scholarly journals The use of a “chimeric” autotissue complex from the subscapularis vascular basin for maxillary reconstruction after malignant tumors resection

2021 ◽  
Vol 11 (3) ◽  
pp. 18-29
Author(s):  
M.   V. Bolotin ◽  
V.  A. Sobolevsky ◽  
I. V. Orlova ◽  
I. M. Gelfand ◽  
H. Chen
Keyword(s):  
Malignant Tumors ◽  
Functional Results ◽  
Vascular Lesions ◽  
Total Maxillectomy ◽  
Aesthetic Results ◽  
Scapular Flap ◽  
Group 2 ◽  
Maxillary Defects ◽  
Scapular Region ◽  
Group 1

The objective of this work – to evaluate the results of reconstructive interventions using free revascularized tissue complexes of the scapular region in patients after maxillary resection for malignant tumors. Materials and methods. Between 2014–2020 the post-resection maxillary defects were replaced with free blood-sup plied flaps of the scapular region in 19 patients. In Group 1 (n = 10), the defect was eliminated after total maxillectomy with preservation of the eyeball using a “chimeric” tissue complex, parts of which were positioned in several planes. In Group 2 (n = 9), total and subtotal defects of the hard palate and alveolar process were replaced using a free flap with the inclusion of the scapula angle, which was placed horizontally. The functional and aesthetic results of the reconstructions, the degree of morphological correspondence of the reconstructed structures, as well as the incidence of postoperative complications were assessed. Results. In Group 1 total necrosis of the flap was noted in 2 cases (20 %), in 1 (10 %) case – necrosis of the skin fragment). In Group 2 graft necrosis was observed in 1 (11 %) patient. Satisfactory and excellent aesthetic and functional results were achieved in 6 (60 %) patients in Group 1 and 8 (89 %) patients in Group 2. Conclusion. The scapular flap has a number of advantages for microsurgical reconstruction, including the presence of a long vascular pedicle with large vessels, inclusion of different tissues, possibility of harvesting a “chimeric” version (with significant mobility of parts), low rate of vascular lesions in the area, and most importantly, morphologically close location of bone tissue of the scapula to the maxilla, which ensures successful application of this flap for maxillary repair in patients with advanced cancer of the upper jaw.

scholarly journals Features of free skin grafting to correct post-burn neck deformities in children

2021 ◽  
Vol 9 (1) ◽  
pp. 77-86
Author(s):  
Olga V. Filippova ◽  
Konstantin A. Afonochev
Keyword(s):  
Preventive Measures ◽  
Preventive Measure ◽  
Skin Grafting ◽  
Long Term Results ◽  
Neck Extension ◽  
Scar Contracture ◽  
Aesthetic Results ◽  
Group 2 ◽  
Grade Iii ◽  
Group 1

BACKGROUND: In the literature, various methods of reconstructive plastic surgery for neck cicatricial contractures, from free skin grafting to expander dermotension and microsurgical tissue complex autotransplantation, are widely covered. However, very little attention has been paid to conservative measures aimed at stabilizing surgical treatment results. AIM: This study aims to evaluate the long-term results of free skin grafting of neck granulating wounds after burns and secondary relapsing scar contracture correction. The study also aims to analyze the causes of poor results and demonstrate the possibility of using free skin grafting to correct neck contractures with basic preventive measures. MATERIALS AND METHODS: Forty-six patients with neck burn cicatricial sequelae were treated at the clinic of trauma sequelae in H. Turner National Medical Research Center from 2017 to 2019. The patients were divided into two groups: group 1 patients with neck contractures after plasty of granulating wounds with free skin autografts, and group 2 patients with a relapse of neck contracture after corrective reconstructive surgery. Anamnestic data analysis enabled establishing the actual volume of preventive rehabilitation measures in both patient groups. The classification by N.E. Povstyany (1973) was used to determine the severity of contracture. RESULTS: The most severe neck contractures, grade III and IV, developed in group 1 patients (grade III 41.2%). In group 2 patients, there was a limitation of neck extension, corresponding to grades I (33.3%) and II (58.3%). Conservative preventive measures as immobilization and compression therapy were absent in group 1 in 100% of cases. The most common preventive measure was the prescription of topical anti-scar drugs. Two-stage skin grafting with full-thickness skin autografts combined with conservative measures made it possible to correct neck contractures of grade I-IV completely and obtain good aesthetic results. CONCLUSION: The main reason for neck contractures development is the retraction of skin autografts, which inevitably develops in the absence of appropriate preventive measures. Correction of neck contractures using free skin grafting combined with preventive immobilization using a Schantz collar and a compression half-mask allows obtaining good functional and aesthetic results.

