Delayed Neural Reconstruction in the Lower Extremity: Results of Interfascicular Nerve Grafting

During a 4-year period, one of the authors (M.B.W.) performed 16 nerve reconstructions by interfascicular grafting in the lower extremities of 13 patients. Three patients were excluded from the study: one was lost to follow-up and two had less than 1-year follow-up. At an average follow-up of 30 months, the results of 13 procedures in 10 patients were evaluated. Results were good after five procedures, fair after five, and poor after three. Superior results were evident with shorter graft lengths and after nerve transection injuries.

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644 Use of Plantar Foot Plate Splints and High-Profile Leg Net Devices for Prevention of Plantarflexion Contracture following Placement of Cultured Epidermal Autograft to Lower Extremities

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.294 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S178-S179

Author(s):

Brooke Dean ◽

Gregory Andre ◽

Scott F Vocke

Keyword(s):

Lower Extremity ◽

Burn Injury ◽

Lower Extremities ◽

Ankle Dorsiflexion ◽

Burn Scar ◽

Thermoplastic Material ◽

Scar Contracture ◽

High Profile ◽

Left Ankle

Abstract Introduction Burn Therapists strive to prevent burn scar contracture through positioning strategies beginning in the acute phase of burn injury. This task is even more challenging when paired with posterior offloading and joint immobilization required for the viability of cultured epidermal autograft (CEA). High profile leg net devices are the standard for posterior offloading after application of CEA circumferentially to lower extremities but can result in poor positioning of the ankle. Custom foot plate splints were designed and fabricated to preserve ankle dorsiflexion during the initial stages of CEA healing. Methods The high-profile leg net devices were assembled using 3/4 inch PVC piping and PVC fittings (45 degrees, 90 degrees, and tees) with double layered elastic tubular netting to allow proper wound ventilation while supporting the lower extremity with the patient in supine. The plantar foot plates were custom molded to the patient’s foot using thermoplastic material and lined with medium density temper foam for pressure relief. The foot plate was attached to the frame using Velcro and straps. Instructions with photographs were posted in the patient’s room for nursing staff to reference. Netting was exchanged daily and frames were disinfected using standard techniques. Results Goniometric measures were taken for ankle dorsiflexion were taken on day of CEA application with lower extremities positioned on high profile nets (in alignment with cutaneous functional unit modified position): -6 degrees right ankle, -2 degrees left ankle. Repeat measures were taken after one week period of bilateral lower extremity immobilization per CEA protocol: -1 degree right ankle, 2 degrees left ankle. One month follow-up at the discontinuance of leg net devices showed bilateral ankle dorsiflexion preserved with 3-degree right ankle dorsiflexion and 5 degrees on the left. Conclusions The use of custom foot plates on high profile leg net devices appears to improve ankle dorsiflexion range of motion while maintaining adequate posterior offloading required for CEA precautions for a burn survivor with extensive lower extremity burn wounds.

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A Rare Case of Primary Upper Extremity Varicose Veins

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0039-1692382 ◽

2019 ◽

Vol 04 (01) ◽

pp. 029-031

Author(s):

Ramisertti Bhargavi ◽

Tammiraju Iragavarapu ◽

A Aswini Kumar

Keyword(s):

Lower Extremity ◽

Upper Extremity ◽

Upper Limb ◽

Rare Case ◽

Varicose Veins ◽

Case Reports ◽

Vascular Surgeon ◽

Doppler Study ◽

Lost To Follow Up

AbstractThe incidence of varicosities of upper extremity is far most uncommon from that of lower extremity varicose veins for varied reasons even though the causes are almost the same. Here, the authors present a case of right upper limb varicose veins in a 55-year-old female who is a housewife. After ruling out all the secondary and congenital causes on clinical and Doppler study, the authors diagnosed it as a case of primary upper extremity varicose veins. They referred the case to a vascular surgeon but the patient denied the surgery, and is lost to follow-up. Hence, the authors report this case of primary upper limb varicosities as the incidence is very low when compared with lower extremity, and not much of literature is available except for a few case reports.

