scholarly journals Intramedullary Fixation of Calcaneal Fractures: Early US Experience

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0010
Author(s):  
Kevin C. Anderson
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Articular Surface ◽  
Case Series ◽  
Intramedullary Fixation ◽  
Wound Complications ◽  
Invasive Approach ◽  
Fracture Stabilization ◽  
Intraarticular Fractures ◽  
Anatomic Reduction

Category: Hindfoot; Trauma Introduction/Purpose: The fixation of displaced intraarticular fractures of the calcaneus have posed many challenges for the surgeon, including an anatomic reduction, fracture stabilization, and soft tissue concerns. The extensible lateral and sinus tarsi approaches must be delayed until soft tissues concerns resolve and despite this are susceptible to wound necrosis and skin infections. Intramedullary fixation allows immediate fixation without soft tissue compromise. Methods: The retrospective case series is comprised of 23 patients; 19 intramedullary fixation of the calcaneus and 4 primary arthrodesis with the FH Orthopedics CalcaNail. Fracture classification, timing to surgery, accuracy of reduction, complications, and outcome were recorded. Results: There were zero wound complications. Bohler’s angle was restored as well as articular surface. One patient required implant removal after healing seconding to prominent hardware. One patient required conversion to a subtalar arthrodesis. There were no implant mechanical failures. Conclusion: The intramedullary fixation of calcaneus fractures has been performed extensively outside the US with documented success. This series of early US experience exhibits similar utility. The ability to reduce the fracture intrafocally and stabilize with a minimally invasive approach have proven useful with no incidence of wound complications. Not to mention no delay from time of injury to surgery is needed.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

Arthroscopic Treatment of Anterior Ankle Impingement Syndrome in Dancers

2005 ◽  
Vol 26 (11) ◽  
pp. 908-912 ◽  
Author(s):  
Aneel Nihal ◽  
Donald J. Rose ◽  
Elly Trepman
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Case Series ◽  
Scar Tissue ◽  
Nonoperative Treatment ◽  
Impingement Syndrome ◽  
Arthroscopic Treatment ◽  
Dance Performance ◽  
Ankle Impingement ◽  
Anterior Ankle Impingement

Background: The purpose of this study was to evaluate the results of arthroscopic treatment of anterior bony and soft-tissue impingement of the ankle in elite dancers. Methods: The study is a case series retrospectively reviewed. In the period between 1990 and 1999, 11 elite dancers (12 ankles) had ankle arthroscopy after a diagnosis of anterior ankle impingement that markedly interfered with their dancing. Initial nonoperative treatment failed in all subjects. Previous ankle trauma was noted in all subjects. There were seven women and four men (average age 28 years). Tibiotalar exostoses were radiographically noted in six ankles. Standard anteromedial and anterolateral arthroscopic portals and instrumentation were used for resection of bone spurs and debridement of impinging soft tissues. Patients were nonweightbearing for 5 days after surgery and had postoperative physiotherapy. Results: Nine dancers returned to full dance activity at an average of 7 weeks after surgery. One patient did not return to dance performance because of concurrent unrelated orthopaedic problems, but he resumed work as a dance teacher; he developed a recurrent anterior tibial spur that was successfully resected at a second arthroscopy 9 years later. Another dancer developed postoperative scar-tissue impingement and stiffness; she had a repeat arthroscopy 4 months after the initial procedure and subsequently returned to dance performance. All patients eventually had marked postoperative improvement in pain relief and dance performance. Conclusions: Arthroscopic debridement is an effective method for the treatment of bony and soft-tissue anterior ankle impingement syndrome in dancers and has minimal morbidity.

scholarly journals Ultrasound-guided removal of soft tissue foreign bodies in companion animals: A case series

2020 ◽  
Vol 65 (No. 2) ◽  
pp. 49-55
Author(s):  
S Manfredi ◽  
G Covi ◽  
M Bonazzi ◽  
G Gnudi ◽  
M Fumeo ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Minimally Invasive ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Companion Animals ◽  
Case Series ◽  
Invasive Technique ◽  
Surgical Removal ◽  
Small Animals ◽  
Ultrasound Guided

