an immense unprecedented tibial bone lengthening of 33.5 cm. The management of chronic osteomyelitis of the right tibia with subtotal tibial bone defect, talus defect and equinus ankle deformity. We demonstrate limb reconstruction by distraction osteogenesis and correction of ankle deformity with the Ilizarov technique. Limb salvage was preferred as an alternative to amputation to restore basic limb function. Case presentation A 16-year-old male patient fell and injured his right lower leg. He attempted to treat the symptoms with traditional home remedies. During 15 months of self-treating, he developed osteomyelitis of the right tibia and had lost function in his foot. Radiology revealed immense bone defect of the right tibia, including talus bone defect and equinus deformity of the calcaneus. The patient’s right tibia was non weight-bearing, had drainage sinus just below his knee and a large scar anteriorly along the entire length of the tibia. Conclusion Upon completion of treatment, the patient was able to avoid amputation of his leg with partially restored function for weight-bearing. He carried himself without assistance after 3 years of lost function in his right leg. Tibial bone distraction osteogenesis of 33.5 cm was done after 90% of the tibial length was defected. To the best of our best knowledge, this case is one of a kind to achieve distraction of tibial bone to such length.

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Accessory museulus soleus

Kazan medical journal ◽

10.17816/kazmj64671 ◽

1926 ◽

Vol 22 (5-6) ◽

pp. 511-513

Author(s):

V. N. Ternovsky ◽

M. Sadykova

Keyword(s):

Lower Limb ◽

Lower Leg ◽

Flexor Hallucis Longus ◽

Posterior Surface ◽

Flexor Digitorum Longus ◽

Accessory Muscle ◽

Peroneus Brevis ◽

The Right ◽

Flexor Digitorum

Dissecting the muscles of the right lower limb of an unknown corpse, we found an accessory muscle on the posterior surface of the lower leg. This muscle (see Fig.) Was bordered behind in. soleus and with the tendon m. plantaris, in front - with in. flexor hallucis longus, medially - c m. flexor digitorum longus and laterally - c m. peroneus brevis.

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Stren. A case of melorheostosis. (Acta Chirurgica Scandinavica Vol. LXXVIII, Fasc. I-III, S. 94-102)

Kazan medical journal ◽

10.17816/kazmj56635 ◽

1937 ◽

Vol 33 (1) ◽

pp. 111-111

Author(s):

V. S. Mayat

Keyword(s):

Lower Limb ◽

Lower Leg ◽

The Right ◽

Entire Limb

The author reports a case of melorheostosis (osteosclerotic process) in the right lower limb in a 13-year-old girl. The case of the author. fourteenth in literature. With this disease, a significant shortening of the entire limb is found, and 3/4 of the shortening refers to the lower leg, the damaged part of which is more affected.

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Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report

Medicinski pregled ◽

10.2298/mpns1504137l ◽

2015 ◽

Vol 68 (3-4) ◽

pp. 137-142

Author(s):

Ivica Lalic ◽

Mirko Obradovic ◽

Mirka Lukic-Sarkanovic ◽

Vladimir Djan

Keyword(s):

Case Report ◽

Joint Stiffness ◽

Functional Results ◽

Shaft Fracture ◽

Lower Leg ◽

Negative Effects ◽

Lower Leg Fracture ◽

Ilizarov Apparatus ◽

Fracture Nonunions ◽

The Right

Introduction. Nonunion of long bones may often be associated with significant function loss of affected extremity, joint stiffness, and even extremity amputation or systemic manifestations in the case of infection. The aim of this case report is to highlight the possibilities of Ilizarov apparatus in the treatment of fracture nonunions of both lower legs treated by different operative methods and to show that it is not necessary to remove osteosynthetic material (intramedullary nail) in every case when nonunion occurs to achieve its recovery. Case Report. A 62 year-old man was injured in a traffic accident as a pedestrian in April 2012, when he experienced polytrauma, including shaft fracture of the right femur, and segmental open fractures of the right (Gustillo-Anderson grade I) and left (Gustillo-Anderson grade II) lower leg. The fractures of right femur and right tibia were stabilized initially with intramedullary nails, while the left lower leg fracture was treated by unilateral external fixator. After 5 months, there were no clinical and radiographic signs of union on lower legs, therefore the patient underwent re-surgery. Ilizarov apparatus was applied on both lower legs. The patient was early verticalized and both apparatus were removed after 4 months. According to the modified protocol of the Association for the Study and Application of Methods of Ilizarov, the lower leg bony results were good and excellent, and the functional results were excellent on both sides. Conclusion. Nonunion fracture of the right lower leg initially treated by the method of intramedullary osteosynthesis and afterwards by placing Ilizarov apparatus shows that in some cases it is not indicated to remove fixative material in order to achieve full recovery of fracture, thus eliminating the danger of all negative effects resulting from the classical extensive surgical treatment.

