TRIANGULAR FLAPS: A MODIFIED TECHNIQUE FOR THE CORRECTION OF CONGENITAL CONSTRICTION RING SYNDROME

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 387-393 ◽  
Author(s):  
Puay-Ling Tan ◽  
Yuan-Cheng Chiang
Keyword(s):  
Wide Spectrum ◽  
Lower Limbs ◽  
Modified Technique ◽  
Constriction Ring ◽  
Contour Deformity ◽  
Aesthetic Results ◽  
Advancement Flaps ◽  
A New Technique ◽  
Constriction Ring Syndrome

Congenital constriction ring syndrome (CCRS) is a congenital anomaly with a wide spectrum of clinical presentation. The accepted method of correcting a circular constriction is to excise the deep part of the constriction, and break the line of the circular scar with multiple Z- or W-plasties. Specific correction of soft tissue is recommended concurrently, to better correct the "sandglass" deformity. Here we describe a new technique using triangular advancement flaps to correct the deformity in eight patients with constriction ring syndrome, involving either the upper or lower limbs. In this technique, triangular flaps can be introduced either proximal or distal to the ring, depending on the limb circumference, to correct the contour deformity. In all eight patients, a normal extremity contour was obtained, with complete elimination of the deformity caused by the constriction ring. A mean follow-up of 43 months revealed an aesthetically acceptable scar, with no case of recurrence. Triangular flaps designed either proximal or distal to the constriction ring is able to correct the contour deformity of the limbs with great versatility and acceptable aesthetic results.

A new technique of flexor profundus repair in the distal part of zone I: inclusion of the palmar plate

2010 ◽  
Vol 35 (6) ◽  
pp. 459-463 ◽  
Author(s):  
M. M. Al-Qattan ◽  
T. M. Al-Turaiki ◽  
A. Y. Al-Zahrani ◽  
M. S. Al-Harbi ◽  
F. S. Al-Kahtani
Keyword(s):  
Experimental Study ◽  
Distal Part ◽  
Prospective Clinical Study ◽  
Modified Technique ◽  
Active Motion ◽  
Repair Technique ◽  
Palmar Plate ◽  
The Mean ◽  
A New Technique

Flexor profundus lacerations in the distal part of zone I are usually treated by tendon reinsertion into bone. We present a modified technique in which three ‘figure of eight’ sutures include the palmar plate in the distal purchase. Inclusion of the palmar plate significantly strengthens the tensile strength of the repair and this was confirmed biomechanically in an experimental study. In a prospective clinical study, 15 patients with clean-cut complete lacerations of the profundus tendon in the distal part of zone I underwent the modified repair technique of three separate ‘figure of eight’ sutures with the palmar plate included in the suture distally and 7 mm suture purchase proximally, with postoperative immediate active motion that ensured full active extension of the interphalangeal joints. There were no ruptures or infections. At final follow-up 12–25 weeks after surgery, the mean range of motion at the distal, proximal, and combined interphalangeal joints was 66°, 100° and 166° respectively. All patients achieved an excellent or good outcome.

Island Flap Reconstruction of the Web Space in Congenital Incomplete Syndactyly

2004 ◽  
Vol 29 (4) ◽  
pp. 377-380 ◽  
Author(s):  
M. D. BRENNEN ◽  
B. J. FOGARTY
Keyword(s):  
Skin Grafts ◽  
Residual Defect ◽  
Aesthetic Results ◽  
Operative Planning ◽  
Flap Design ◽  
Web Space ◽  
A New Technique ◽  
Complex Planning ◽  
The Web

A number of techniques have been described for the correction of incomplete syndactyly, some of which may produce obvious dorsal scarring of the fingers or hand while others rely on the use of skin grafts. Many of the methods require complex planning. We present our experience of a new technique which simplifies the operative planning, allows a natural looking web space to be reconstructed with minimal dorsal scarring and should minimize the need for skin grafts. Seven patients (nine webs) who underwent correction of incomplete syndactyly were reviewed (follow-up range, 6–32 months). Only one patient early on in the series required a small skin graft to cover a residual defect, following which modifications to the flap design were made. All the web spaces healed without complication and at review there were good functional and aesthetic results.

scholarly journals Persistence of the embryonic lateral marginal vein: report of two cases