Foreign bodies (FBs) retained in the subcutaneous tissues are a common reason for medical consultation. In small animals, FBs usually consist of vegetal materials, especially grass awns. Failure to remove the FBs is likely to give rise to acute or late complications. The surgical removal of the FBs can be invasive, costly and technically challenging. Ultrasound has become a mainstay in the detection of FBs and it can be used to guide the extraction of the FBs with a minimally invasive technique. This study describes the detection and extraction of soft-tissue FBs in small animals. One hundred-sixty-two patients, presenting at two veterinary clinics with suspected FBs retained in the soft tissues of various body districts, were considered. Once an ultrasound diagnosis was established, the ultrasound-guided removal of the FB was performed. A high-frequency linear transducer, a skin disinfection, sedation or anaesthesia was used when needed and a scalpel and some Hartmann forceps were also used. One hundred-eighty-two FBs were successfully removed in all the patients. In six cases, the FB was identified during a second ultrasonographic examination, after recurrence of the fistula. No complications were reported after the procedure. The extraction of the FB was performed in an echographic suite in 138 cases and in a surgery room with surgical intervention in 24 cases. In the latter situation, the surgical minimally invasive dissection of tissues under ultrasound guidance was performed before the removal of the FB. In conclusion, the ultrasound-guided removal of the FBs retained in the superficial soft tissue can be considered a good alternative to surgery. However, failure to remove a FB does not preclude the removal by traditional surgery.

scholarly journals Upper limb soft tissue metastasis in post mastectomy patient

2018 ◽  
Vol 5 (10) ◽  
pp. 3433
Author(s):  
Janani S. Reddy ◽  
Surya Rao Rao Venkata Mahipathy ◽  
Alagar Raja Durairaj ◽  
Narayanamurthy Sundaramurthy
Keyword(s):  
Soft Tissue ◽  
Breast Carcinoma ◽  
World Literature ◽  
Soft Tissues ◽  
Case Series ◽  
Anterior Chest Wall ◽  
Clinicopathological Characteristics ◽  
Soft Tissue Metastasis ◽  
Primary Malignancy ◽  
Chest Wall Recurrence

Soft tissue metastasis from any primary malignancy is considered very rare and a breast carcinoma metastasizing to soft tissue is still rarer. To the best of our knowledge, carcinoma breast with soft tissue metastasis to upper extremity is very uncommon with only seven cases been reported in world literature till date and our case is the eighth such case in an elderly female, a known case of carcinoma left breast operated 7 years back. Only few case series and isolated cases reports have been published regarding any primary malignancy or breast carcinoma metastasizing to soft tissues. PET CT done showed features suggestive of left anterior chest wall recurrence with contralateral axillary lymphnodal metastasis and with soft tissue metastases in the left arm. We hereby present this case with review of literature to highlight its extreme rarity, unusual presentation, clinicopathological characteristics and its overall prognosis.

scholarly journals Intra- and interobserver agreement on the Oestern and Tscherne classification of soft tissue injury in periarticular lower-limb closed fractures

2014 ◽  
pp. 173-178 ◽  
Author(s):  
Carlos Oliver Valderrama-Molina ◽  
Mauricio Estrada-Castrillón ◽  
Jorge Andres Hincapie ◽  
Luz Helena Lugo-Agudelo
Keyword(s):  
Soft Tissue ◽  
Tibial Plateau ◽  
Interobserver Agreement ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Lower Extremities ◽  
Tibial Pilon ◽  
Pilon Fractures

Background: The soft tissues injury in periarticular fractures of the lower extremities determines the proper time to perform bone fixation. Objetive: The aim of this study was to determine the intra and interobserver agreement in the Tscherne classification. Methods: This is a descriptive, prospective study for patients admitted to the Pablo Tobón Uribe Hospital (PTUH) with tibial plateau or tibial pilon fractures. We performed a standardize evaluation using video photography at the time of admission and 24, 48, and 72 h after admission. Fifteen five reviewers who had various levels of training produced a total of 1,200 observations. The intra- and interobserver agreement was assessed using a weighted kappa for multiple raters and more than two categories. Results: Twenty patients were admitted with tibial plateau and tibial pilon fractures. The intraobserver agreement for all 15 raters was kappa 0.81 (95% CI 0.79-0.83), and the interobserver agreement for all 15 raters was kappa 0.65 (95% CI 0.55-0.73). The interobserver agreement at 24 h was kappa 0.67 (95% CI 0.46-0.86). Conclusions:Classifying the severity of soft tissue injury is critical in planning the surgical management of fractures of the lower extremities. Based on our results, we can reasonably argue that the Tscherne classification produced an adequate level of agreement and could be used to standardize and to guide the treatment, and to conduct research studies. Level of Evidence: Level IV, Case Series

