scholarly journals Transtibial Amputation with Removal of the Tibial Intramedullary Nail: Hardware Removal in a Retrograde Manner

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Youn-Ho Choi ◽  
DoJoon Park
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Intramedullary Nail ◽  
Diabetic Foot ◽  
Patella Instability ◽  
Special Situation ◽  
Transtibial Amputation ◽  
Knee Amputation ◽  
Distal Interlocking ◽  
Nail Insertion

Transtibial amputation is the preferred strategy for treating a diabetic foot with an infection and necrosis. However, if a tibial intramedullary nail was previously inserted into the ipsilateral lower extremity, the nail must be removed to perform the transtibial amputation. In this special situation, the removal of the tibial intramedullary nail can cause various complications after transtibial amputation. We present a case and surgical technique report of a 46-year-old male with an uncontrolled diabetic foot with tibial intramedullary nail insertion. With the nail and ankle fixed by distal interlocking screws, a below-knee amputation was performed by removing the nail and the amputated limb together. This surgical method is expected to reduce postoperative complications such as infections and patella instability after the amputation of a diabetic foot.

scholarly journals New Technique: A Novel Femoral Derotation Osteotomy for Malrotation following Intramedullary Nailing

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
S. Jagernauth ◽  
A. J. Tindall ◽  
S. Kohli ◽  
P. Allen
Keyword(s):  
Female Patient ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Femoral Fracture ◽  
Fracture Site ◽  
Distal Interlocking ◽  
Nail Insertion ◽  
Derotation Osteotomy ◽  
Walking Difficulty

A 19-year-old female patient sustained a closed spiral midshaft femoral fracture and subsequently underwent femoral intramedullary nail insertion. At followup she complained of difficulty in walking and was found to have a unilateral in-toeing gait. CT imaging revealed 30 degrees of internal rotation at the fracture site, which had healed. A circumferential osteotomy was performed distal to the united fracture site using a Gigli saw with the intramedullary femoral nail in situ. The static distal interlocking screws were removed and the malrotation was corrected. Two further static distal interlocking screws were inserted to secure the intramedullary nail in position. The osteotomy went on to union and her symptoms of pain, walking difficulty, and in-toeing resolved. Our paper is the first to describe a technique for derotation osteotomy following intramedullary malreduction that leaves the intramedullary nail in situ.

scholarly journals 318. Deferring Amputation in Diabetic Foot Osteomyelitis: Doing more Harm than Good?

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S231-S232
Author(s):  
Shiwei Zhou ◽  
Brian M Schmidt ◽  
Oryan Henig ◽  
Keith S Kaye
Keyword(s):  
Diabetic Foot ◽  
Medical Management ◽  
Wound Care ◽  
Cohort Analysis ◽  
Severity Of Illness ◽  
Complete Healing ◽  
Knee Amputation ◽  
Management Group ◽  
One Year ◽  
Diabetic Foot Osteomyelitis

Abstract Background Diabetic foot osteomyelitis (DFO) is a leading cause of below knee amputation (BKA). Even when medical treatment is deemed unlikely to succeed, patients with DFO are often resistant to amputation. Methods An observational cohort analysis was done on patients with DFO at Michigan Medicine who were evaluated by podiatry and recommended BKA from Oct 2015 - Jun 2019. Primary outcome was mortality after BKA recommendation. Secondary outcomes were healing of affected limb, rate of BKA or above knee amputation (AKA) and total antibiotic days in the 6 months following. All intravenous antibiotics and oral courses of linezolid and fluoroquinolones were captured. Results Of 44 patients with DFO, 18 chose BKA, 26 chose medical management with wound care. Mean age of the cohort was 61, 68% male, 80% white with a median Charlson Comorbidity Index of 6 (IQR 4,7). The two groups were similar with regards to demographics and comorbid conditions. Those who chose medical management did so because their infection was non-life-threatening and they desired to avoid amputation. One-year mortality was greater in patients who were medically managed compared to those who had BKA (23.1% vs 0%, OR 11.7, 95% CI 0.6–222.9). Considering only the 33 patients who were followed for at least 2 years, 2-year mortality was also greater in the medically managed group compared to the BKA group (38.5% vs 5.6%, OR 10.6, 95% CI 1.2–92.7, Figure 1). Fewer patients in the medical management group had complete healing of their wound/stump compared to the BKA group (46.2% vs 88.9%, OR 9.3, 95% CI 1.8–49.1). In the medically managed group, 18 (69%) patients went on to require BKA or AKA at a median of 76.5 days compared to 2 (11%) in the BKA group who required AKA at 1 and 11 days following recommendation. Median antibiotic days were significantly greater in the medically managed group compared to the BKA group (55 IQR 42,78 vs 17 IQR 10,37, p=0.0017). Conclusion In this cohort of DFO patients where BKA was recommended, medical management was associated with increased mortality, poor healing of the affected limb, and excess antibiotic exposure compared to BKA. These findings are particularly notable as case mix and severity of illness were similar between the two groups. This study can be used to inform providers and patients in cases where BKA is recommended. Disclosures All Authors: No reported disclosures

