Exposure of the Medial Talar Dome

2013 ◽  
Vol 6 (1) ◽  
pp. 12-14 ◽  
Author(s):  
Jaymes D. Granata ◽  
William T. DeCarbo ◽  
Christopher F. Hyer ◽  
Angela M. Granata ◽  
Gregory C. Berlet
Keyword(s):  
Surgical Technique ◽  
Complication Rate ◽  
Surgical Techniques ◽  
Osteochondral Lesions ◽  
Medial Malleolus ◽  
Talar Dome ◽  
Medial Aspect ◽  
Surgical Exposure ◽  
Chevron Osteotomy ◽  
Anterior Tibial

Open surgical exposure of the medial aspect of the talus is primarily indicated for osteochondral lesions of the talus and talar body fractures. Secondary to the difficulty of access, a variety of techniques have been described. The surgical techniques described in the literature include transmalleolar access windows, medial and anterior tibial osteotomies, and resection osteotomies (plafondoplasty). The purpose of this article is to describe the surgical technique for the bi-planar chevron osteotomy of the medial malleolus. This osteotomy can provide full exposure to the entire medial aspect of the talus. The orientation of the osteotomy allows for perpendicular placement of instrumentation on the medial half of the talus and is particularly useful for cartilage transplant procedures. The technique is reproducible and has a low complication rate when performed correctly.

scholarly journals Retrospective Review of Patients Operated on with Bilateral Cleft Lip through Surgical Outreaches in Kenya

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
F. W. Nangole ◽  
S. O. Khainga
Keyword(s):  
Surgical Technique ◽  
Complication Rate ◽  
Cleft Lip ◽  
Surgical Techniques ◽  
Complication Rates ◽  
Outreach Programs ◽  
Bilateral Cleft Lip ◽  
The Mean ◽  
One Year ◽  
Cleft Surgery

This was a study to evaluate the characteristics and outcome of patients operated on with bilateral cleft lip through surgical outreach programs in Kenya between January 2006 and December 2011. Files for fifty-nine patients operated on during the study period were evaluated. The mean age for surgery was ten months with about forty-five percent of the patients more than one year of age. No presurgical orthopaedic devices were utilized on any of the patients. Mulliken surgical technique and the Manchester technique were the commonest surgical techniques in equal proportions. An overall complication rate of about 7.5 percent was noted. In conclusion we noted a delay in the surgical management of the majority of our patients. This resulted in a backlog of cases. There is thus a need to intensify more surgical outreach camps as well as training more surgeons to assist in the management of clefts. Cleft surgery is a relatively safe surgery that could be carried out in relatively remote centers through surgical outreach programs. This was evidenced by the low complication rates in our series.

scholarly journals Access to the talar dome through the medial posterolateral approach: an anatomical study.

2021 ◽  
Vol 15 (3) ◽  
pp. 247-251
Author(s):  
Wellington Farias Molina ◽  
Lourenço Galizia Heitzmann ◽  
Guilherme Bottino Martins ◽  
Luiz Sergio Martins Pimenta ◽  
Giezy Rasfasky Fiorot ◽  
...  
Keyword(s):  
Osteochondral Lesion ◽  
Anatomical Study ◽  
Posterolateral Approach ◽  
Osteochondral Lesions ◽  
Medial Malleolus ◽  
Talar Dome ◽  
Chi Square ◽  
Left Limb ◽  
Significant Difference ◽  
Chi Square Test

Background: The osteochondral grafting has become a popular procedure for treating challenging talar dome lesions. However, the vast majority are treated through medial malleolus osteotomy. The aim of this study was to determine the posteromedial area of the talus that can be reached without malleolar osteotomy through the posteromedial approach. Study Design: Descriptive laboratory study. Evidence Level 4 Methods: Fifteen human cadaveric ankles were dissected in a standard fashion to expose the posteromedial talar dome. Seven approaches were used on the cadaver's left limb (46.7%). We did not observe any significant difference between the evaluated sides (chi-square test, p = 0.715).  Results: On average, 2,09 cm2 (range, 1,72-2,69) of the posteromedial talus dome or 15,27 % (range 12-20) of total talus dome can be accessed without osteotomy. Conclusion: If the osteochondral lesion is within the area accessible through PM approach (mean 2 cm2), as seen on magnetic resonance imaging, it is possible that it can be treated without a medial malleolus osteotomy. Keywords: talus; osteochondral lesions; osteotomy; arthrotomy; surgery

Osteochondral lesions of the talar dome: an up-to-date approach to multimodality imaging and surgical techniques

2021 ◽  
Author(s):  
Júlio Brandão Guimarães ◽  
Isabela Azevedo Nicodemos da Cruz ◽  
Caio Nery ◽  
Flávio Duarte Silva ◽  
Alípio Gomes Ormond Filho ◽  
...  
Keyword(s):  
Multimodality Imaging ◽  
Surgical Techniques ◽  
Osteochondral Lesions ◽  
Talar Dome

