scholarly journals Two Cases of Morel-Lavallée Lesion Which Resulted in a Wide Skin Necrosis from a Small Laceration

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Tadahiro Nakajima ◽  
Kaoru Tada ◽  
Mika Nakada ◽  
Masashi Matsuta ◽  
Hiroyuki Tsuchiya
Keyword(s):  
Blood Vessel ◽  
Skin Necrosis ◽  
Shear Force ◽  
Soft Tissues ◽  
Initial Visit ◽  
Shearing Force ◽  
Vessel Damage ◽  
Degloving Injury ◽  
Wide Range

Morel-Lavallée lesion (MLL) is a degloving injury in soft tissues caused by shear force accompanying trauma. Even if it is a small lacrimal wound at the initial visit, there is a range of skin necrosis which is not suitable for it. As a cause of the injury, a shearing force was applied over a wide range, and penetrating blood vessel damage to the skin occurred, resulting in skin necrosis. Attention is required.

scholarly journals Quantification of assembly forces during creation of head-neck taper junction considering soft tissue bearing: a biomechanical study

Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Toni Wendler ◽  
Torsten Prietzel ◽  
Robert Möbius ◽  
Jean-Pierre Fischer ◽  
Andreas Roth ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Work Experience ◽  
Soft Tissues ◽  
Force Sensor ◽  
Biomechanical Study ◽  
Measuring System ◽  
Wide Range ◽  
Head Neck

Abstract Background All current total hip arthroplasty (THA) systems are modular in design. Only during the operation femoral head and stem get connected by a Morse taper junction. The junction is realized by hammer blows from the surgeon. Decisive for the junction strength is the maximum force acting once in the direction of the neck axis, which is mainly influenced by the applied impulse and surrounding soft tissues. This leads to large differences in assembly forces between the surgeries. This study aimed to quantify the assembly forces of different surgeons under influence of surrounding soft tissue. Methods First, a measuring system, consisting of a prosthesis and a hammer, was developed. Both components are equipped with a piezoelectric force sensor. Initially, in situ experiments on human cadavers were carried out using this system in order to determine the actual assembly forces and to characterize the influence of human soft tissues. Afterwards, an in vitro model in the form of an artificial femur (Sawbones Europe AB, Malmo, Sweden) with implanted measuring stem embedded in gelatine was developed. The gelatine mixture was chosen in such a way that assembly forces applied to the model corresponded to those in situ. A study involving 31 surgeons was carried out on the aforementioned in vitro model, in which the assembly forces were determined. Results A model was developed, with the influence of human soft tissues being taken into account. The assembly forces measured on the in vitro model were, on average, 2037.2 N ± 724.9 N, ranging from 822.5 N to 3835.2 N. The comparison among the surgeons showed no significant differences in sex (P = 0.09), work experience (P = 0.71) and number of THAs performed per year (P = 0.69). Conclusions All measured assembly forces were below 4 kN, which is recommended in the literature. This could lead to increased corrosion following fretting in the head-neck interface. In addition, there was a very wide range of assembly forces among the surgeons, although other influencing factors such as different implant sizes or materials were not taken into account. To ensure optimal assembly force, the impaction should be standardized, e.g., by using an appropriate surgical instrument.

scholarly journals The Captain’s View: A Novel Radiographic View to Assess Axial Alignment of the Calcaneus

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0042
Author(s):  
Brian Velasco ◽  
Bruno Moura ◽  
John Kwon
Keyword(s):  
Soft Tissues ◽  
Articular Surface ◽  
Lateral Wall ◽  
Varus Deformity ◽  
High Rate ◽  
Clear Correlation ◽  
Lateral Side ◽  
Axial Alignment ◽  
Wide Range ◽  
Fresh Frozen

