The ICEROSS concept: A discussion of a philosophy

1993 ◽  
Vol 17 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Ö. Kristinsson
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Skin Care ◽  
Custom Made ◽  
The Subject ◽  
Distal Direction ◽  
Inside Out

Prefabricated ICEROSS (Icelandic Roll On Silicone Socket) sockets have been in use in Iceland since early 1986. Use of custom-made silicone sockets began several years earlier, and a paper devoted to the subject was presented at the 1984 AOPA Assembly by the author of this article. The ICEROSS system is primarily used for suspension. At the same time the author believes it considerably improves the weight-bearing capability of the prosthesis and the interface between prosthesis and user. After being turned inside out and rolled over the stump, the silicone sleeve forces skin in a distal direction, stabilising soft tissue and minimising pistoning. Both prosthetist and user may experience some problems initially, although most can be overcome by careful socket design and skin care.

scholarly journals Non-locking buttress plate in distal tibial metaphyseal fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 87-91
Author(s):  
Norman Lamichhane ◽  
Bhogendra Bahadur KC ◽  
Chandra Bahadur Mishra ◽  
Sabita Dhakal
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Delayed Union ◽  
Full Weight Bearing ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Metaphyseal Fractures

Background: Treatment of distal tibial metaphyseal fractures is often challenging and no single technique has been unanimously advocated. Open reduction and internal fixation with plates and screws allows better restoration of anatomical alignment but with more soft tissue complication. Simultaneous fixation of the fibula is not universally carried out. This study aims at evaluation of the outcome of plating technique and the effect of fixation of fibula fracture in treatment of distal tibial metaphyseal fractures. Material and methods: Thirty-one cases (14 cases in Group A with concomitant distal fibula fracture and 17 cases in Group B without distal fibula fracture) were analyzed retrospectively for the mean duration of full weight bearing, mean union time and complications, and compared. Results: The mean time for full weight bearing and radiological union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively. 16.1% of cases had post-operative complications including one case of deep infection and malalignment of 6 degree varus (following delayed union) was seen in one case of Group A. Range of motion (ROM) at ankle was not problem in any of the cases except the one delayed union which had 5 degrees of dorsiflexion and 15 degrees of plantiflexion. Conclusion: Open reduction and internal fixation with plate and screws in distal tibial metaphyseal fracture is more economic means of treatment modality with comparable incidence of post-union malalignment and union time,though more soft tissue complications compared to other modalities. Fixation of fibula fracture aids in reducing the incidence of malalignment.

Stress Fractures in Royal Marine Recruits

1970 ◽  
Vol 56 (1) ◽  
pp. 78-91
Author(s):  
J. Bertram
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Fracture Site ◽  
Stress Fractures ◽  
Vigorous Activity ◽  
Main Symptom ◽  
Soft Tissue Swelling ◽  
History Of ◽  
Radiological Changes

AbstractThe main features of stress fractures in Royal Marine recruits are that they occur in normal bones, most often those that are weight bearing. There is no history of injury, but there is usually a history of unaccustomed or more vigorous activity for some weeks before onset. The main symptom is pain on use of the affected part and this pain is relieved by rest. Localised tenderness and soft tissue swelling are present at the fracture site when the affected bone is readily palpable. Radiological changes are absent in the first seven to ten days, but become visible within two months, unless treatment starts or stress ceases early.

scholarly journals The Effect of “High-ankle Sprain” Taping on Ankle Syndesmosis Congruity: A Cadaveric Study

2020 ◽  
Vol 13 (1) ◽  
pp. 123-128
Author(s):  
Stéphanie Lamer ◽  
Jonah Hébert-Davies ◽  
Vincent Dubé ◽  
Stéphane Leduc ◽  
Émilie Sandman ◽  
...  
Keyword(s):  
Ankle Sprain ◽  
Weight Bearing ◽  
Axial Loading ◽  
Cadaveric Study ◽  
P Value ◽  
Level Of Evidence ◽  
Parametric Data ◽  
Custom Made ◽  
Significant Difference ◽  
High Ankle Sprain