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.

scholarly journals Clinical Aspects of Prevention and Management of Primary Inferior Oblique Muscle Overaction

2019 ◽  
Vol 4 (4) ◽  
pp. 77-82
Author(s):  
I. L. Plisov ◽  
V. B. Pushchina ◽  
N. G. Antsiferova ◽  
G. V. Gladysheva ◽  
D. R. Mamulat ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Rectus Muscle ◽  
Functional Results ◽  
Oblique Muscle ◽  
Clinical Aspects ◽  
Inferior Oblique Muscle ◽  
Infantile Esotropia ◽  
Group 2 ◽  
Clinically Significant ◽  
Group 1

Background. Primary inferior oblique muscle overaction (PIOOA) may occur for various reasons and happens to 72 % patients with infantile esotropia. The criterion for the first surgical step is prevalence of vertical or horizontal deviation. The choice of tactics weakening inferior oblique muscle is ambiguous.Aims: to carry out retrospective analysis of PIOOA frequency in patients with infantile esotropia; to assess influence of esodeviation reduction by a surgical, chemodenervational or prismatic method on the existing PIOOA dynamics; to assess clinical and functional results of PIOOA treatment.Methods and methods. The retrospective analysis of 572 patients’ cases lay in assessment of PIOOA frequency and rate in patients with infantile esotropia that manifested under 9 months, with different treatment tactics. The prospective part of the research included two groups of patients. Group 1 (106 patients, 222 eyes) – studying the influence of surgical treatment of PIOOA. Group 2 (127 patients, 207 eyes) – studying the effectiveness of surgical PIOOA treatment. Conclusion. PIOOA frequency in case of different treatment tactics for patients with infantile esotropia is from 17 to 69 %, and the degree of its clinical manifestation is from 1.2 ± 0.4 to 2.6 ± 0.8. Bilateral weakening of medial rectus muscle reduces its probability up to 17–19 %, and the degree of its manifestation up to 1.2 ± 0.4. In cases of combination of PIOOA with infantile esotropia from 20 to 25° with paretic component, it is reasonable to carry out esodeviation reduction by means of bilateral recession, chemorecession or prismatic correction as the first treatment stage, whereas the rate of existing PIOOA is credibly reduced. In cases of choice of tactics, which is necessary for clinically significant reduction or elimination of PIOOA, it is reasonable to carry out chemorecession, marginal partial myotomy or myectomy depending on the PIOOA manifestation.

scholarly journals Surgical Treatment of Clubfoot in Children with Moebius Syndrome

Children ◽  
2021 ◽  
Vol 8 (4) ◽  
pp. 310
Author(s):  
Maurizio De Pellegrin ◽  
Lorenzo Marcucci ◽  
Lorenzo Brogioni ◽  
Giovanni Prati
Keyword(s):  
Surgical Treatment ◽  
Functional Results ◽  
Foot And Ankle ◽  
Moebius Syndrome ◽  
Peritalar Release ◽  
Long Term Follow Up ◽  
Group 2 ◽  
Group 1