2001 ◽  
Vol 56 (5) ◽  
pp. 159-162 ◽  
Author(s):  
Raúl Rojas Martinez ◽  
Pedro Puech-Leão ◽  
Guimarães Paulo Motta ◽  
Muraco Netto Baptista
Keyword(s):  
Surgical Intervention ◽  
Venous Malformation ◽  
Lower Limbs ◽  
Surgical Removal ◽  
Marginal Vein ◽  
Vascular Surgeon ◽  
Aesthetic Results ◽  
Rare Malformation ◽  
The Right

PURPOSE: Congenital venous malformations of the lower limbs represent a particular challenge for the vascular surgeon. Persistence of fetal veins is a rare malformation, and the most common is the persistence of the lateral marginal vein usually observed in patients with Klippel-Trenaunnay Syndrome. The persistence of this embryonic vein as an isolated venous malformation without the other characteristics of the Klippel-Trenaunnay Syndrome has not yet been reported. This paper describes two cases. METHODS: Two patients, a 17-year-old male patient and a 16-year-old female, have had since their birth a large venous trunk in the lateral aspect of the right leg and thigh. The limbs underwent duplex scanning and phlebography. The surgical removal of the lateral marginal vein was performed. RESULTS: Surgical treatment resulted in very good functional and aesthetic results. Follow-up at 26 months showed no evidence of varicose vein recurrence. CONCLUSIONS: To achieve good results, surgical intervention may be indicated in cases of orthopedic deformity, hemorrhage, symptomatic, and unaesthetic lesions.

Non-Vascularized Free Toe Phalanx Transplantation in the Treatment of Symbrachydactyly and Constriction Ring Syndrome

2005 ◽  
Vol 30 (5) ◽  
pp. 446-451 ◽  
Author(s):  
T. GOHLA ◽  
CH. METZ ◽  
U. LANZ
Keyword(s):  
Hand Function ◽  
Donor Site ◽  
Growth Potential ◽  
Patient Age ◽  
Safe Method ◽  
Constriction Ring ◽  
Initial Surgery ◽  
The Mean ◽  
Constriction Ring Syndrome

Forty-eight patients underwent a total number of 113 non-vascularized free toe phalanx transplantations for congenital short digits between 1975 and 2003, a mean number of 2.3 transplanted phalanges per patient. The mean age at the time of initial surgery was 3.6 years (range 6 months to 21 years). The follow-up time ranged from 4 months to 14 years with a mean of 6 years. Sixty-four phalanges showed radiographically measured growth, 22 phalanges showed signs of resorption, while 27 phalanges showed neither growth nor resorption. Resorption increased with patient age. Three patients developed donor site problems. The optimum timing for initial surgery is as early as possible because of the safer and greater growth potential and less resorption of the transplanted phalanges. Non-vascularized free toe phalanx transplantations offer a simple and safe method of lengthening with a significant improvement of hand function.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

Congenital Constriction Ring Syndrome in Lower Limb-A Rare Entity

2012 ◽  
Vol 3 (5) ◽  
pp. 425-426
Author(s):  
Dr. Anoop Kumar Singh Dr. Anoop Kumar Singh ◽  
◽  
Dr. Anumita Sinha ◽  
Dr. Archika Dr. Archika
Keyword(s):  
Lower Limb ◽  
Rare Entity ◽  
Constriction Ring ◽  
Constriction Ring Syndrome

ASSESSMENT RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY AT HUE CENTRAL HOSPITAL

2011 ◽  
pp. 114-118
Author(s):  
Nhu Hiep Pham ◽  
Huu Thien Ho ◽  
Anh Vu Pham ◽  
Van Nghia Tran
Keyword(s):  
Laparoscopic Appendectomy ◽  
Single Port ◽  
Operation Time ◽  
Invasive Procedure ◽  
Minimal Invasive ◽  
Central Hospital ◽  
Surgical Department ◽  
A New Technique ◽  
Rate Female

Objectives: Laparoscopic appendectomy (LA) is becoming popular for the treatment of acute appendicitis. Since it was the first described, LA has been modified various times. We present the results of a new technique of LA conducted through a single port. Materials and methods: From March 2011 to November 2011, we have performed 28 operations Single Port Laparoscopic Appendectomy at the Surgical Department of Hue Central Hospital. Results: There were 28 patients, 57.1% were female, 42.9% were male, rate female/male was 1.3. The mean age is 36.4. The second port insertion was required in 2 patients (7.2%). Mean operation time was 44.6 minutes and postoperative hospital stay 3-5 days took 71.4%. Postoperative compications occurred in 1 case (3.6%) was of omphalitis. During 2-4 weeks follow up no problem related to the appendectomy have been reported. Conclusions: Single - port intracorporeal appendectomy procedure is a safe, minimal invasive procedure with excellent cosmetic results.