Complication Rate after Radical Cystectomy Depends on the Surgical Technique and Patient’s Clinical Status

2021 ◽  
pp. 1-8
Author(s):  
Przemysław Adamczyk ◽  
Paweł Pobłocki ◽  
Mateusz Kadlubowski ◽  
Adam Ostrowski ◽  
Witold Mikołajczak ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Complication Rate ◽  
Tnm Stage ◽  
Complication Rates ◽  
Open Approach ◽  
Invasive Approach ◽  
Asa Score

<b><i>Purpose:</i></b> This study aimed to explore the complication rates of radical cystectomy in patients with muscle-invasive bladder cancer and identify potential risk factors. <b><i>Methods:</i></b> A total of 553 patients were included: 131 were operated on via an open approach (ORC), 242 patients via a laparoscopic method (LRC), and 180 by a robot-assisted procedure (RARC). Patient age, gender, American Society of Anesthesiologists (ASA) score, urinary diversion type, preoperative albumin level, body mass index (BMI), pathological (TNM) stage, and surgical times were collected. The severity of complications was classified according to the Clavien-Dindo scale (Grades 1–5). <b><i>Results:</i></b> The surgical technique was significantly related to the number of complications (<i>p</i> &#x3c; 0.00005). Grade 1 complications were observed most frequently following LRC (52.5%) and RARC (51.1%), whereas mostly Grade 2 complications were detected after ORC (78.6%). Those with less severe complications had significantly higher albumin levels than those with more severe complications (<i>p</i> &#x3c; 0.05). Patients with an elevated BMI had fewer complications if a minimally invasive approach was used rather than ORC. The patient’s general condition (ASA score) did not impact the number of complications, and urinary diversion type did not affect the severity of the complications. Mean surgical time differed according to the urinary diversion type in patients with a similar TNM stage (<i>p</i> &#x3c; 0.005); however, no difference was found in those with more locally advanced disease. Longer operation time and lower protein concentration were associated with higher probability of complication rate, that is, Clavien-Dindo score 3–5. <b><i>Conclusions:</i></b> The risk of complications after RC is not related to the type of urinary diversion, and can be reduced by using a minimally invasive surgical technique, especially in patients with high BMI.

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children

2021 ◽  
pp. 019459982110151
Author(s):  
Rahul G. Baijal ◽  
Karla E. Wyatt ◽  
Teniola Shittu ◽  
Eugenia Y. Chen ◽  
Eric Z. Wei ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Chart Review ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Airway Disease ◽  
Respiratory Complications ◽  
Patient Factors ◽  
Children's Hospital ◽  
Reactive Airway Disease ◽  
Children’S Hospital

Objectives The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques. Study Design The study was a retrospective cohort study. Setting Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. Methods Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications. Results A total of 2437 patients underwent a tonsillectomy at Texas Children’s Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection. Conclusion Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.

The anterior approach for the treatment of posterior osteochondral lesions of the talus: comparison of different surgical techniques

2005 ◽  
Vol 126 (4) ◽  
pp. 241-246 ◽  
Author(s):  
Peter Cornelius Kreuz ◽  
Matthias Steinwachs ◽  
Max Edlich ◽  
Tim Kaiser ◽  
Jörg Mika ◽  
...  
Keyword(s):  
Anterior Approach ◽  
Surgical Techniques ◽  
Osteochondral Lesions

scholarly journals Hospitalization time after open appendectomy by three different surgical techniques

2014 ◽  
Vol 27 (3) ◽  
pp. 188-190 ◽  
Author(s):  
Agláia Moreira Garcia XIMENES ◽  
Fernando Salvo Torres MELLO ◽  
Zailton Bezerra de LIMA-JÚNIOR ◽  
Cícero Faustino FERREIRA ◽  
Amanda Dantas Ferreira CAVALCANTI ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Open Appendectomy ◽  
Surgical Techniques ◽  
Conventional Technique ◽  
Site Infection ◽  
Hospitalization Time ◽  
Contingency Coefficient ◽  
Appendicular Stump

BACKGROUND: The choice of surgical technique to approach the appendicular stump depends mostly on skill and personal preference of the surgeon or on the protocol used in the service, and the influence of this choice in hospitalization time is not evaluated. AIM: To evaluate the relation between surgical technique and postoperative hospitalization time in patients presenting with acute appendicitis. METHODS: Retrospective analysis of 180 patients who underwent open appendectomy. These where divided into three groups according to surgical technique: conventional appendectomy (simple ligation of the stump), tobacco pouch suture and Parker-Kerr suture. Data where crossed with hospitalization time (until three days, from four to six days and over seven days). RESULTS: A hundred and eighty patients with age from 15 to 85 years where included. From these, 95 underwent conventional technique, had an average hospitalization time of 3,9 days and seven had complications (surgical site infection, seroma, suture dehiscence and evisceration). In 67 patients, tobacco pouch suture was chosen and had average hospitalization time of 3,7 days and two complications (infection and seroma). In 18 Parker-Kerr suture was made, with average hospitalization time of 2,6 days, with no complication. Contingency coefficient between the variables hospitalization time and technique was 0,255 and Cramér's V was 0,186. CONCLUSION: There was tendency to larger hospitalization time and larger number of complications in conventional appendectomy, whereas in patients where Parker-Kerr suture was performed, hospitalization time was significantly smaller.