scholarly journals Treatment of severe actinic rectitis

1998 ◽  
Vol 116 (1) ◽  
pp. 1629-1633
Author(s):  
Benedito Mauro Rossi ◽  
Wilson Toshihiko Nakagawa ◽  
José Augusto P. Fernandes ◽  
Ademar Lopes ◽  
Lauma Dzidra Paegle
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Anal Canal ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Coloanal Anastomosis ◽  
Left Colon ◽  
Sphincter Function ◽  
First Case ◽  
Absorbable Sutures

BACKGROUND: The authors report the treatment of three female patients with severe actinic rectitis, with stenosis or perforation, submitted to anterior proctosigmoidectomy and transanal coloanal anastomosis. METHODS: In all cases surgery consisted of total proctosigmoidectomy, mucosectomy of the anal canal, lowering of the left colon through the pelvis and transanal anastomosis performed manually at the level of the pectineal line using separate absorbable sutures. A protective intestinal shunt was performed in all cases. RESULTS: The three patients did not present transoperative or immediate postoperative complications, but the first patient developed deep venous thrombosis of the leg that was submitted to successful clinical treatment. The intestinal shunts were later closed in all three cases. Sphincter function was considered very good in the first case and regular in the remaining two. CONCLUSION: The surgical technique utilized was considered to be adequate for the cases reported and is the first option for the maintenance of transit in patients with severe actinic rectitis since the anastomosis is performed using non-irradiated colon with the pectineal line, practically outside the pelvis.

The Boyd amputation as a treatment for osteomyelitis of the foot

2000 ◽  
Vol 90 (5) ◽  
pp. 234-239 ◽  
Author(s):  
JF Grady ◽  
CL Winters
Keyword(s):  
Surgical Technique ◽  
Knee Amputation ◽  
Below The Knee ◽  
Heel Pad ◽  
Difficult Procedure ◽  
Syme Amputation

The Boyd amputation is a surgical technique used to treat osteomyelitis of the foot. This amputation is a technically more difficult procedure to perform than the Syme amputation, but it offers certain advantages. The Boyd amputation provides a more solid stump because it preserves the function of the plantar heel pad. Also, because a portion of the calcaneus is left and fused to the tibia, the weightbearing surface is more solid than in the case of a Syme amputation. The authors recommend a Boyd amputation as an alternative to a Syme or a below-the-knee amputation to treat patients with osteomyelitis of the forefoot and midfoot.

scholarly journals Results obtained after the surgical treatment of Graves’ disease depending on the levels of anti-thyroid antibodies

2021 ◽  
Author(s):  
S. L. Shliakhtych ◽  
V. R. Antoniv
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Surgical Technique ◽  
Hormone Receptors ◽  
Thyroid Stimulating Hormone ◽  
Endocrine Surgery ◽  
Graves Disease ◽  
Autoimmune Thyroid ◽  
Early Postoperative Complications ◽  
Surgery Duration

