Surgical treatment of noniatrogenic trauma of the femoral arteries

Trauma to the femoral arteries corresponds to 30 percent of all arterial traumas. The authors reviewed 74 patients with noniatrogenic trauma of the femoral arteries treated from January 1991 to December 1993. Ages ranged from 11 to 50 years, with a mean of 24. Seventy-one patients were male and three female. Fifty-two patients (70.2 percent) were white, 20 (27 percent) were black and two (2.8 percent) were Asian. Trauma due to firearms had the highest incidence, with 61 cases (82.4 percent). Absence of pulse was the most frequent clinical symptom (62.5 percent). Severe ischemia, with risk of loss of limb, was found in 66.2 percent of the cases. The superficial femoral artery was impaired in 77 percent of the cases. A preoperative arteriography was performed on only five patients, victims of multiple penetrating trauma or an asymptomatic penetrating wound along a vessel passage. In six cases, arterial and venous ligature was the chosen procedure. In three cases, a primary arterial anantomosis was performed. Simple arterriorraphy was feasible in one patient. In 64 of the patients, a venous graft was undertaken using a segment of the inverted great saphenous vein withdrawn from the other lower limb. Fasciotomoy was used in 32 patients (43.2 percent), all of whom exhibited pasting of the lower limb muscles at admission. One patient died during the immediate postoperative period as the result of multiple organ failure caused by polytraumatism. Preservation of the limb was attained in 72 patients (97.3 percent) Severe, previously-incurred ischemia was responsible for the only two amputations, aggravated by an exceedingly long delay between the time of injury and surgery. One of these patients, in addition to severe ischemia, had extensive injuries to the soft tissues. We conclude that trauma of the femoral arteries, attended while the limb still maintains its vitality, has a positive clinical outcome with a high rate of limb preservation. Mortality usually results from injury to other organs.

Download Full-text

Vibration Attenuation Via Mean of Lower Limb Muscles Occurs During Whole Body Vibrations And Differs Across Frequencies And Postures

10.21203/rs.3.rs-1032225/v1 ◽

2021 ◽

Author(s):

Isotta Rigoni ◽

Tecla Bonci ◽

Paolo Bifulco ◽

Antonio Fratini

Keyword(s):

Muscle Contraction ◽

Lower Limb ◽

Soft Tissues ◽

Muscular Activity ◽

Whole Body ◽

Tonic Vibration Reflex ◽

Leg Muscles ◽

Lower Limb Muscles ◽

Limb Muscles ◽

Whole Body Vibrations

Abstract Lower limb muscles actively contribute to maintain body posture but also act to attenuate soft tissues oscillations that occur during everyday life. This elicited activity can be exploited as a mean of neuromuscular training or rehabilitation. In this study, Whole Body Vibrations (WBV) at different frequencies were delivered to healthy subjects while holding static postures to test the transient muscles mechanical responses. Twenty-five participants underwent WBV at 15, 20, 25 and 30 Hz while holding either a static ‘hack squat’ or ‘fore feet’ posture. Soft tissue accelerations and surface electromyography (sEMG) were recorded from Gastrocnemius Lateralis (GL), Soleus (SOL) and Tibialis Anterior (TA) muscles. Estimated displacement at muscle bellies revealed a resonant pattern, different across frequencies and postures (p<.001). Specifically, a peak in the displacement was measured after the onset of the stimulation, followed by a drop and a further plateau (only after few seconds after the peak) suggesting a delayed neuromuscular activation. Although oscillation dampening was correlated to an increased muscular activity, only specific WBV settings were promoting a significant muscle contraction. For example, SOL and GL induced activation was maximal for subject in forefeet and while exposed to higher frequencies (p<.05). The non-immediate response of leg muscles to a vibratory stimulation confirms the tonic nature of the vibration induced muscle contraction (the tonic vibration reflex) and its strong influence on postural tonic muscles (GL and SOL). This may have significant impact on training or rehabilitation protocols aiming towards postural and balance improvement or recovery.

Download Full-text

The Comparative Analysis of Mood and EMG Activities on Upper and Lower Limb Muscles in HealSwing Exercise

The Korean Journal of Growth and Development ◽

10.34284/kjgd.2018.11.26.4.411 ◽

2018 ◽

Vol 26 (4) ◽

pp. 411-419

Author(s):

Nam-Ik Kim ◽

Chang-hyung Park ◽

Kwang Pyo Lee

Keyword(s):

Comparative Analysis ◽

Lower Limb ◽

Lower Limb Muscles ◽

Limb Muscles

Download Full-text

Reliability of a New Portable Dynamometer for Assessing Hip and Lower Limb Strength

Applied Sciences ◽

10.3390/app11083391 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3391

Author(s):

Jan Marušič ◽

Goran Marković ◽

Nejc Šarabon

Keyword(s):