Background: Different treatment options exist for dynamically unstable purely ligamentous syndesmotic injury, including surgery, walking boot, brace and taping. Objective: The main purpose of this study was to evaluate the effect of high-ankle sprain taping (ring taping) on syndesmotic stability in various ligament conditions when axial loading is applied. Methods: This controlled cadaveric laboratory study included ten cadaveric specimens installed in a custom-made device applying 750N of axial loading in order to simulate weight-bearing. Sectioning of syndesmotic ligaments, AiTFL and IOL, was done sequentially and CT scan images were taken with and without high-ankle sprain taping. A validated measurement system consisting of 3 lengths and 1 angle was used. Results were compared with Wilcoxon tests for paired samples and non-parametric data. Results: In every ligament condition (intact vs. cut), no statistically significant difference was observed between specimens, with or without high-ankle sprain taping and with or without axial loading. When the data from ankles with AiTFL and IOL ruptures were compared, the mean for length “b” without axial loading was 7.19 (±2.17), compared to 7.20 (±1.98) with axial loading (p-value = 0.905). With taping and the leg still in axial loading, the value was 7.17 (±2.09) (p-value = 0.721), which is not statistically significant. Conclusion: It is impossible to conclude regarding high-ankle sprain taping’s capacity to maintain syndesmosis congruity because no significant difference was observed, regardless of condition. The most important finding is that high-ankle sprain taping did not cause malreduction of the injured syndesmosis. Level of Evidence: Level V cadaveric study

scholarly journals Extended reverse sural artery pedicle flap: a versatile and reproducible option for coverage of ankle and foot defects

2019 ◽  
Vol 7 (3) ◽  
pp. 866
Author(s):  
Bhushan R. Patil ◽  
Chandrashekhar Wahegaonkar ◽  
Nikhil Agarkhedkar ◽  
Bharat Bhushan Dogra
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Free Tissue Transfer ◽  
Soft Tissue Defects ◽  
Pedicle Flap ◽  
Tissue Transfer ◽  
Major Vessel ◽  
Sural Artery ◽  
Tissue Defects ◽  
Ankle And Foot

Background: Coverage of soft tissue defects around distal third of the leg, particularly ankle and foot is a common situation faced by a plastic and reconstructive surgeon. Options available for such defects are limited due to scarcity of additional soft tissue that can be used without exposing tendons or bone. Associated conditions such as major vascular compromise, comorbidities and lack of facilities or expertise make free tissue transfer less preferred. Distally based sural artery flap has been a frequently used flap in such conditions, easy to perform and has reproducible results. We extended the reach of the flap and reproduced the results.Methods: We performed extended reverse sural artery pedicled flaps in 19 patients who presented to us between 2015 to 2017 with soft tissue defects around ankle and foot. Patients included 15 post RTA, 2 diabetic foot, 1 post resection defect and 1 post burn contracture release defect. Size of the defect ranged between 8x6cm to 14x10cm. Average follow up period was ranging from 8 months to 2.5 years.Results: All the flaps healed well without any obvious complications except one patient in whom marginal necrosis (2 cm margin of distal most flap) was observed and was secondarily treated with skin grafting.Conclusions: We observed that extended reverse sural pedicle flap is a rapid, reliable option for coverage of soft tissue defects around ankle and heel, sparing major vessel compromise and lengthy surgical procedure during free tissue transfer. This flap should be the first option for the patients with trauma and defects over weight bearing foot in whom peroneal axis vessels are preserved.

