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[PMID]:29384949
[Au] Autor:Wang P; Cui MY; Zhao J; Lv J
[Ad] Endereço:The Second Affiliated Hospital of Soochow University, Department of Hand and Foot Surgery.
[Ti] Título:Compound grafting of residual vascularized fibular head flap to reconstruct contralateral lateral malleolus: A case report.
[So] Source:Medicine (Baltimore);96(52):e9501, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Serious external ankle injuries caused by high-energy trauma are often associated not only with bone defect but also with a loss of skin and soft tissue that seriously affects ankle function. Therefore, it is particularly important to reconstruct the external ankle. PATIENT CONCERNS: The patient was a 64-year-old man with destructive injury of both lower extremities due to a machine accident. His left ankle and heel bone, along with the soft tissue, were torn off, and the peripheral blood supply and sensation to the toes of the left foot were lost concerns. DIAGNOSES: Complicated lateral malleolus defect. INTERVENTIONS: We used a composite tissueflap taken from thefibular head on the left side to reconstruct the rightfibular lateral malleolus. OUTCOMES: With the help of a prosthesis, the patient regained basic walking function by the 1 year follow-up. LESSONS: Using a combined compositeflap of the vascularizedfibular head to reconstruct the lateral malleolus is a good choice.
[Mh] Termos MeSH primário: Fraturas do Tornozelo/cirurgia
Traumatismos do Tornozelo/cirurgia
Fíbula/cirurgia
Retalhos Cirúrgicos/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
Recuperação de Função Fisiológica
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009501


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[PMID]:29381938
[Au] Autor:Ye C; Lai Q; Zhang S; Gao T; Zeng J; Dai M
[Ad] Endereço:Department of Orthopedics, The First Affiliated Hospital of Nanchang University. Artificial Joints Engineering and Technology Research Center of Jiangxi Province, Nanchang, Jiangxi, China.
[Ti] Título:Osteopoikilosis found incidentally in a 17-year-old adolescent with femoral shaft fracture: A case report.
[So] Source:Medicine (Baltimore);96(47):e8650, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Osteopoikilosis is a rare and asymptomatic disease of the bone, which is often discovered occasionally on radiography for irrelevant complaints. Characterized by multiple, small, circular, or oval-shaped radiodense lesions, it may be confused with bony metastatic tumors. PATIENT CONCERNS: The present study describes a case of a 17-year-old adolescent who suffered from pain and movement limitation of his left thigh following a fall from standing height. DIAGNOSES: Plain radiographs showed spiral fracture in left femoral shaft; besides, multiple scattered sclerotic lesions of variable size were also observed over the bilateral proximal femurs, left distal femur, proximal tibia, and distal tibia and fibula through X-rays, computed tomography, and magnetic resonance imaging. The patient was finally diagnosed with left femoral shaft fracture and osteopoikilosis. INTERVENTIONS: The patient underwent reduction and internal fixation with intramedullary nail a week after injury. OUTCOMES: The patient was discharged without any complications 12 days after the surgery. At the 3-month follow-up, the patient recovered well and remained symptom-free with no changes to his sclerotic lesions. LESSONS: Although this case is not so complicated, we have to be cautious when differentiating osteopoikilosis and bony metastases in clinical practice in future, which should avoid causing undue distress to both the patients and doctors.
[Mh] Termos MeSH primário: Fraturas do Fêmur/diagnóstico
Fêmur
Fíbula/diagnóstico por imagem
Neoplasias de Tecido Ósseo/diagnóstico
Osteopecilose/diagnóstico
Radiografia/métodos
Tíbia/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Fraturas do Fêmur/cirurgia
Fêmur/diagnóstico por imagem
Fêmur/lesões
Fixação Intramedular de Fraturas/métodos
Seres Humanos
Achados Incidentais
Imagem por Ressonância Magnética/métodos
Masculino
Tomografia Computadorizada por Raios X/métodos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180208
[Lr] Data última revisão:
180208
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008650


