Surgical Treatment for Congenital Venous Malformations in the Lower Limb.

Background Venous malformations (VMs) are the most common type of vascular malformations. Intramuscular venous malformations (IMVMs) are lesions involving the muscles, excluding intramuscular hemangiomas. The purpose of this study was to compare clinical outcomes between patients with IMVMs who were treated with sclerotherapy and those who were treated with surgical excision.Methods Of 492 patients with VMs treated between July 2011 and August 2020 at a single medical center for vascular anomalies, 63 patients diagnosed with IMVM were retrospectively reviewed. Pain, movement limitations, swelling, and quality of life (QOL) were evaluated subjectively, while radiological outcomes were assessed by qualified radiologists at the center. Complication rates were also evaluated, and radiological and clinical examinations were used to determine which treatment group (sclerotherapy or surgical excision) exhibited greater improvement.Results Although there were no significant differences in pain (P=0.471), swelling (P=0.322), or the occurrence of complications (P=0.206) between the two treatment groups, the surgical treatment group exhibited significantly better outcomes with regard to movement limitations (P=0.010), QOL (P=0.013), and radiological outcomes (P=0.017). Moreover, both duplex ultrasonography and magnetic resonance imaging showed greater improvements in clinical outcomes in the surgical excision group than in the sclerotherapy group.Conclusions Although several studies have examined IMVM treatment methods, no clear guidelines for treatment selection have been developed. Based on the results of this study, surgical excision is strongly encouraged for the treatment of IMVMs.

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Long-Term Surgical Treatment Results of Critical Lower Limb Ischemia Following Simultaneous Direct and Indirect Revascularization

Novosti Khirurgii ◽

10.18484/2305-0047.2017.2.131 ◽

2017 ◽

Vol 25 (2) ◽

pp. 131-139

Author(s):

V.I. Rusin ◽

◽

V.V. Korsak ◽

P.A. Boldizhar ◽

V.V. Rusin ◽

...

Keyword(s):

Surgical Treatment ◽

Lower Limb ◽

Limb Ischemia ◽

Treatment Results ◽

Lower Limb Ischemia ◽

Indirect Revascularization

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Intraspinal Sparganosis Diagnosed by Metagenomics Next Generation Sequencing：An Uncommon Infection

10.21203/rs.3.rs-742886/v1 ◽

2021 ◽

Author(s):

Rongming Wang ◽

Bobin Hu ◽

Jianning Jiang ◽

Minghua Su

Keyword(s):

Surgical Treatment ◽

High Risk ◽

Lower Limb ◽

Poor Prognosis ◽

High Dose ◽

Next Generation ◽

Praziquantel Treatment ◽

Long Course ◽

Generation Sequencing ◽

Complex Lesions

Abstract In this paper, we report a case of lumbago with lower limb fatigue. After a series of biochemical, immunological, imaging, and pathological examinations, the patient was diagnosed with intraspinal sparganosis based on metagenomics next generation sequencing. Due to the length of infection, the presence of multiple complex lesions, and the high risk of surgical treatment with poor prognosis, we did not advocate surgical treatment, but chose to administer a high dose and long course of praziquantel treatment for this case.

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Clinical and Radiological Outcomes After Surgical Treatment of Lower Limb Fractures in Patients With Spinal Cord Injury

Global Spine Journal ◽

10.1177/2192568219871019 ◽

2019 ◽

Vol 10 (6) ◽

pp. 715-719

Author(s):

Lars Ung ◽

Malte Ohlmeier ◽

Birger Jettkant ◽

Dennis Grasmücke ◽

Mirko Aach ◽

...

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

Lower Limb ◽

Bone Consolidation ◽

Lower Limb Fractures ◽

Kaplan Meier ◽

Cord Injury ◽

Limb Fractures ◽

Consolidation Time ◽

Internal Group

Study Design: Retrospective observational study. Objectives: To analyze the clinical and radiological outcomes of lower limb fractures following surgical treatment in patients with chronic spinal cord injury (SCI). Methods: Between January 2003 and December 2015, 102 chronic SCI patients with a lower limb fracture were surgically treated at our hospital. A total of 58 patients met the inclusion criteria and were recruited for final analysis. Patients with 2-stage procedure or incomplete clinical records with lost-to-follow-up were excluded from the study. Patients were divided into 2 groups (group 1= internal fixation; group 2 = external fixation). Primary outcome measures were to identify the number of nonunions via Kaplan-Meier analysis and the time to bone consolidation. The diagnosis of a pseudarthrosis was made after more than 180 days of consolidation time. Considering the Kaplan-Meier analysis, pseudarthrosis was interpreted as treatment failure. Secondary outcome measure was to evaluate the complication rate with special focus on heterotopic ossification. Results: A total of 58 chronic SCI patients with closed bone fractures were included in this study. Fifty-two fractures (88%) were simple and 7 (12%) were complex (type C) fractures according to AO classification. The majority of patients (34 cases, 59%) developed femur fractures followed by 24 tibial fractures (41%). Seventeen patients received an external (29%) and 41 an internal fixation (71%). Bone consolidation was reported in 31 patients (53%) with a mean time interval of bone consolidation after 97 days (range from 45 to 160 days; SD = 30). The reported nonunion (pseudarthrosis) rate was 47%. Comparing the internal group (n = 15 patients) versus the external group (n = 14), we could not find any significant difference ( P = .939) concerning the bone consolidation time. The Kaplan-Meier analysis showed a 75% cumulative survivorship at 120 days (internal group) versus 111 days (external group). Most common postoperative complications occurred in the internal fixation group with Wound infections being predominantly observed (10%), followed by heterotopic ossifications (8%). Conclusions: Our results show that surgical treatment of lower limb fractures in chronic SCI patients is a challenging treatment with a high pseudarthrosis rate in both groups. The complication rate seems to be lower in the patients treated with external fixation. As a clinical recommendation, longer implants should be used for a stable osteosynthesis since SCI patients seem to have a higher load on the osteosynthesis material due to missing sensomotoric feedback.

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Intramuscular venous malformations of the calf: Surgical treatment outcomes of 57 patients

Phlebology The Journal of Venous Disease ◽

10.1177/0268355520920811 ◽

2020 ◽

Vol 35 (8) ◽

pp. 597-604

Author(s):

Claude Laurian ◽

Pierre Cerceau ◽

Nikos Paraskevas ◽

Claudine Massoni ◽

Veronique Marteau ◽

...

Keyword(s):

Quality Of Life ◽

Surgical Treatment ◽

Venous Malformation ◽

Functional Limitation ◽

Venous Malformations ◽

Complete Excision ◽

Muscle Involvement ◽

Residual Functional

Objectives To report the outcomes of surgical treatment of calf intramuscular venous malformations (IMVMs) on pain, functional limitation, and quality of life. Methods We retrospectively reviewed 57 consecutive patients who had surgery for IMVM of the posterior compartment of the leg between 2010 and 2015. Treatments were all done at a single institution. Results Patients presented with pain (52), muscle contracture (14), or pulmonary embolism (4). Muscle involvement included the soleus muscle (n = 28, 49%), the gastrocnemius muscle (n = 25, 43%), and deep muscles (n = 4, 7%). Complete excision was possible in 52 patients (91%) and partial excision in 5 (9%). Thirty-five of 46 patients who had an MRI follow-up at six months had no residual venous malformation. At the final follow-up (mean 39 months), 32 of 40 patients seen had no residual pain and 37 had no residual functional impairment. Conclusion In cases where IMVM is located in one muscle in the leg, we demonstrated that surgery yielded improvement in pain, function, and quality of life.

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