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Effect of active muscle mass during ischemic exercise on peak lower leg vascular conductance

Journal of Applied Physiology ◽

10.1152/japplphysiol.00468.2004 ◽

2005 ◽

Vol 98 (3) ◽

pp. 765-771 ◽

Cited By ~ 4

Author(s):

Aaron J. Polichnowski ◽

Ellen K. Heyer ◽

Alexander V. Ng

Keyword(s):

Blood Flow ◽

Muscle Mass ◽

Plantar Flexion ◽

Arterial Occlusion ◽

Venous Occlusion ◽

Lower Leg ◽

Isokinetic Dynamometer ◽

Active Muscle ◽

Vascular Conductance ◽

The Right

Uncertainty exists as to whether a period of passive arterial occlusion (PAO) or ischemic exercise (IE) results in peak lower leg vascular conductance (LVC). This uncertainty is due to the different body positions, active muscle mass, and occlusion times used for PAO or IE. The purpose of this study was to examine whether 10 min of PAO elicits a similar LVC compared with ischemic dorsiflexion (IDF), ischemic plantar flexion (IPF), and ischemic plantar-dorsiflexion (IPDF). Ten subjects (5 women, 27 ± 9 yr, 68 ± 3 kg) were studied on 3 days over 1 wk in a semireclined position with the right foot attached to an isokinetic dynamometer. Mean arterial pressure (Finapres) and lower leg blood flow (LBF, venous occlusion plethysmography) were measured at rest and after PAO and IE. PAO was administered randomly on 1 of the 3 days and before IE. IE protocols consisted of maximal isokinetic dorsiflexion and/or plantar flexion at 120 and 60°/s, respectively. In a second experiment, an additional eight subjects (4 women, 29 ± 12 yr, 77 ± 12 kg) were studied to examine the effect of isokinetic speed during IDF on peak LBF and LVC. Peak LVC (ml·min−1·100 ml−1·mmHg−1) was similar among IPF (0.590 ± 0.16), IPDF (0.532 ± 0.17), and PAO (0.511 ± 0.18), and significantly lower after IDF (0.334 ± 0.15). No differences in peak LBF and LVC were observed after IDF using different isokinetic speeds. We conclude that 10 min of PAO, IPF, and IPDF performed in a similar posture are adequate stimuli to elicit peak LVC.

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A twenty years prospective observation of iatrogenic limphatic system damage of the right lower leg. Paliative liposuction the effectiveness in the affected extremity

Phlebological Review ◽

10.1066/s10003050006 ◽

2005 ◽

Vol 13 (1-1) ◽

pp. 25-27

Author(s):

ZBIGNIEW RYBAK ◽

ROBERT WOJCIECHOWSKI ◽

WOJCIECH RYBAK

Keyword(s):

Lower Leg ◽

The Right

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Applying Intravenous Immunoglobulin and Negative-Pressure Wound Therapy to Treat Refractory Pyoderma Gangrenosum: A Case Report

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620940459 ◽

2020 ◽

pp. 153473462094045

Author(s):

Shi-Ying Jin ◽

Mei Chen ◽

Feng-Yuan Wang ◽

Fei Wang

Keyword(s):

Intravenous Immunoglobulin ◽

Pyoderma Gangrenosum ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Lower Leg ◽

Neutrophilic Dermatosis ◽

Wound Therapy ◽

Systemic Corticosteroids ◽

Painful Ulcer ◽

The Right

Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that causes undermining ulcers. Unfortunately, standardization of PG treatment remains a challenge. In this article, we describe a case in which a 69-year-old man presented with a painful ulcer on the right lower leg. The diagnosis of PG was made after excluding other diseases. He had a history of PG on his left lower leg 2 years earlier and was cured by the treatment of systemic corticosteroids and cyclosporin A for 43 days. However, such a treatment was not effective this time. Hence, we applied intravenous immunoglobulin and negative-pressure wound therapy, and the patient was cured. Altogether, this case supports the use of intravenous immunoglobulin as an effective adjuvant for refractory PG, and indicates negative-pressure wound therapy as a treatment option to advance ulcer healing under adequate immunosuppression.

