Combined joint fusion for index and middle carpometacarpal instability in elite boxers

2013 ◽  
Vol 39 (3) ◽  
pp. 242-248 ◽  
Author(s):  
N. Nazarian ◽  
R. S. Page ◽  
G. A. Hoy ◽  
M. J. Hayton ◽  
M. Loosemore
Keyword(s):  
Functional Results ◽  
Middle Finger ◽  
Acute Injury ◽  
Consecutive Series ◽  
Soft Tissue Reconstruction ◽  
Carpometacarpal Joints ◽  
Tissue Reconstruction ◽  
The Uk ◽  
Surgical Treatments ◽  
Simple Reduction

Isolated instability of the index and middle finger carpometacarpal joints is uncommon. An unpublished injury pattern in a consecutive series of 13 elite boxers is described, with mid-term radiological and functional results of two novel surgical treatments. All the boxers (from Australia and the UK) were unable to compete owing to pain and weakness. Four boxers were managed initially by open reduction and temporary K-wire fixation. Nine boxers underwent primary carpometacarpal arthrodesis. All were able to return to their previous level of competition. One boxer who had undergone a soft tissue reconstruction competed at international level but required an arthrodesis because of recurrent symptoms. In elite boxers, simple reduction and wiring may be appropriate for an acute injury causing index or middle finger carpometacarpal joint instability, however, arthrodesis is the treatment of choice when instability and degenerative changes are present.

scholarly journals Comparison between Constrained and Semiconstrained Knee Allograft-Prosthesis Composite Reconstructions

Sarcoma ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
German L. Farfalli ◽  
Luis A. Aponte-Tinao ◽  
Miguel A. Ayerza ◽  
D. Luis Muscolo ◽  
Patrick J. Boland ◽  
...  
Keyword(s):  
Survival Rate ◽  
Aseptic Loosening ◽  
Knee Prosthesis ◽  
Functional Results ◽  
Soft Tissue Reconstruction ◽  
Functional Scores ◽  
Rotating Hinge ◽  
Tissue Reconstruction ◽  
Group 2 ◽  
Group 1

Allograft-prosthesis composite (APC) can restore capsular and ligamentous tissues of the knee sacrificed in a tumor extirpation. We asked if performing APC would restore knee stability and allow the use of nonconstrained arthroplasty while preventing aseptic loosening. We retrospectively compared 50 knee APCs performed with non-constrained revision knee prosthesis (Group 1) with 36 matched APCs performed with a constrained prosthesis (Group 2). In Group 1, the survival rate was 69% at five and 62% at ten years. Sixteen reconstructions were removed due to complications: eight deep infections, three fractures, two instabilities, one aseptic loosening, one local recurrence, and one nonunion. In Group 2, the survival rate was 80% at five and 53% at ten years. Nine reconstructions were removed: 3 due to deep infections, 3 to fractures, and 3 to aseptic loosening. In both groups, we observed more allograft fractures when the prosthetic stem does not bypass the host-donor osteotomy (). Both groups had mainly good or excellent MSTS functional results. Survival rate and functional scores and aseptic loosening were similar in both groups. A rotating-hinge APC is recommended when host-donor soft tissue reconstruction fails to restore knee instability. The use of a short prosthetic stem has a statistical relationship with APC fractures.

Free Vascularized Joint Transfer from Toes for Finger Reconstruction in a 2-Year-Old Child with Good Functional Recovery

2021 ◽  
Author(s):  
Jyoshid R. Balan
Keyword(s):  
Road Traffic ◽  
Ring Finger ◽  
Middle Finger ◽  
Tissue Loss ◽  
Soft Tissue Reconstruction ◽  
Middle Phalanx ◽  
Pip Joint ◽  
Tissue Reconstruction ◽  
Distal Interphalangeal ◽  
The Right

AbstractA 2-year-old male child sustained injury to middle and ring fingers of the right hand following a road traffic accident. He had mutilated fingers with loss of middle phalanx along with proximal interphalangeal (PIP) joint, distal interphalangeal joint of middle finger, and loss of part of middle phalanx and PIP joint of the ring finger. There was dorsal tissue loss of both the fingers. With staged reconstructive strategy, we could salvage the fingers. In the initial part, the soft tissue reconstruction was done using pedicled groin flap. In the later stage, free PIP joint transfer from the second toes of both feet was used to reconstruct the bone and PIP joint of the ring and middle finger. A year following the joint transfer, the child had good functional outcome.

scholarly journals Functional Reconstruction of Sarcoma Defects Utilising Innervated Free Flaps

Sarcoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Damien Grinsell ◽  
Claudia Di Bella ◽  
Peter F. M. Choong
Keyword(s):  
Soft Tissue ◽  
Abdominal Wall ◽  
Upper Limb ◽  
Lower Limb ◽  
Free Flaps ◽  
Functional Results ◽  
Wide Resection ◽  
Soft Tissue Reconstruction ◽  
Functional Scores ◽  
Tissue Reconstruction

Soft-tissue reconstruction following preoperative radiotherapy and wide resection of soft tissue sarcoma remains a challenge. Pedicled and free tissue transfers are an essential part of limb sparing surgery. We report 22 cases of sarcoma treated with radiotherapy and wide excision followed by one-stage innervated free or pedicled musculocutaneous flap transfers. The resection involved the upper limb in 3 cases, the lower limb in 17, and the abdominal wall in 2. The flaps used for the reconstruction were mainly latissimus dorsi and gracilis. The range of motion was restored fully in 14 patients. The muscle strength of the compartment reconstructed was of grades 4 and 5 in all patients except one. The overall function was excellent in all the cases with functional scores of 71.2% in the upper limb and 84% in the lower limb. The only 2 major complications were flap necrosis, both revised with another flap, one of which was innervated with restoration of function. Innervated flaps are valuable alternatives for reconstruction after sarcoma resection in the extremity and in the abdominal wall. The excellent functional results are encouraging, and we believe that innervated muscle reconstruction should be encouraged in the treatment of sarcoma after radiotherapy and wide resection.