Moebius syndrome (MS) is a rare disease, with paralysis of the VI and VII cranial nerves, frequently associated with clubfoot (CF). The aim of this study was to evaluate surgical treatment of CF in MS, providing its peculiarities. Between 1990 and 2019, we collected data of 11 MS patients with unilateral (n = 5) or bilateral (n = 6) CF, for a total of 17 feet (9R,8L). Six patients (3M,3F) for a total of 10 feet (6R,4L) were treated elsewhere, performing first surgery at an average age of nine months, and in our hospital for relapse surgery at an average age of 4.5 years (Group 1). Five patients (3M, 2F), for a total of seven feet (3R,4L), were primarily treated in our hospital with a peritalar release according to McKay at an average age of 9.4 months (Group 2). Diméglio score was used to assess CF severity. Three questionnaires were submitted for evaluation of subjective and functional results: American Orthopedics Foot and Ankle Society for Hindfoot (AOFAS), Foot and Ankle Outcome Score (FAOS), and Foot and Ankle Ability Measure (FAAM). Average AOFAS/FAOS/FAMM scores were 82.8, 84.8, and 82.3 for Group 1, and 93.2, 94.7, and 95.1 for Group 2 at an average follow-up of 16.9 and 13.3 years, respectively. The average Diméglio score improved from 15.5 to 4.8 in the long-term follow-up in Group 1 and from 14.6 to 3.8 in Group 2. The comparison between the groups showed better results for AOFAS, FAOS, and FAAM scores for Group 2, particularly for pain, function, and foot alignment and for the post-surgical Diméglio score. CF in MS is more severe and presented a higher relapse rate (58.8%) than idiopathic CF. Peritalar release showed no relapse and better subjective and functional results in the long-term follow-up compared to other surgical techniques

scholarly journals Surgical treatment of children with hip dysplasia complicated with avascular necrosis of the femoral head

2019 ◽  
Vol 7 (1) ◽  
pp. 25-34
Author(s):  
Mikhail P. Teplenky ◽  
Evgeny V. Oleinikov ◽  
Vyacheslav S. Bunov
Keyword(s):  
Surgical Treatment ◽  
Femoral Head ◽  
Avascular Necrosis ◽  
Hip Dysplasia ◽  
Hip Dislocation ◽  
Functional Results ◽  
X Ray ◽  
Group 2 ◽  
Time Of Operation ◽  
Group 1

Introduction. Avascular necrosis of the femoral head complicates the surgical treatment of hip dysplasia and aggravates the prognosis. Aim. We studied the immediate and medium-term results of reconstructive treatment in 18 children with hip dysplasia complicated by avascular femoral head necrosis, which developed after closed repositioning of a congenitally dislocated femur. Material and methods. Average age at the time of operation was 4.2 0.2 years. The patients were divided into two groups. Group 1 included 12 children with hip subluxation who underwent extra-articular reconstructions on articular components, spinal tunneling of the neck and head, and hardware unloading of the joint and group 2 included six patients with hip dislocation in whom an additional open reduction was performed. Functional results were estimated using DAubigne-Postel classification, whereas X-ray results were evaluated using Kruczynski classification. Results. Duration of observation was 37 years (average, 4.2 0.3 years). Functional results were good (1518 points) in nine joints in group 1, satisfactory (1214 points) in three joints in group 1 and five in group 2, and unsatisfactory (11 points) in one joint in group 2. X-ray results were good in six joints in group 1, satisfactory in six joints in group 1 and five in group 2, and unsatisfactory in one joint in group 2. Conclusions. Extra-articular reconstructive and stimulatory interventions combined with hardware decompression helps improve the shape and structure of the femoral head, and formation of congruent articular surfaces in children with subluxation of the thigh complicated by avascular necrosis.

scholarly journals First results of balloon dacryoplasty in dacryostenosis

2015 ◽  
Vol 8 (2) ◽  
pp. 35-40 ◽  
Author(s):  
Evgeniya L’vovna At’kova ◽  
Vasiliy Dmitrievich Yartsev ◽  
Nikolay Nikolaevich Krakhovetskiy ◽  
Anna Olegovna Root ◽  
Lyudmila Vladimirovna Reznikova
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Single Case ◽  
Photon Emission ◽  
Functional Results ◽  
Positive Outcome ◽  
Nasolacrimal Duct ◽  
Emission Computed Tomography ◽  
Group 2 ◽  
Group 1

Background. Outpatient care is not widely spread in modern dacryology. At the same time, its necessity increases. There are no evidences of balloon dacryoplasty (BDP) application in Russian periodical literature. Material and methods. 50 surgical procedures in 30 patients with partial nasolacrimal duct obliteration were performed, among them 30 BDP without lacrimal pathways intubation (group 1) and 20 with bicanalicular Ritleng intubation of lacrimal pathways (group 2). Lacrimal scintigraphy, single photon emission computed tomography, combined with X-ray computed tomography, subjective tearing estimation in points, and health depending quality of life evaluation wre performed in all cases. Same tests were repeated in 3 months after surgery. Results. A positive outcome rate was 90 % in both groups. There were no complications in group 1. A single case of stent dislocation was recorded in group 2. Conclusion. BDP is an effective procedure in dacryostenosis of the lacrimal pathways vertical part obliteration. This procedure helps to avoid complications associated with long stent retention. It is possible to get good functional results even at short term after BDP surgery, and there is a possibility for this procedure to be carried out in an outpatient setting.