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[PMID]:29310377
[Au] Autor:Lin YN; Chuang CH; Huang SH; Huang SH; Lin TM; Lin IW; Lin SD; Kuo YR
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
[Ti] Título:Fat grafting for resurfacing an exposed implant in lower extremity: A case report.
[So] Source:Medicine (Baltimore);96(48):e8901, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy. DIAGNOSES: The diagnosis of a tibia and fibula shaft open fracture (type IIIA) complicated with an exposed implant was made. INTERVENTIONS: The procedure was performed by deploying purified and emulsified fat with a Micro-Autologous Fat Transplantation gun. The required lipoaspirate amount was grossly estimated using a standard formula: 0.5 cc of a lipoaspirate per square centimeter of wound. We prepared the lipoaspirate simply through centrifugation followed by physical emulsification. The endpoint of fat grafting was when lipoaspirate began to flow out of the wound. The initial dressing after the procedure included the topical usage of biomycin ointment with AQUACEL Foam (ConvaTec Inc., NC, USA) coverage, which was later changed to INTRASITE gel (Smith & Nephew, London, UK) with a gauze dressing for 4 weeks. After 4 weeks, dressing components were changed to Mepilex (Mölnlycke Health Care, Gothenburg, Sweden) alone. OUTCOMES: The wound healed completely without requiring major flap surgery by 18 weeks after surgery. LESSONS: Fat grafting is one kind of cell therapy and potentially has regenerative effects during wound healing. Fat grafting is critical in the healing processes of complicated wounds and might be considered a step in reconstruction surgery.
[Mh] Termos MeSH primário: Tecido Adiposo/transplante
Fíbula/lesões
Fíbula/cirurgia
Fixação Interna de Fraturas/instrumentação
Fixadores Internos
Traumatismos da Perna/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Traumatismos da Perna/etiologia
Retalhos Cirúrgicos
Cicatrização
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008901


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[PMID]:29068940
[Au] Autor:Stranix JT; Lee ZH; Jacoby A; Anzai L; Avraham T; Thanik VD; Saadeh PB; Levine JP
[Ad] Endereço:New York, N.Y. From the Hansjörg Wyss Department of Plastic Surgery, New York University Langone Medical Center; and the Division of Plastic Surgery, Department of Surgery, Mount Sinai Health System.
[Ti] Título:Not All Gustilo Type IIIB Fractures Are Created Equal: Arterial Injury Impacts Limb Salvage Outcomes.
[So] Source:Plast Reconstr Surg;140(5):1033-1041, 2017 Nov.
[Is] ISSN:1529-4242
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes. METHODS: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria. Patient demographics, flap characteristics, and outcomes were analyzed. RESULTS: Most patients suffered type IIIB [n = 332 (91.9 percent)] injuries; 29 (8.0 percent) had type IIIC injuries. Preoperative angiography [n = 243 (67.3 percent)] demonstrated arterial injury in 126 (51.8 percent); 27 arterial injuries were identified intraoperatively; and the overall incidence was 153 of 361 (42.4 percent). Complications occurred in 143 flaps (39.6 percent) and included 37 partial losses (10.2 percent) and 31 total losses (8.6 percent). Injured recipient arteries [n = 62 (17.2 percent)] had more complications (p = 0.004); specifically, increased take-backs (p = 0.009). Decreasing vessel runoff increased the risk of complications (p = 0.025), take-backs (p = 0.007), and total flap failures (p = 0.024) accordingly. Specifically, among grade IIIB injuries, controlling for age, sex, time since injury, and vein number, single-vessel runoff was associated with higher rates of complications (relative risk, 3.07; p = 0.012), take-backs (relative risk, 3.43; p = 0.013), and total flap failures (relative risk, 4.80; p = 0.010) compared with three-vessel runoff. CONCLUSIONS: Arterial injury was common among Gustilo type IIIB patients and correlated with increased reconstructive complications. Nonischemic arterial injury appears to negatively impact reconstructive outcomes and should be accounted for when considering free tissue transfer for lower extremity salvage. The authors propose a 3-2-1 modification of the Gustilo type IIIB classification to incorporate degree of arterial injury, as it appears to add prognostic value and certainly influences the reconstructive plan. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, IV.
[Mh] Termos MeSH primário: Artérias/lesões
Fíbula/lesões
Fraturas Expostas/cirurgia
Retalhos de Tecido Biológico/transplante
Salvamento de Membro
Fraturas da Tíbia/cirurgia
Lesões do Sistema Vascular/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Artérias/cirurgia
Criança
Feminino
Fraturas Expostas/complicações
Fraturas Expostas/diagnóstico
Seres Humanos
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/cirurgia
Masculino
Meia-Idade
Artéria Poplítea/lesões
Artéria Poplítea/cirurgia
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Artérias da Tíbia/lesões
Artérias da Tíbia/cirurgia
Fraturas da Tíbia/complicações
Fraturas da Tíbia/diagnóstico
Índices de Gravidade do Trauma
Resultado do Tratamento
Lesões do Sistema Vascular/complicações
Lesões do Sistema Vascular/diagnóstico
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171026
[St] Status:MEDLINE
[do] DOI:10.1097/PRS.0000000000003766