Category: Hindfoot, Trauma Introduction/Purpose: The axial alignment of the calcaneus has paramount importance in the management of these fractures. The Harris view has long stood as the recommended radiograph to assess axial alignment. However, given the obliquity at which the radiograph is obtained, it doesn´t represent a true axial view and is subject to inaccuracies secondary to rotational malpositioning of the foot and mismeasurement of angulation. Multiple reports have described the axial alignment as a surgical outcome, but usually this assessment of the residual deformity have no described method. The objectives of this study are to evaluate the capacity of Harris view to assess axial alignment in a cadaveric model and to describe the use of a true AP view of the calcaneus that we have named Captain´s view. Methods: Five below knee amputated fresh-frozen cadaveric specimens were used in the study. For each specimen, the soft tissues over the lateral side were removed to access to the lateral wall. A small wedge of the cuboid was removed to visualize the center of the calcaneocuboid articular surface. LCA-guide and a cannulated drill were used to create a tunnel in the axis of the calcaneus. An oblique osteotomy was performed in order to simulate a non-comminuted fracture. Varus deformity was created by inserting solid radiolucent wedges into the osteotomy to create models of 10, 20, and 30 degrees of varus angulation. Harris and Captain views were obtained for each specimen with 0 (control), 10, 20, and 30 degrees of varus malalignment. Measurements of the deformity were made digitally on each fluoroscopic image. Results: The average degrees of varus in Harris views were 10,9 (5,5-16); 11,5 (8,2-13,6); and 18,3 (13,3-23,6) for 10,20 and 30 degrees of deformity respectively. The average degrees of varus in Captain´s view were 13,0 (7,3-20,9); 18,4 (11,7-23,5); and 28,2 (24,4-31,1) for 10,20 and 30 degrees of deformity respectively. The average degrees of error for varus deformity in Harris views were 4,1 (41%); 8,4 (42%) and 11,6 (39%) for 10,20 and 30 degrees of deformity respectively. The average degrees of error for varus deformity in Captain´s views were 4,8 (48%); 3,6 (18%) and 2,8 (8%) for 10,20 and 30 degrees of deformity respectively. Conclusion: The results of this study show a high rate of mismeasurement for both radiographic views. Despite the average angles have a clear correlation with the severity of varus, the wide range of error observed between specimens make this assessment unreliable and inaccurate. We observed an improvement of accuracy of captain´s view for more severe deformities, but not with Harris views which maintain a 40% mismeasurement in all the settings. Therefore, intraoperative Harris views should not be used in isolation to evaluate axial alignment and Captain´s view provides an additional perspective that can be useful to rule out severe deformities.

scholarly journals Efficient finite element hyperelasticity solver for blood vessel simulations

2020 ◽  
Vol 14 ◽  
pp. 174830262093101
Author(s):  
Xinhong Wang ◽  
Zhengzheng Yan ◽  
Yi Jiang ◽  
Rongliang Chen
Keyword(s):  
Finite Element ◽  
Blood Vessel ◽  
Blood Vessels ◽  
High Performance ◽  
Soft Tissues ◽  
Circulatory System ◽  
Numerical Algorithms ◽  
External Pressure ◽  
Patient Specific ◽  
Schwarz Method

The blood vessels play a key role in the human circulatory system. As a tremendous amount of efforts have been devoted to develop mathematical models for investigating the elastic behaviors of human blood vessels, high performance numerical algorithms aiming at solving these models have attracted attention. In this work, we present an efficient finite element solver for an elastodynamic model which is commonly used for simulating soft tissues under external pressure loadings. In particular, the elastic material is assumed to satisfy the Saint–Venant–Kirchhoff law, the governing equation is spatially discretized by a finite element method, and a fully implicit backward difference method is used for the temporal discretization. The resulting nonlinear system is then solved by a Newton–Krylov–Schwarz method. It is the first time to apply the Newton–Krylov–Schwarz method to the Saint–Venant–Kirchhoff model for a patient-specific blood vessel. Numerical tests verify the efficiency of the proposed method and demonstrate its capability for bioengineering applications.

Use of Platelet-Rich Plasma and Platelet-Rich Fibrin in Dentistry and Oral Surgery: Introduction and Review of the Literature

2019 ◽  
Vol 36 (2) ◽  
pp. 109-123 ◽  
Author(s):  
Kristina Feigin ◽  
Bonnie Shope
Keyword(s):  
Soft Tissues ◽  
Oral Surgery ◽  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Oral And Maxillofacial Surgery ◽  
Platelet Concentrates ◽  
Platelet Rich Fibrin ◽  
Wide Range ◽  
Comprehensive Examination ◽  
And Function

Platelet concentrates, mostly represented by platelet-rich plasma and platelet-rich fibrin, have gained significant interest in various medical and oral disciplines because of their potential to stimulate and boost regeneration of hard and soft tissues. Prepared from the patient’s own blood, they have been tested and used in various different surgical fields including oral and maxillofacial surgery. The effects of these biomaterials are described to be a result of the large concentration of platelets which contain a wide range of growth factors. The aim of this article is to introduce the principle and function of these platelet concentrates, to review their preparation, and to provide a comprehensive examination of the published oral and maxillofacial literature on this subject.