Arthroscopy-Assisted Retrograde Drilling of Osteochondral Lesions of the Talar Dome

2005 ◽  
Vol 95 (1) ◽  
pp. 91-96 ◽  
Author(s):  
Scott C. Nelson ◽  
Darryl M. Haycock
Keyword(s):  
Clinical Presentation ◽  
Osteochondral Lesion ◽  
Final Diagnosis ◽  
Osteochondral Lesions ◽  
Resonance Imaging ◽  
Talar Dome ◽  
Advanced Imaging ◽  
Retrograde Drilling ◽  
High Index Of Suspicion

Traumatic ankle conditions can lead to long-term sequelae if a pathologic process is misdiagnosed. The clinical presentation of an osteochondral lesion of the talar dome requires the clinician to have a high index of suspicion, and advanced imaging is often necessary to make the final diagnosis. Treatment should be initiated once the lesion is appropriately staged by radiologic or magnetic resonance imaging. We discuss the use of arthroscopy-assisted retrograde drilling of the medial talar dome that spares the articular cartilage within the talotibial articulation. (J Am Podiatr Med Assoc 95(1): 91–96, 2005)

scholarly journals Patofisiologi dan Tatalaksana Osteochondral Lesion of the Talus

2019 ◽  
Vol 1 (2) ◽  
pp. 45
Author(s):  
Maghrizal Roychan ◽  
Andre Triadi Desnantyo
Keyword(s):  
Ct Scan ◽  
Cartilage Repair ◽  
Osteochondral Lesion ◽  
Operative Therapy ◽  
Cartilage Regeneration ◽  
Osteochondral Lesions ◽  
X Rays ◽  
Talar Dome ◽  
Operative Techniques ◽  
Reduced Space

ABSTRAKPenyakit Osteochondral Lesion of the Talus (OLT) adalah kelainan pada tulang talus di lapisan subchondral yang berupa lesi osteochondral pada talar dome dengan konsekuensi abnormalitas pada tulang rawan sendi talar. Pasien biasanya datang berobat ke tenaga kesehatan dengan keluhan yang tidak spesifik dan dengan gejala seperti nyeri pada pergelangan kaki, bengkak serta berkurangnya berkurangnya ruang gerak. Penegakan diagnosis bisa dilakukan dengan anamnesis, pemeriksaan fisik dan pemeriksaan penunjang sederhana seperti foto X-ray maupun pemeriksaan penunjang canggih seperti CT-Scan dan MRI. Tatalaksana OLT bervariasi. Tatalaksana pada OLT tergantung dari tahapan lesi, kronisitasnya, dan keluhan simtomatis yang menyertainya. Pasien dengan keluhan simtomatis yang akut dan non-displaced sering diberikan terapi nonoperatif biasanya berupa terapi konservatif dengan imobilisasi. Lesi yang tidak berhasil atau tidak menunjukkan perbaikan dalam keluhan simtomatisnya setelah 3 sampai 6 bulan, serta lesi dengan displacement dapat direncanakan untuk terapi operatif. Ada beberapa macam tehnik operatif yang dapat dilakukan untuk menyembuhkan OLT. Tehnik operatif ini dapat dikategorikan menjadi cartilage repair, cartilage regeneration dan cartilage replacement techniques.Kata kunci: osteochondral lesion of the talus, patofisiologi, tatalaksanaABSTRACTOsteochondral Lesion of the Talus (OLT) is an abnormality in the talus bone in the subchondral layer in the form of osteochondral lesions in the talar dome with consequent abnormalities in the talar joint cartilage. Patients usually come to a health care provider with nonspecific complaints and with symptoms such as pain in the ankles, swelling and reduced space for movement. The diagnosis can be made with a history, physical examination and simple investigations such as X-rays and sophisticated investigations such as CT-Scan and MRI. The management of OLT varies. The management of OLT depends on the stage of the lesion, its chronicity, and the accompanying symptomatic complaints. Patients with acute and non-displaced symptomatic complaints are often given nonoperative therapy usually in the form of conservative therapy with immobilization. Lesions that are unsuccessful or show no improvement in symptomatic complaints after 3 to 6 months, and lesions with displacement can be planned for operative therapy. There are several types of operative techniques that can be done to cure OLT. These operative techniques can be categorized into cartilage repair, cartilage regeneration and cartilage replacement techniques. Keywords: osteochondral lesion of the talus, patophysiology, treatment

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