scholarly journals Outcomes of robotic-assisted radical prostatectomy for patients in two extreme age-groups ( 65 years)

2018 ◽  
Vol 91 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Radu-Tudor Coman ◽  
Nicolae Crisan ◽  
Iulia Andras ◽  
Gabriela Bud ◽  
Deliu-Victor Matei ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Age Groups ◽  
Functional Results ◽  
Nerve Sparing ◽  
Robotic Radical Prostatectomy ◽  
Robotic Assisted ◽  
Robotic Assisted Radical Prostatectomy ◽  
Group 2 ◽  
Continence Rate ◽  
Group 1

Background and aims. To assess the outcomes of robotic radical prostatectomy in two different age subgroups of pre-operatively potent patients: younger than 50 years and older than 65 years.Methods. We included in the present study a number of 202 patients with prostate cancer divided into two groups: 99 patients older than 65 years (group 1) and 103 patients younger than 50 years (group 2).Results. More than half of the younger patients were low-risk vs 57% of the older patients who were high-risk. Overall positive surgical margins rate was 21.2% in group 1 vs 12.1% in group 2. The early biochemical recurrence at 6 months after radical prostatectomy was 4% in group 1 vs 11.6% in group 2. The continence rate at 6 months was similar between the two groups and was not correlated with the patients’ age (p=0.72), nerve-sparing (p=0.3 for group 1, p=0.92 for group 2) or pathological staging (overall p=0.81, p=0.89 in group 1 and p=0.63 in group 2). We observed a significantly higher rate of potency for patients in group 2 (91.5% vs 47.2%, p<0.0001). The most important factor associated with the regain of potency at 6 months after the procedure was the age of the patient (p<0.0001), independently of the type of nerve-sparing performed.Conclusions. Age seems to be the most important predictor of the regain of potency after robotic radical prostatectomy. Patients should be counseled accordingly in order to have realistic expectations about the functional results after robotic-assisted surgery.             

scholarly journals Functional Comparison of Immediate and Late Weight Bearing after Ankle Bimalleolar Fracture Surgery

2015 ◽  
Vol 9 (1) ◽  
pp. 188-190 ◽  
Author(s):  
İsmail Ağır ◽  
Nejat Tunçer ◽  
Fatih Küçükdurmaz ◽  
Seyitali Gümüstaş ◽  
Esra Demirel Akgül ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Scoring System ◽  
Weight Bearing ◽  
Functional Results ◽  
The Other ◽  
Group 2 ◽  
One Year ◽  
Fracture Surgery ◽  
Group 1

Aim : The aim of the study is to compare immediate weight bearing with below-knee cast or immobilization with plaster splint in 6 weeks in patients after operative treatment for ankle bimalleolar fractures. Methods : Fifty-three patients with ankle bimalleolar fractures were treated operatively in 2005 to 2010 and then were randomly allocated to two groups. Immediately weight bearing in a below-knee cast (26 patients) and immobilization in a plaster splint for the first six postoperative weeks (27 patients). A mean age 37.9 (min 17; max 72). An average follow-up 26.1 months. (min 14; max 55). All fractures were classified with Lauge-Hansen classification. Functional results of both groups were evaluated with AOFAS for the postoperative one year after surgical treatment. Results : According to the AOFAS scoring system, results were excellent and good in 17 patients in group 1. On the other hand, results were excellent and good in 14 patients in group 2. Conclusion : As a result we think that weight bearing protocol should be advantaged for patients with ankle bimalleolar fractures after surgical treatment immediately.

scholarly journals PATHOGENETIC APPROACH IN TREATMENT OF DIABETIC AND VENOUS TROPHIC ULCERS USING PLASMATHERAPY AND LASER THERAPY