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Spontaneous Bilateral Ankle and Midfoot Sepsis in a Nonimmunocompromised Patient

Journal of the American Podiatric Medical Association ◽

10.7547/0960139 ◽

2006 ◽

Vol 96 (2) ◽

pp. 139-147

Author(s):

Thomas S. Roukis ◽

Jeffrey R. Baker ◽

Breck Tiernan

Keyword(s):

Soft Tissue ◽

Bone Growth ◽

Platelet Rich Plasma ◽

Growth Stimulation ◽

Lower Leg ◽

Split Thickness Skin Graft ◽

Allogeneic Bone ◽

Thickness Skin ◽

Autologous Platelet Rich Plasma ◽

The Right

We describe a 70-year-old nonimmunocompromised woman with spontaneous bilateral ankle and midfoot sepsis and a deep-space abscess of the right lower leg. Salvage of both limbs was achieved by aggressive bilateral soft-tissue and osseous debridement, including a four-compartment fasciotomy of the right lower leg, antibiotic-loaded polymethyl methacrylate bone cement implantation, delayed allogeneic bone grafting of the osseous defects impregnated with autologous platelet-rich plasma bilaterally, and external fixation immobilization, implantable bone growth stimulation, and split-thickness skin graft coverage of the right lower leg, ankle, and foot. Osseous incorporation of the bone grafts bilaterally occurred 8 weeks after surgery. No soft-tissue or osseous complications occurred during the postoperative period or at 18-month follow-up except for arthrofibrosis in the right ankle; there was no evidence of recurrent abscesses, sequestrum, or wound-related problems. A review of the literature regarding bilateral pedal sepsis and the techniques used for limb salvage in this patient are presented in detail. (J Am Podiatr Med Assoc 96(2): 139–147, 2006)

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Acute compartment syndrome of the lower leg causing cardiac arrest after resection of the right external iliac vein for autologous graft: a case report

JA Clinical Reports ◽

10.1186/s40981-019-0286-2 ◽

2019 ◽

Vol 5 (1) ◽

Author(s):

Koji Hoshino ◽

Toru Nakamura ◽

Mineji Hayakawa ◽

Yusuke Itosu ◽

Hitoshi Saito ◽

...

Keyword(s):

Cardiac Arrest ◽

Portal Vein ◽

Compartment Syndrome ◽

Iliac Vein ◽

Lower Leg ◽

Acute Compartment Syndrome ◽

External Iliac Vein ◽

Portal Vein Reconstruction ◽

Vein Resection ◽

The Right

Abstract Background The right external iliac vein (REIV) is often used for portal vein reconstruction in patients undergoing pancreatoduodenectomy with portal-superior mesenteric vein resection. We report a case of cardiac arrest caused by acute lower leg compartment syndrome as a result of REIV resection. Case presentation A 53-year-old man underwent pancreatoduodenectomy with portal vein resection. Hyperkalemia progressed during surgery due to intestinal reperfusion injury, which caused recurrent ventricular arrhythmia required for cardio-pulmonary resuscitation. The surgery was discontinued after resuscitation, and portal vein reconstruction using the REIV was performed 2 days post-operatively. Acute compartment syndrome was diagnosed immediately following the surgery. Hyperkalemia progressed, causing pulseless ventricular tachycardia. Emergent fasciotomy was performed, but right leg dysfunction persisted after discharge. Conclusion REIV resection can cause lower-extremity acute compartment syndrome. The status, including intracompartmental pressure, of the lower extremity should be carefully observed after REIV resection during and after surgery.

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Limb Salvage in Recurrent Synovial Sarcoma of the Right Ankle and Lower Leg

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-92-2-90 ◽

2002 ◽

Vol 92 (2) ◽

pp. 90-96 ◽

Cited By ~ 3

Author(s):

Ellen Sobel ◽

Renato Giorgini ◽

Ruben Oropeza ◽

Kalyani Bapat ◽

Hugh Richardson

Keyword(s):

Soft Tissue ◽

Synovial Sarcoma ◽

Limb Salvage ◽

Soft Tissue Sarcomas ◽

Lower Leg ◽

Wide Excision ◽

Lateral Aspect ◽

Distal Lower Leg ◽

The Right

Synovial sarcoma of the extremities represents 7% of all soft-tissue sarcomas. This article presents the case of a patient who was treated for a synovial sarcoma of the lateral aspect of the distal lower leg extending to the ankle and involving the fibular bone. The patient underwent a wide excision of the tumor, including the fibular bone, followed by radiation and chemotherapy, rather than undergo an amputation of the right leg. Consideration is also given to the traumatic etiology of the tumor. (J Am Podiatr Med Assoc 92(2): 90-96, 2002)

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