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Clinical Experience with End-to-Side Nerve Transfer

Journal of Hand Surgery (European Volume) ◽

10.1016/j.jhsb.2004.03.006 ◽

2004 ◽

Vol 29 (5) ◽

pp. 438-443 ◽

Cited By ~ 16

Author(s):

C. PIENAAR ◽

M. C. SWAN ◽

W. DE JAGER ◽

M. SOLOMONS

Keyword(s):

Nerve Transfer ◽

Nerve Grafting ◽

Nerve Transfers ◽

Mean Delay ◽

Peripheral Nerve Lesions ◽

Objective Evidence ◽

The Mean ◽

Protective Sensation ◽

Lost To Follow Up

A retrospective study was undertaken to determine the effectiveness of end-to-side nerve transfer. Twenty patients with peripheral nerve lesions of varying aetiology underwent 23 end-to-side nerve transfers over a 15-month period. The mean patient age was 30 years and 18 were male. The mean delay in presentation was 2.4 months. All underwent end-to-side nerve repairs and were reviewed in outpatients at regular intervals. Ten patients were lost to follow-up before 12 months and were therefore excluded from the study. The remaining ten patients, who had undergone 13 end-to-side procedures, had a mean follow-up period of 16 months. None demonstrated objective evidence of motor recovery at the end of the study period. Four patients had modest recovery of deep protective sensation, and two patients suffered a subtle degree of ”donor“ nerve morbidity. We have abandoned this technique in our centre in preference for standard nerve grafting techniques.

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Rheovasographic Evaluation of Peripheral Blood Circulation at Lengthening of Lower Extremities in Children

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17816/vto200411373 ◽

2004 ◽

Vol 11 (3) ◽

pp. 73

Author(s):

T. S Vinokurova ◽

Yu. E Garkavenko

Keyword(s):

Lower Extremity ◽

Peripheral Blood ◽

Blood Circulation ◽

Lower Extremities ◽

Distal Extremity ◽

Before And After ◽

Peripheral Blood Circulation

Rheovasography was applied for the evaluation of blood circulation in the femur and crus before and after restoration of lower extremity length. There were 51 children, aged 5—18, with acquired pathology of proximal (39 patients) and distal (12 patients) metaepiphysis of femur. Positive dynamics in regional blood circulation was noted both in proximal and distal extremity segments at 1—5 years follow up after lengthening

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Epidemiology of time-loss injuries in international fencing: a prospective, 5-year analysis of Fédération Internationale d’Escrime competitions

British Journal of Sports Medicine ◽

10.1136/bjsports-2018-100002 ◽

2019 ◽

Vol 53 (7) ◽

pp. 442-448 ◽

Cited By ~ 1

Author(s):

Peter A Harmer

Keyword(s):

Lower Extremity ◽

Median Time ◽

Lower Risk ◽

Lower Extremities ◽

Common Mechanism ◽

Ankle Sprains ◽

Sprains And Strains ◽

Time Loss

ObjectivesThe study aimed to determine the risk of time-loss injuries in international fencing and to characterise their type, location, severity and mechanism. Variations in risk associated with sex and discipline categories are also examined.MethodsData on participation and withdrawal due to injury from 809 competitions comprising the major events of the 2010–2014 seasons (inclusive) for the Fédération Internationale d’Escrime were compiled from official results. Athletes who withdrew due to injury sustained in each competition were contacted individually to obtain follow-up information including time lost from fencing participation (practice/competition) and sequelae.ResultsA total of 176 injuries were recorded from 637 776 athlete exposures (AEs) in 85 686 participants (men=47 869; women=37 817) over the study period, for an overall incidence of 0.28/1000 AEs (95% CI 0.24 to 0.32). Men had significantly greater risk than women (RR=1.42, 95% CI 1.05 to 1.94); épée had a significantly lower risk than foil or sabre (RR=0.52, 95% CI 0.35 to 0.76; RR=0.47, 95% CI 0.32 to 0.69, respectively). The majority of injuries were sprains (40.8%) and strains (20.1%), which occurred in the lower extremities (72.4%); ankle sprains were the most common specific injury (25.3%). Intrinsic effort of the fencer (non-contact injury) was the most common mechanism related to a time-loss injury (47.1% of cases). The overall median time loss was 4 weeks; 32.1% of the injuries involved 2 weeks or less away from fencing participation.ConclusionThe data indicate that the risk of time-loss injury in international fencing is very low and primarily involves sprains and strains in the lower extremity.

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