Safety Profile of Synthetic Elastic Degradable Matrix for Soft Tissue Reconstruction in Foot & Ankle Surgery

2021 ◽  
pp. 193864002110676
Author(s):  
Michael J. Kelly ◽  
Daniel M. Dean ◽  
Syed H. Hussaini ◽  
Steven K. Neufeld ◽  
Daniel J. Cuttica
Keyword(s):  
Soft Tissue ◽  
Safety Profile ◽  
Tissue Repair ◽  
Case Series ◽  
Wound Complications ◽  
Soft Tissue Reconstruction ◽  
Complication Rates ◽  
Foot And Ankle ◽  
Soft Tissue Repair ◽  
Level Of Evidence

Background Augmentation of soft tissue repairs has been helpful in protecting surgically repaired tissues as they heal. FlexBand (Artelon, Marietta, Georgia) is a synthetic, degradable, polycaprolactone-based polyurethane urea (PUUR) matrix that has been investigated and used for soft tissue repair in a variety of settings. The purpose of this study was to evaluate the safety profile of a PUUR matrix in a large cohort of patients undergoing soft tissue repairs about the foot and ankle. Methods A retrospective chart review of consecutive patients who underwent surgery using FlexBand to augment a soft tissue repair was performed to evaluate for major and minor complications related to the PUUR matrix. Results. A total of 105 patients with an average >6 months follow-up were included. The most common procedures were spring ligament repair, Achilles tendon repair, and Brostrom. There were 12 complications. Four major complications occurred with only 1 requiring PUUR matrix removal. Patients with wound complications had a higher body mass index (BMI) and rate of smoking. Conclusion Complication rates involving PUUR matrix in soft tissue foot and ankle reconstruction procedures are low and comparable with historical complication rates. The PUUR matrix is safe for use in a variety of soft tissue procedures about the foot and ankle. Level of Evidence: Level 4, Retrospective case-series

scholarly journals Radiopathological correlations of myopericytomas of the hand: emphasis on the MRI perivascular pushing growth pattern

2020 ◽  
Vol 6 (2) ◽  
pp. 20190074
Author(s):  
Amandine Crombé ◽  
Amine Bouhamama ◽  
François Le Loarer ◽  
Michèle Kind
Keyword(s):  
Soft Tissue ◽  
Growth Pattern ◽  
Soft Tissues ◽  
Case Series ◽  
Soft Tissue Tumors ◽  
Adult Patients ◽  
Radiological Diagnosis ◽  
Imaging Features ◽  
Pathological Findings ◽  
Pre Treatment

Myopericytomas are exceedingly rare soft-tissue tumors with less than 10 cases including radiological depictions. We report three new cases of benign myopericytomas located in the soft-tissues of the hand in adult patients. A pre-treatment MRI was available for all patients and systematically evidenced well-defined, lobulated tumors closely related to the superficial palmar vascular arch and/or digital vessels with a perivascular pushing growth pattern that correlated with pathological findings. Though rare, this small case series show that myopericytomas display recurrent imaging features that could support their radiological diagnosis.

Simplified bone-anchored hearing aid insertion using a linear incision without soft tissue reduction

2013 ◽  
Vol 127 (S2) ◽  
pp. S33-S38 ◽  
Author(s):  
J Husseman ◽  
J Szudek ◽  
P Monksfield ◽  
D Power ◽  
S O'Leary ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Hearing Aid ◽  
Skin Flap ◽  
Standard Technique ◽  
Modified Technique ◽  
Skin Reactions ◽  
Invasive Approach ◽  
Bone Anchored Hearing Aid ◽  
Tissue Reduction