2020 ◽  
Vol 8 (4) ◽  
pp. 458-465
Author(s):  
T.A. Kharchenko ◽  
A.S. Ivanova ◽  
O.K. Melekhovets ◽  
V.F. Orlovskyi ◽  
Iu.V. Melekhovets
Keyword(s):  
Clinical Status ◽  
Clinical Severity ◽  
Vascular Lesions ◽  
Duration Of Treatment ◽  
Plasma Therapy ◽  
Area Reduction ◽  
Initial Stage ◽  
Patients With Diabetes ◽  
Group 2 ◽  
Group 1

In Ukraine more than 13,000 lower limb amputations are performed per year, of which about 8,000 are due to vascular lesions, and more than 3,000 are associated with diabetes mellitus (DM). The effectiveness of photodynamic therapy (PDT) in group 1 was assessed by the VCSS-1 and VCSS-2 scales. At baseline, the total score of clinical severity of CVI was 20.9 points, and two weeks later – 15.71 points, which shows an improvement by 24.83% (p≤0.05). The effectiveness of PDT in group 2 was assessed by the S(AD) SAD-1 scales at baseline and S(AD) SAD-2 at 2 weeks. The overall score on the scale S(AD) SAD-1 was 13.91 points, two weeks later it improved by 11.65% (12.29 points), which shows a much slower rate of normalization of the clinical picture in patients with diabetes compared with CVI. The effectiveness of plasma therapy in group 1 was assessed by the VCSS-1 and VCSS-3 scales. The total score of clinical severity of CVI after 6 weeks of treatment was 9.72 points, indicating an improvement in clinical status by 53.49% from baseline (20.9 points) (p≤0.05). In group 2, the evaluation of the effectiveness of plasma therapy was based on a comparison of the scales S(AD) SAD-1 and S(AD) SAD-3. The overall score of clinical severity at 6 weeks was 6.39 points, indicating an improvement by 54.06% from baseline (13.91 points). Analysis of the ulcer healing dynamics in group 1 revealed 0 points (no active ulcers) in 87.5% of patients (28 patients), while in the remaining 4 patients the size of active ulcers was 1 point. In group 2, the dynamics of the area reduction showed slower results: in 74.2% of patients the TU area was 2 points, 0 points were achieved in 12.9% patients, in the remaining patients (12.9%) – 4 points. Due to using of combined scheme of basic therapy, supplemented with PDT at the initial stage and plasma therapy in the granulation phase, it was possible to improve the dynamics of the rate of healing of TU and reduce the duration of treatment.

scholarly journals Value of Shear Wave Elastography for differentiating benign and malignant renal lesions

2018 ◽  
Vol 1 (1) ◽  
pp. 21 ◽  
Author(s):  
Sinem Aydin ◽  
Seyma Yildiz ◽  
Ihsan Turkmen ◽  
Rasul Sharifov ◽  
Omer Uysal ◽  
...  
Keyword(s):  
Shear Wave ◽  
Negative Correlation ◽  
Renal Cortex ◽  
Malignant Tumors ◽  
Shear Wave Elastography ◽  
Benign Tumors ◽  
Renal Masses ◽  
Renal Lesions ◽  
Group 2 ◽  
Group 1

Aims: To investigate the diagnostic accuracy of shear-wave elastography (SWE) for assessing malignant and benign kidneymasses.Materials and methods: Forty patients with solid renal masses underwent US elastographic evaluation. SWE values of the lesions and adjacent cortical renal parenchyma and SWER were detected prospectively. Malignant tumors were recorded as group 1 and benign tumors were recorded as group 2.Results: The highest elasticity values were 27.27±25.66 kPa for group 1 and 16.13±8.89 kPa for group 2. The mean±SD elasticity values for adjacent renal cortex for groups 1 and 2 were 2.7±2.08 and 2.75±1.35, respectively. For group 1, a negative correlation was observed between the age of the patients and SWER value (p=0.047, rs=‑0.401). There was also a negative correlation between the SWER value and the SWE value of adjacent renal cortex (p=0.004, rs=‑0.555).Conclusion: SWE is a noninvasive method that provides quantitative elasticity informationon tissues. Overlaps among different types of renal lesions may be due to heterogeneity of the lesions. Larger studygroups may clarify the other factors affecting SWE values under both normal and pathological conditions.

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