Lower Limb ◽

External Rotation ◽

Peak Torque ◽

Knee Extension ◽

Lower Limb Muscles ◽

Lower Limb Strength ◽

Flexion Extension ◽

Strength Tests ◽

Hip Abduction ◽

Maximal Peak

The purpose of this study was to evaluate intra- and inter-session reliability of the new, portable, and externally fixated dynamometer called MuscleBoard® for assessing the strength of hip and lower limb muscles. Hip abduction, adduction, flexion, extension, internal and external rotation, knee extension, ankle plantarflexion, and Nordic hamstring exercise strength were measured in three sessions (three sets of three repetitions for each test) on 24 healthy and recreationally active participants. Average and maximal value of normalized peak torque (Nm/kg) from three repetitions in each set and agonist:antagonist ratios (%) were statistically analyzed; the coefficient of variation and intra-class correlation coefficient (ICC2,k) were calculated to assess absolute and relative reliability, respectively. Overall, the results display high to excellent intra- and inter-session reliability with low to acceptable within-individual variation for average and maximal peak torques in all bilateral strength tests, while the reliability of unilateral strength tests was moderate to good. Our findings indicate that using the MuscleBoard® dynamometer can be a reliable device for assessing and monitoring bilateral and certain unilateral hip and lower limb muscle strength, while some unilateral strength tests require some refinement and more extensive familiarization.

Download Full-text

Endovascular treatment of an ilio-iliac arteriovenous fistula accompanied by venous thromboembolism presenting with multiple organ failure – A case report and literature review

Vascular ◽

10.1177/1708538121996576 ◽

2021 ◽

pp. 170853812199657

Author(s):

Tiehao Wang ◽

Jichun Zhao ◽

Ding Yuan

Keyword(s):

Multiple Organ Failure ◽

Arteriovenous Fistula ◽

Organ Failure ◽

Iliac Artery ◽

Vena Cava ◽

Artery Aneurysm ◽

Multiple Organ ◽

High Rate ◽

Type Ii ◽

Type Ii Endoleak

Objectives Multiple organ failure is a rare manifestation of ilio-iliac arteriovenous fistula which can lead to a high rate of misdiagnosis and death. Methods We reported a 61-year-old man presenting with multiple organ failure rapidly after right lower limb swelling. Computed tomography angiography showed an ilio-iliac arteriovenous fistula caused by right common iliac artery aneurysm, and venous thrombosis of bilateral common iliac veins. A bifurcated stent-graft with coil embolization of right internal iliac artery was used for repair. Results The patient recovered rapidly and was discharged without complications. Although arteriovenous fistula persisted due to type II endoleak, aneurysm sac and inferior vena cava significantly shrunk at six months follow-up. Conclusions This report demonstrated that multiple organ failure may appear when the distal outflow tracts of arteriovenous fistula are obstructed. Moreover, endovascular repair is effective for reversal of multiple organ failure caused by arteriovenous fistula, even if arteriovenous fistula persists due to type II endoleak.

Download Full-text

Unilateral and Bilateral Strength Asymmetry among Young Elite Athletes of Various Sports

Medicina ◽

10.3390/medicina56120683 ◽

2020 ◽

Vol 56 (12) ◽

pp. 683

Author(s):

Maros Kalata ◽

Tomas Maly ◽

Mikulas Hank ◽

Jakub Michalek ◽

David Bujnovsky ◽

...

Keyword(s):

Lower Limb ◽

Elite Athletes ◽

Lower Limbs ◽

Knee Extensors ◽

Young Athletes ◽

Lower Limb Muscles ◽

Significant Difference ◽

Strength Asymmetry ◽

Main Factor ◽

Objective Type

Background and objective: Type of physical activity may influence morphological and muscular asymmetries in the young population. However, less is known about the size of this effect when comparing various sports. The aim of this study was to identify the degree of bilateral asymmetry (BA) and the level of unilateral ratio (UR) between isokinetic strength of knee extensors (KE) and flexors (KF) among athletes of three different types of predominant locomotion in various sports (symmetric, asymmetric and hybrid). Material and methods: The analyzed group consisted of young elite athletes (n = 50). The maximum peak muscle torque of the KE and KF in both the dominant (DL) and non-dominant (NL) lower limb during concentric muscle contraction at an angular velocity of 60°·s−1 was measured with an isokinetic dynamometer. Results: Data analysis showed a significant effect of the main factor (the type of sport) on the level of monitored variables (p = 0.004). The type of sport revealed a significant difference in the bilateral ratio (p = 0.01). The group of symmetric and hybrid sports achieved lower values (p = 0.01) of BA in their lower limb muscles than those who played asymmetric sports. The hybrid sports group achieved higher UR values (p = 0.01) in both lower limbs. Conclusions: The results indicate that sports with predominantly symmetrical, asymmetrical, and hybrid types of locomotion affected the size of the BA, as well as the UR between KE and KF in both legs in young athletes. We recommend paying attention to regular KE and KF strength diagnostics in young athletes and optimizing individual compensatory exercises if a higher ratio of strength asymmetry is discovered.

Download Full-text