AbstractBackground:Numerous techniques have been described to manage the skin and other soft tissues during bone-anchored hearing aid insertion. Previously, generally accepted techniques have sometimes led to distressing alopecia and soft tissue defects. Now, some surgeons are rejecting the originally described split skin flap in favour of a less invasive approach.Objective:To investigate bone-anchored hearing aid placement utilising a single, linear incision with either no or minimal underlying soft tissue reduction.Patients and methods:Thirty-four adults were prospectively enrolled to undergo single-stage bone-anchored hearing aid placement with this modified technique. A small, linear incision was used at the standard position and carried down through the periosteum. Standard technique was then followed with placement of an extended length abutment. Patients were reviewed regularly to assess wound healing, including evaluation with Holgers' scale.Results:Only 14.7 per cent of patients had a reaction score of 2 or higher. Most complications were limited to minor skin reactions that settled with silver nitrate cautery and/or antibiotics. None required revision surgery for tissue overgrowth, and there were no implant failures.Conclusion:Our results suggest this to be a simple and effective insertion technique with favourable cosmesis and patient satisfaction.

Role of Extra-articular Tibiotalocalcaneal Arthrodesis and Posterior Approach in Highly Complex Cases

2017 ◽  
Vol 39 (2) ◽  
pp. 219-225
Author(s):  
Sergio Eckholt ◽  
Ruben Garcia-Elvira ◽  
Nicolás Fontecilla ◽  
Alvaro Fernandez-Reinales ◽  
Daniel Poggio
Keyword(s):  
Posterior Approach ◽  
Soft Tissues ◽  
Salvage Surgery ◽  
Case Series ◽  
Wound Complications ◽  
Level Of Evidence ◽  
Tibiotalocalcaneal Arthrodesis ◽  
Alternative Approaches ◽  
Complex Cases

Background: Tibiotalocalcaneal (TTC) arthrodesis is a procedure commonly used as salvage surgery for various pathologic processes that compromise the ankle and subtalar joints. It is a reasonably standardized procedure when performed as a primary surgery in advanced stages of TTC arthritis. For such cases, there are several alternative approaches, fixation materials, and bone substitutes that can be used. Most represent valid options with similar results in the literature. However, in highly complex cases requiring TTC arthrodesis, the options for the approach and fixation material can be limited. Understanding the alternative approaches and techniques is of great help to the surgeon when faced with highly complex cases, such as patients with multiple previous operations, lack of bone stock, severe deformities, or compromise of associated soft tissues. In this article, we describe the role of the posterior approach with some technical variation that allows extra-articular arthrodesis in highly complex cases, and we present a series of patients with tibiotalocalcaneal arthrodesis who were operated on using this technique. Methods: Retrospective review of all patients who underwent tibiotalocalcaneal arthrodesis via posterior approach between 2008 and 2016. The surgeries were performed by 2 different surgeons with the same technique (posterior approach with sliding graft) but 2 different fixation methods. Radiographs and computed tomographic (CT) studies were reviewed and patient satisfaction was rated using the Coughlin scale. Mean follow-up was 38 months. We identified 20 patients. The mean age was 51.2 years; 11 patients had post-traumatic arthritis whereas the others had other causes of arthritis (inflammatory disease, neurologic deformity, etc). Results: The arthrodesis was performed using a tibiotalocalcaneal plate in 9 patients and retrograde intramedullary nail in 11 patients. Radiographic fusion was observed at an average of 3.1 months. Four patients had complications and 15 reported good or excellent results after surgery. Conclusion: Our study found a fusion rate comparable to other studies in highly complex cases. There were no operative wound complications. We observed that the posterior approach, with an extra-articular fusion procedure, was a valid option for salvage surgery in highly complex cases that require tibiotalocalcaneal fusion. Level of Evidence: Level IV, retrospective case series.

Case Series: Superficial Sonography in Urgent Care

2021 ◽  
pp. 875647932110554
Author(s):  
Garth S. Nanni ◽  
Samantha Cofsky
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Imaging Modality ◽  
Low Cost ◽  
Case Series ◽  
Urgent Care ◽  
The Past ◽  
Imaging Protocols ◽  
Diagnostic Applications ◽  
Outpatient Settings

Sonography is an essential imaging modality, known for its real-time capabilities, relative low cost, and multiple diagnostic applications. Although there are protocols which are well-established for specific examinations, there are not clear guidelines for sonographic examinations of soft tissues. Many sonographers have to establish their own imaging protocols when completing a soft tissue examination. This case series details five soft tissue examinations that represent just a few of the clinical requests generated in an Urgent Care (UC) facility. Since UC usage has increased over the past several years, it appears likely that any sonographer working in such outpatient settings will benefit from as much exposure to soft tissue examinations as possible.

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