Soft Tissue Reconstruction Pyramid in the Diabetic Foot

2010 ◽  
Vol 3 (5) ◽  
pp. 241-248 ◽  
Author(s):  
Claire M. Capobianco ◽  
John J. Stapleton ◽  
Thomas Zgonis
Keyword(s):  
Soft Tissue ◽  
Diabetic Foot ◽  
Weight Bearing ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Best Interest ◽  
Foot Complications ◽  
Uncontrolled Diabetes ◽  
Wound Healing Response ◽  
Tissue Reconstruction

Foot complications and ulceration are well-known sequelae to uncontrolled diabetes. Patients with chronic foot ulcers or wounds resulting from surgical debridement of deep-space infections are at continued risk for development of osteomyelitis and potential amputation. Moreover, these wounds often necessitate multiple outpatient clinic visits, daily dressing care, and prolonged periods of non—weight bearing, all of which have been shown to adversely affect the patient’s quality of life. After a prudent period of wound-healing response, the authors believe that early and aggressive soft tissue reconstruction is in the patient’s best interest and is crucial for resolution of the chronic nonhealing wound. The options for soft tissue coverage and the logical progression of application of these techniques in the diabetic foot will be described.

The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report

2018 ◽  
Vol 23 (01) ◽  
pp. 128-131
Author(s):  
José Couceiro ◽  
Mariangeles De la Red-Gallego ◽  
Luis Yeste ◽  
Higinio Ayala ◽  
Manuel Sanchez-Crespo ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Soft Tissue Defects ◽  
Thumb Reconstruction ◽  
Degloving Injury ◽  
Dorsal Metacarpal Artery ◽  
The Subject ◽  
Tissue Defects

The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.

Playful Falls in a Milieu of Contagion

2017 ◽  
Author(s):  
Timothy C. Campbell
Keyword(s):  
Limit Case ◽  
Central Figure ◽  
Form Of Life ◽  
The Subject ◽  
Inside Out

Roberto Rossellini’s Germany Year Zero is the subject of this chapter, in which the relation of the generous form of life to play is analysed in a milieu of ingratitude and mythic violence. The central figure of the film, the boy Edmund, is read as a limit case of the generous form of life in a context of massive envy. Here parricide and suicide become the only possibilities when gratitude has been reduced to year zero. The chapter includes a reading of Melanie Klein’s Gratitude and Envy and ends with a reflection on how the film turns gratitude inside out; in lieu of good and bad objects, there is law and guilt.

Epoxy-Pin External Skeletal Fixation for Management of Open Bone Fractures in Calves and Foals: A Review of 32 Cases

2019 ◽  
Vol 32 (03) ◽  
pp. 257-268
Author(s):  
Hari Aithal ◽  
Prakash Kinjavdekar ◽  
Abhijit Pawde ◽  
Prasoon Dubey ◽  
Rohit Kumar ◽  
...  
Keyword(s):  
Bone Fractures ◽  
Weight Bearing ◽  
Fracture Site ◽  
Open Fractures ◽  
Adhesive Tape ◽  
Stable Fixation ◽  
Early Weight Bearing ◽  
Pin Fixation ◽  
Bone Fragments ◽  
The Subject

Objective The aim of this study was to evaluate epoxy-pin external skeletal fixation technique for the treatment of open fractures in calves and foals. Study Design Twenty-eight calves and four foals (weighing 45–105 kg) with fractures distal to the stifle or elbow made the subject for the retrospective study. The pins (2.0–3.0-mm Kirschner wires, crossed at 60–90°) were fixed at least at two locations in both proximal and distal bone fragments as per the case situation. The pins in the same plane were bent (∼2 cm from the skin) towards the fracture site or joint and were joined using an adhesive tape (additional pins used when required) to make a temporary scaffold of connecting bars or rings. Thoroughly mixed epoxy putty was applied along the pin scaffold (the epoxy columns were 20–25 mm diameter) and allowed to set for 45 to 60 minutes. All animals were evaluated based on various clinical and radiographic observations made at regular intervals. Results The epoxy-pin fixation was easy to apply and provided stable fixation of bone as indicated by early weight bearing, and fracture healing within 45 to 60 days (17/32 cases). The functional recovery was good to very good in 14 animals and satisfactory in nine cases by 12 months after removal of the fixator. Conclusions The multiplanar epoxy-pin external skeletal fixation provides stable fixation of unstable open fractures distal to the stifle or elbow joint; hence, it can be used to treat a variety of fractures in calves and foals weighing up to approximately 100 kg, especially open infected fractures of lower limb, which are difficult to treat by conventional techniques.