scholarly journals Double Rectangle Fascia Lata Frontalis Sling: A Rationale Approach for Ptosis

2021 ◽  
Vol 54 (01) ◽  
pp. 058-062
Author(s):  
Pawan Agarwal ◽  
Dhananjaya Sharma ◽  
Vikesh Agrawal ◽  
Swati Tiwari ◽  
Rajeev Kukrele
Keyword(s):  
Retrospective Study ◽  
Surgical Outcomes ◽  
Functional Outcomes ◽  
Fascia Lata ◽  
Modified Technique ◽  
Eyelid Margin ◽  
Upper Eyelid ◽  
Light Reflex ◽  
Straight Line

AbstractBackground The purpose of this study was to evaluate the functional outcomes of a modified technique of double rectangle pattern for correction of severe ptosis.Methods This is a retrospective study over a period of 8 years including patients who underwent correction of ptosis by double rectangle using autologous fascia lata sling. Surgical outcomes were assessed postoperatively by distance from the corneal light reflex to the upper eyelid margin (MRD1) and levator function.Results Twenty-six eyelids were operated in 20 patients. There were 9 males and 11 females, with age ranging from 4 to 35 years. Preoperatively, all patients had poor MRD1 and poor levator function. Postoperative MRD1 was good in 13 patients (17 eyelids), fair in 5 (7eyelids), and poor in 2 patients (2 eyelids). Postoperative levator function was excellent in 12 patients (15 eyelids), good in 6 (9 eyelids), and fair in 2 patients (2 eyelids). At a mean follow-up of 12 months, adequate correction was achieved in 24 eyelids, and 2 eyelids had undercorrection.Conclusion Frontalis sling with a double rectangle is simple and more efficient, as it provides a straight line of pull to the eyelid for correction of severe ptosis.

scholarly journals Temperature and Relative Humidity Profile Retrieval from Fengyun-3D/HIRAS in the Arctic Region

2021 ◽  
Vol 13 (10) ◽  
pp. 1884
Author(s):  
Jingjing Hu ◽  
Yansong Bao ◽  
Jian Liu ◽  
Hui Liu ◽  
George P. Petropoulos ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Real Time ◽  
Wide Spectrum ◽  
Warm Season ◽  
Arctic Region ◽  
Cold Season ◽  
The Arctic ◽  
Practical Applications ◽  
A New Technique ◽  
The Arctic Region

The acquisition of real-time temperature and relative humidity (RH) profiles in the Arctic is of great significance for the study of the Arctic’s climate and Arctic scientific research. However, the operational algorithm of Fengyun-3D only takes into account areas within 60°N, the innovation of this work is that a new technique based on Neural Network (NN) algorithm was proposed, which can retrieve these parameters in real time from the Fengyun-3D Hyperspectral Infrared Radiation Atmospheric Sounding (HIRAS) observations in the Arctic region. Considering the difficulty of obtaining a large amount of actual observation (such as radiosonde) in the Arctic region, collocated ERA5 data from European Centre for Medium-Range Weather Forecasts (ECMWF) and HIRAS observations were used to train the neural networks (NNs). Brightness temperature and training targets were classified using two variables: season (warm season and cold season) and surface type (ocean and land). NNs-based retrievals were compared with ERA5 data and radiosonde observations (RAOBs) independent of the NN training sets. Results showed that (1) the NNs retrievals accuracy is generally higher on warm season and ocean; (2) the root-mean-square error (RMSE) of retrieved profiles is generally slightly higher in the RAOB comparisons than in the ERA5 comparisons, but the variation trend of errors with height is consistent; (3) the retrieved profiles by the NN method are closer to ERA5, comparing with the AIRS products. All the results demonstrated the potential value in time and space of NN algorithm in retrieving temperature and relative humidity profiles of the Arctic region from HIRAS observations under clear-sky conditions. As such, the proposed NN algorithm provides a valuable pathway for retrieving reliably temperature and RH profiles from HIRAS observations in the Arctic region, providing information of practical value in a wide spectrum of practical applications and research investigations alike.All in all, our work has important implications in broadening Fengyun-3D’s operational implementation range from within 60°N to the Arctic region.

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