scholarly journals ACE inhibitors can reverse blood vessel damage

1991 ◽  
Vol 12 ◽  
pp. 239-241 ◽  
Author(s):  
Pramod R. Saxena ◽  
Arie J. Man In't Veld
Keyword(s):  
Blood Vessel ◽  
Ace Inhibitors ◽  
Vessel Damage

scholarly journals Constitutive modelling of arteries

2010 ◽  
Vol 466 (2118) ◽  
pp. 1551-1597 ◽  
Author(s):  
Gerhard A. Holzapfel ◽  
Ray W. Ogden
Keyword(s):  
Mechanical Behaviour ◽  
Soft Tissues ◽  
Elastic Strain Energy ◽  
Cylindrical Tube ◽  
Strain Energy Function ◽  
Biological Tissues ◽  
Constitutive Modelling ◽  
Highly Nonlinear ◽  
Wide Range ◽  
Modelling Effort

This review article is concerned with the mathematical modelling of the mechanical properties of the soft biological tissues that constitute the walls of arteries. Many important aspects of the mechanical behaviour of arterial tissue can be treated on the basis of elasticity theory, and the focus of the article is therefore on the constitutive modelling of the anisotropic and highly nonlinear elastic properties of the artery wall. The discussion focuses primarily on developments over the last decade based on the theory of deformation invariants, in particular invariants that in part capture structural aspects of the tissue, specifically the orientation of collagen fibres, the dispersion in the orientation, and the associated anisotropy of the material properties. The main features of the relevant theory are summarized briefly and particular forms of the elastic strain-energy function are discussed and then applied to an artery considered as a thick-walled circular cylindrical tube in order to illustrate its extension–inflation behaviour. The wide range of applications of the constitutive modelling framework to artery walls in both health and disease and to the other fibrous soft tissues is discussed in detail. Since the main modelling effort in the literature has been on the passive response of arteries, this is also the concern of the major part of this article. A section is nevertheless devoted to reviewing the limited literature within the continuum mechanics framework on the active response of artery walls, i.e. the mechanical behaviour associated with the activation of smooth muscle, a very important but also very challenging topic that requires substantial further development. A final section provides a brief summary of the current state of arterial wall mechanical modelling and points to key areas that need further modelling effort in order to improve understanding of the biomechanics and mechanobiology of arteries and other soft tissues, from the molecular, to the cellular, tissue and organ levels.

scholarly journals Extradural Spinal Tumors: Report of 36 Cases and Review of Literature

2016 ◽  
Vol 13 (1) ◽  
pp. 3-10
Author(s):  
Gopal R Sharma ◽  
Nilam Khadka ◽  
Rajiv Jha ◽  
Dhurba R Adhikari ◽  
Prakash Bista
Keyword(s):  
Back Pain ◽  
Soft Tissues ◽  
Relevant Literature ◽  
Bone Cyst ◽  
Neurological Status ◽  
Motor Deficit ◽  
Spinal Tumors ◽  
Metastatic Lesions ◽  
Wide Range

About 55% of spinal tumors are extradural arising from vertebral bodies, epidural and surrounding neural and soft tissues. More than 90% of extradural spinal tumors are metastatic lesions. Extradural spinal tumors are common cause of back pain, sensory motor deficit and sphincters dysfunction. The wide range of lesions and varied clinical profile, make management of spinal extradural tumors a challenging task for any neurosurgeon.Aim of this study is to analyze and discuss the results of extradural spinal tumors after surgical treatment and relevant literature will be reviewed.This is a retrospective study of 36 patients who were operated for spinal extradural tumors between May 1999 and December 2012 in our institute.Follow up period ranged from 3 years to 12 years. Functional neurological outcome was assessed by McCormick's grading. There were 20 male and 16 female and age ranged from 10 to 80 years. 30 patients presented with back pain and 15 had radicular pain. On presentation 18 patients had motor sensory deficit and 15 had sphincters dysfunction. Most common involved level of spines were thoracic followed by cervical and lumbar.Gross total excision of masses were carried out in all cases. Common pathologies were neurofibromas (16), Ewing's sarcoma (7), granulomas (3), metastatic lesions (2), angiolipoma (2), chondroma (2), aneurysmal bone cyst (1), plasmacytoma (1), rabdomyosarcoma (1) and neuroblastoma (1).Out of 14 patients who harbored malignant pathology 12 patients received radio and chemotherapy. Post operative wound infection occurred in 5 patients. Regarding post operative neurological status, 18 patients showed improvement, 6 patients remained same and 12 patients had deteriorated neurology. Tumor recurrence occurred in 15 patients; 12 patients with malignant and 3 patients with benign lesions on follow up period. There was no surgery related mortality, however, 11 patients died during 3 years follow up period due to adverse pathology they were having.Nepal Journal of Neuroscience 13:3-10, 2016

scholarly journals Blood vessel occlusion by Cryptococcus neoformans is a mechanism for haemorrhagic dissemination of infection