scholarly journals Tricks and pitfalls in the surgical treatment of malignant bone tumours of the forearm in children and adolescents

2021 ◽  
Vol 15 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Bulent Erol ◽  
Omer Sofulu
Keyword(s):  
Surgical Management ◽  
Multidisciplinary Approach ◽  
Functional Results ◽  
Bone Tumours ◽  
Soft Tissue Reconstruction ◽  
Unique Region ◽  
Reconstruction Methods ◽  
Malignant Bone Tumours ◽  
Tissue Reconstruction ◽  
Bone Sarcomas

Malignant bone tumours around the forearm are rare. Nowadays, oncological and surgical management of bone sarcomas of this region has improved significantly. Although the anatomical features are complex, limb-sparing surgery is possible with wide surgical resection. Biological reconstruction methods are promising in this anatomically unique region. In addition, meticulous soft-tissue reconstruction yields good functional results in the hand and wrist. This study reviews malignant bone tumours of the forearm and their oncological and surgical management. Malignant bone tumours should be treated with a multidisciplinary approach based on chemotherapy, radiotherapy and limb salvage procedures.

Autologous Fat Transfer and Cell-Based Strategies for Soft Tissue Reconstruction

2014 ◽  
Vol 3 (1) ◽  
pp. 62-69
Author(s):  
Kshemendra Senarath-Yapa ◽  
Rebecca Garza ◽  
Adrian McArdle ◽  
Graham Walmsley ◽  
Michael Hu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Reconstruction ◽  
Fat Transfer ◽  
Autologous Fat ◽  
Autologous Fat Transfer ◽  
Tissue Reconstruction

scholarly journals Motility Improvement of Biomimetic Trachea Scaffold via Hybrid 3D-Bioprinting Technology

Polymers ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 971
Author(s):  
Young Soo Yu ◽  
Chi Bum Ahn ◽  
Kuk Hui Son ◽  
Jin Woo Lee
Keyword(s):  
Rotation Angle ◽  
Thick Layer ◽  
Cartilage Tissue ◽  
Soft Tissue Reconstruction ◽  
3D Bioprinting ◽  
Rotating Beam ◽  
Rotational Angle ◽  
Gelatin Hydrogel ◽  
Tissue Reconstruction ◽  
Neck Rotation

A trachea has a structure capable of responding to various movements such as rotation of the neck and relaxation/contraction of the conduit due to the mucous membrane and cartilage tissue. However, current reported tubular implanting structures are difficult to impelement as replacements for original trachea movements. Therefore, in this study, we developed a new trachea implant with similar anatomical structure and mechanical properties to native tissue using 3D printing technology and evaluated its performance. A 250 µm-thick layer composed of polycaprolactone (PCL) nanofibers was fabricated on a rotating beam using electrospinning technology, and a scaffold with C-shaped cartilage grooves that mimics the human airway structure was printed to enable reconstruction of cartilage outside the airway. A cartilage type scaffold had a highest rotational angle (254°) among them and it showed up to 2.8 times compared to human average neck rotation angle. The cartilage type showed a maximum elongation of 8 times higher than that of the bellows type and it showed the elongation of 3 times higher than that of cylinder type. In cartilage type scaffold, gelatin hydrogel printed on the outside of the scaffold was remain 22.2% under the condition where no hydrogel was left in other type scaffolds. In addition, after 2 days of breathing test, the amount of gelatin remaining inside the scaffold was more than twice that of other scaffolds. This novel trachea scaffold with hydrogel inside and outside of the structure was well-preserved under external flow and is expected to be advantageous for soft tissue reconstruction of the trachea.

scholarly journals 273 The Consequences of a Failed Screening Programme

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Sharrock ◽  
C Whelton ◽  
R Paton
Keyword(s):  
Screening Programme ◽  
Demographic Data ◽  
Late Presentation ◽  
Developmental Dysplasia ◽  
Late Diagnosis ◽  
Operation Rate ◽  
Increasing Trend ◽  
The Uk ◽  
Clinical Records ◽  
Surgical Treatments

Abstract Introduction Controversy exists surrounding the efficacy of the UK screening programme for developmental dysplasia of the hip (DDH). Method Clinical records were reviewed in children who were treated surgically for DDH. Demographic data, age and mode of presentation, and surgical treatments were analysed, as well as outcomes, re-operation rate and AVN incidence. Late diagnosis was defined as greater than 4 months. Results 106 children (16 male, 90 female) underwent surgery from 1997 to 2018. 95 hips were operated for dislocation and 22 were operated for dysplasia. 13 patients had bilateral dislocations. Of the dislocated hips, the median age at diagnosis was 9 months (IQR 2-19). 56% were diagnosed late. In the late diagnosis group the median age for diagnosis was 19 months (IQR 15-21). We have identified an increasing trend in late presentation in recent years. This has been matched with an increasing trend in operation rates for dislocation per 1000 births. Conclusions This study demonstrates that DDH is being diagnosed increasingly late, which correlates with an increased need for surgical management. This suggests that the current UK screening programme is failing to identify children with DDH in a timely fashion, which necessitates more aggressive surgical treatment and less favourable outcomes.

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infection Rate ◽  
Clinical Data ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Satisfactory Outcome ◽  
Tissue Damages ◽  
Tissue Reconstruction ◽  
Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

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