scholarly journals Ceramic Artificial Talus as the Initial Treatment for Comminuted Talar Fractures

2019 ◽  
Vol 41 (1) ◽  
pp. 79-83 ◽  
Author(s):  
Ryuhei Katsui ◽  
Yoshinori Takakura ◽  
Akira Taniguchi ◽  
Yasuhito Tanaka
Keyword(s):  
Range Of Motion ◽  
Initial Treatment ◽  
Weight Bearing ◽  
High Energy ◽  
Level Of Evidence ◽  
Custom Made ◽  
Sport Activities ◽  
Talar Fractures ◽  
American Orthopaedic ◽  
Retrospective Comparative Study

Background: Comminuted talar fractures are rare. Generally, this fracture occurs as a result of high-energy injuries. Therefore, this operation is challenging for the surgeon. We started to replace the whole talus with a total talar prosthesis in cases of aseptic talar necrosis in 2005. Based on these results, replacement with a ceramic artificial talus was performed as the initial treatment for comminuted talar fractures. Methods: From 2009 to 2016, a total of 6 feet of 6 patients with comminuted talar dome fractures or talar body defects were replaced with a ceramic artificial talus. The patients’ mean age was 40.3 years (range, 19-59). Postoperative assessments were performed in accordance with the American Orthopaedic Foot & Ankle Society (AOFAS) ankle/hindfoot score system. Postoperative range of motion and sports activities were also evaluated. Follow-up ranged from 12 to 84 (mean, 46.8) months. Results: The postoperative AOFAS score was on average 78.8 (64-100). The postoperative range of motion was on average 10 degrees (5-20) for dorsiflexion and 31 degrees (15-50) for plantarflexion. Three patients had returned to sport activities. Conclusion: Prosthetic total talar replacement was a useful procedure for patients with comminuted talar fractures, which had good congruency of the custom-made implant with the adjacent joints, resulting in stability, and maintained ankle function. Furthermore, this procedure could prevent the complications of long-term external fixation and non-weight-bearing walking seen after open reduction and arthrodesis. Level of Evidence: Level IV, retrospective comparative study.

scholarly journals 3D Printed Silicone Meniscus Implants: Influence of the 3D Printing Process on Properties of Silicone Implants

Polymers ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2136
Author(s):  
Eric Luis ◽  
Houwen Matthew Pan ◽  
Anil Kumar Bastola ◽  
Ram Bajpai ◽  
Swee Leong Sing ◽  
...  
Keyword(s):  
Photoelectron Spectroscopy ◽  
Weight Bearing ◽  
Thermo Gravimetric Analysis ◽  
Silicone Implants ◽  
Osteoarthritis Of The Knee ◽  
Gravimetric Analysis ◽  
Scanning Calorimetry ◽  
Hydrogel Scaffolds ◽  
Custom Made ◽  
3D Printed

Osteoarthritis of the knee with meniscal pathologies is a severe meniscal pathology suffered by the aging population worldwide. However, conventional meniscal substitutes are not 3D-printable and lack the customizability of 3D printed implants and are not mechanically robust enough for human implantation. Similarly, 3D printed hydrogel scaffolds suffer from drawbacks of being mechanically weak and as a result patients are unable to execute immediate post-surgical weight-bearing ambulation and rehabilitation. To solve this problem, we have developed a 3D silicone meniscus implant which is (1) cytocompatible, (2) resistant to cyclic loading and mechanically similar to native meniscus, and (3) directly 3D printable. The main focus of this study is to determine whether the purity, composition, structure, dimensions and mechanical properties of silicone implants are affected by the use of a custom-made in-house 3D-printer. We have used the phosphate buffer saline (PBS) absorption test, Fourier transform infrared (FTIR) spectroscopy, surface profilometry, thermo-gravimetric analysis (TGA), X-ray photoelectron spectroscopy (XPS), differential scanning calorimetry (DSC), and scanning electron microscopy (SEM) to effectively assess and compare material properties between molded and 3D printed silicone samples.

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