2020 ◽  
Author(s):  
Josie F Gibson ◽  
Aleksandra Bojarczuk ◽  
Robert J Evans ◽  
Alfred Kamuyango ◽  
Richard Hotham ◽  
...  
Keyword(s):  
Blood Vessel ◽  
Cryptococcus Neoformans ◽  
Severe Infection ◽  
Cell Junctions ◽  
Cell Junction ◽  
Vascular Events ◽  
Zebrafish Model ◽  
Vessel Occlusion ◽  
Vessel Damage

AbstractMeningitis caused by infectious pathogens are associated with vessel damage and infarct formation, however the physiological cause is unknown. Cryptococcus neoformans, is a human fungal pathogen and causative agent of cryptococcal meningitis, where vascular events are observed in up to 30% of cases, predominantly in severe infection. Therefore, we aimed to investigate how infection may lead to vessel damage and associated pathogen dissemination using a zebrafish model for in vivo live imaging. We find that cryptococcal cells become trapped within the vasculature (dependent on there size) and proliferate there resulting in vasodilation. Localised cryptococcal growth, originating from a single or small number of cryptococcal cells in the vasculature was associated with sites of dissemination and simultaneously with loss of blood vessel integrity. Using a cell-cell junction tension reporter we identified dissemination from intact blood vessels and where vessel rupture occurred. Finally, we manipulated blood vessel stifness via cell junctions and found increased stiffness resulted in increased dissemination. Therefore, global vascular vasodilation occurs following infection, resulting in increased vessel tension which subsequently increases dissemination events, representing a positive feedback loop. Thus, we identify a mechanism for blood vessel damage during cryptococcal infection that may represent a cause of vascular damage and cortical infarction more generally in infective meningitis.

scholarly journals Extensive skin necrosis after periprosthetic knee infection: a case that highlights the possibility of complications induced by low-molecular-weight heparin

2021 ◽  
Vol 6 (6) ◽  
pp. 235-240
Author(s):  
Hélder Fonte ◽  
André Carvalho ◽  
João Rosa ◽  
Cláudia Pereira ◽  
Alexandre Pereira ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Molecular Weight ◽  
Skin Necrosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Soft Tissue Management ◽  
Knee Infection ◽  
Complex Approach ◽  
Wide Range ◽  
Periprosthetic Knee Infection

Abstract. We describe a case of a patient with atrial fibrillation, anticoagulated with dabigatran, that developed severe knee skin necrosis in the setting of an acute periprosthetic knee infection, after initiating low-molecular-weight heparin. A wide range of etiology hypotheses was discussed within a multidisciplinary team. The complex approach consisted of treating the underlying infection, multiple types of soft-tissue management, and stopping enoxaparin.

scholarly journals Ex-Vivo Exposure on Biological Tissues in the 2-μm Spectral Range with an All-Fiber Continuous-Wave Holmium Laser

Photonics ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 20
Author(s):  
Mariya S. Kopyeva ◽  
Serafima A. Filatova ◽  
Vladimir A. Kamynin ◽  
Anton I. Trikshev ◽  
Elizaveta I. Kozlikina ◽  
...  
Keyword(s):  
Solid State ◽  
Soft Tissues ◽  
Continuous Wave ◽  
Ex Vivo ◽  
Laser System ◽  
Biological Tissues ◽  
Holmium Laser ◽  
Experimental Point ◽  
Ablation Efficiency ◽  
Wide Range

We present the results on the interaction of an all-fiber Holmium-doped laser CW radiation at a wavelength of 2100 nm with soft tissues and compare it with the other results obtained by the most used solid-state laser systems. Ex-vivo single spot experiments were carried out on the porcine longissimus muscles by varying the laser impact parameters in a wide range (average output power 0.3, 0.5 and 1.1 W; exposure time 5, 30 and 60 s). Evaluation of the laser radiation exposure was carried out by the size of coagulation and ablation zones on the morphological study. Exposure to a power of 0.3 W (1.5–18 J of applied energy) caused only reversible changes in the tissues. The highest applied energy of 66 J for 1.1 W and a 60-s exposure resulted in a maximum ablation depth of approximately 1.2 mm, with an ablation efficiency of 35%. We have shown that it is not necessary to use high powers of CW radiation, such as 5–10 W in the solid-state systems to provide the destructive effects. Similar results can be achieved at lower powers using the simple all-fiber Holmium laser based on the standard single-mode fiber, which could provide higher power densities and be more convenient to manufacture and use. The obtained results may be valuable as an additional experimental point in the field of existing results, which in the future will allow one to create a simple optimal laser system for medical purposes.

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