Graves' disease (GD) is a hereditary autoimmune disease which is characterized by persistent abnormal hypersecretion of thyroid hormones and thyrotoxicosis syndrome development. GD affects from 0.5 % to 2.0 % of population in different regions. 46 % of these patients develop ophthalmopathy. GD is a common cause of disabilities in patients under 60 years of age. In recent years, the incidence of GD in Ukraine has increased by 9.9 % — from 106.2 to 117.9 per 100,000 individuals. This can be connected with the improved diagnostic possibilities and active disease detection as well as with the increased number of autoimmune thyroid disorders. The recent studies focus on prevention of specific complications and recurrences of GD after surgery. Objective — to compare the levels of antibodies to the thyroid‑stimulating hormone receptors (TSHR‑Ab) during different postoperative periods as well as the incidence of early and late complications depending on the surgical technique used for the treatment of GD. Materials and methods. The results of surgical treatment of 130 patients, with GD were compared. 29 male patients and 101 female patients aged from 19 to 76 (average — 44.1 ± 3.2 years), receiving their treatment for GD in Kyiv Center of Endocrine Surgery during 2010—2018, were randomly selected and divided into two groups. At the time of operation the duration of disease was from 1 to 30 years (average — 4.6 ± 1.2 years). Group  1 included 65 patients that underwent total thyreoidectomy (TT) and group 2 included 65 patients that underwent subtotal thyreoidectomy (ST). The following parameters were compared: surgery duration, the incidence of early postoperative complications, including bleedings and damage to the recurrent laryngeal nerves, and late outcomes of surgical treatment (persistent hypoparathyreoidism disorder and disorder recurrences) depending on the method of surgery (ST or TT). Furthermore, the patterns of the TSHR‑Ab level reduction were studied for different postoperative periods. Results. The comparison of surgical outcomes following TТ and ST didn’t reveal any statistically significant differences in such evaluation criteria as the average surgery duration, the average volume of intraoperative blood loss and the average duration of the postoperative inpatient treatment. The comparative assessment of the thyroid stump volume and the average amount of drained discharge showed statistically significant differences for TТ. It allows considering TТ as a surgery which causes less complications than ST. The studied parameters of early postoperative complications had no significant differences for ST and TТ. The long‑term (5 years) postoperative level of TSHR‑Ab was statistically significantly lower in patients after TT and made up 1.15 ± 0.13 IU/L (thus corresponding to the normal level). Conclusions. Total thyroidectomy is an optimal surgical technique and is more appropriate compared with subtotal thyroid gland resection. It should be noted that TT provides lower risk of complications due to significantly lower level of TSHR‑Ab in late postoperative period.  

scholarly journals Physiotherapeutic approach in managing a patient after below-knee amputation due to diabetic foot syndrome

2018 ◽  
Vol 6 (6) ◽  
pp. 218-220
Author(s):  
Karolina Wolnik-Piernicka ◽  
Małgorzata Hałoń-Gołąbek ◽  
Bogumił Wolnik ◽  
Rita Hansdorfer-Korzon ◽  
Anna Korzon-Burakowska
Keyword(s):  
Diabetic Foot ◽  
Diabetic Foot Syndrome ◽  
Knee Amputation

Hands-on robotic distal interlocking in intramedullary nail fixation of femoral shaft fractures

2010 ◽  
Vol 18 (4-5) ◽  
pp. 325-334 ◽  
Author(s):  
Markus Oszwald ◽  
Ralf Westphal ◽  
Daniel Klepzig ◽  
Rebecca Stier ◽  
Ralph Gaulke ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Femoral Shaft ◽  
Femoral Shaft Fractures ◽  
Distal Interlocking ◽  
Shaft Fractures ◽  
Hands On

scholarly journals Circumcision: postoperative complications that required reoperation

2018 ◽  
Vol 16 (3) ◽  
Author(s):  
Carolina Talini ◽  
Letícia Alves Antunes ◽  
Bruna Cecília Neves de Carvalho ◽  
Karin Lucilda Schultz ◽  
Maria Helena Camargo Peralta Del Valle ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Technique ◽  
Medical Records ◽  
Statistical Significance ◽  
Postoperative Outcome ◽  
Conventional Technique ◽  
Significant Difference ◽  
Operative Complications ◽  
Classic Technique ◽  
The Difference

ABSTRACT Objective To evaluate post-operative complications of circumcision requiring surgical reintervention. Methods Retrospective analysis of medical records of patients submitted to circumcision from May 1st, 2015 to May 31st, 2016. Results A total of 2,441 circumcisions were performed; in that, 1,940 using Plastibell and 501 by the classic technique. Complications requiring surgical reintervention were found in 3.27% of patients. When separated by surgical technique, 3.4% of circumcisions using Plastibell device required reoperation, as compared to 3% of conventional technique (p=0.79). Preputial stenosis was most frequently found in classic circumcision, with statistical significance (p<0.001). Bleeding was more frequent when using Plastibell device, but the difference was not statistically different (p=0.37). Patients’ age was also evaluated to investigate if this variable influenced on the postoperative outcome, but no significant difference was found. Conclusion There was no statistically significant difference when comparing complications between the different techniques performed at this hospital. Preputial stenosis was most frequently found in the classic circumcision, while bleeding was more prevalent when using Plastibell device. Patients’ age did not influence in complications.

Sign in / Sign up

Export Citation Format

Share Document