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[PMID]:28904724
[Au] Autor:Osman W; Alaya Z; Kaziz H; Hassini L; Braiki M; Naouar N; Ben Ayeche ML
[Ad] Endereço:Department of Orthopedic Surgery, University College Hospital Sahloul, Tunisia.
[Ti] Título:Treatment of high-energy pilon fractures using the ILIZAROV treatment.
[So] Source:Pan Afr Med J;27:199, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:eng
[Ab] Resumo:The management of high-energy pilon fractures is still controversial. Open reduction and internal fixation are often associated with serious complications. Various methods have been used to treat these injuries, with variable results. The aim of this retrospective study was to analyze the clinical and radiographic outcome of the ILIZAROV technique in patients with high-energy pilon fractures. Thirty cases of distal tibia epiphysis fractures (pilon fractures) were managed from 1999 to 2012. The study group included 5 cases of open fractures. The mean age was 47 years. According to Rüedi and Algower classification; 11 fractures were type II, and 19 type III. All fractures were a consequence of high-energy trauma. Fractures of the lower fibula were present in 28 of the patients. An external Fixator was applied for open fractures. Closed injuries were operated on 3 to 13 days after injury, with an average of 8 days. The mean follow-up was 48 months. All fractures united. The external fixator was removed after a mean of 22 weeks (10 - 28 weeks). Two patients with a type III fracture had a delayed union and were treated with corticotomy and dynamisation of the ILIZAROV fixator. Only one secondary displacement of a type III fracture was noted after two months and was treated by adjuction of 2 olive wires. There were no cases of osteomyelitis or deep infections. Pin-tract infections occurred in ten patients. We had not any case of nervous injury due to introduction of the pins. Using radiological criteria for assessement of reduction of the articular fragments, there was excellent and good restoration of articular structure in 24 cases. The average American Orthopeadic Foot and Ankle Society ankle-hind foot score was excellent in 16, good in 6, fair in 6 and poor in 2. Soft tissue healing occurred without need for plastic surgery in all cases. The movements of the ankle ranged from 0 to 20° of dorsiflexion and 5° to 40° of plantar flexion. Twenty patients had gone back to their preinjury profession. The ILIZAROV technique is a safe and a very effective treatment for severe pilon fractures with minimum complications and good healing results.
[Mh] Termos MeSH primário: Articulação do Tornozelo/fisiopatologia
Fraturas Expostas/cirurgia
Técnica de Ilizarov
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Fios Ortopédicos
Fixadores Externos
Feminino
Fíbula/lesões
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Amplitude de Movimento Articular
Estudos Retrospectivos
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.199.11066


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[PMID]:28860406
[Au] Autor:Emori M; Kaya M; Irifune H; Takahashi N; Shimizu J; Mizushima E; Murahashi Y; Yamashita T
[Ad] Endereço:Sapporo Medical University School of Medicine, West 16, South 1, Chuo- ku, Sapporo, Hokkaido, 060-8543, Japan.
[Ti] Título:Vascularised fibular grafts for reconstruction of extremity bone defects after resection of bone and soft-tissue tumours : a single institutional study of 49 patients.
[So] Source:Bone Joint J;99-B(9):1237-1243, 2017 Sep.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aims of this study were to analyse the long-term outcome of vascularised fibular graft (VFG) reconstruction after tumour resection and to evaluate the usefulness of the method. PATIENTS AND METHODS: We retrospectively reviewed 49 patients who had undergone resection of a sarcoma and reconstruction using a VFG between 1988 and 2015. Their mean follow-up was 98 months (5 to 317). Reconstruction was with an osteochondral graft (n = 13), intercalary graft (n = 12), inlay graft (n = 4), or resection arthrodesis (n = 20). We analysed the oncological and functional outcome, and the rate of bony union and complications. RESULTS: Five- and ten-year overall survival rates were 89% and 86%, respectively. Local recurrence occurred in two patients. Eight patients developed pulmonary metastases. Bone union was achieved in 44 patients (90%). Fracture occurred in six patients (12%), infection in three (6%), and nonunion in five (10%). The mean Musculoskeletal Tumor Society (MSTS) scores were as follows: osteochondral graft 70%; intercalary graft 73%; inlay graft 89%; and resection arthrodesis 83%. CONCLUSION: Although associated with a relatively high rate of complications, each reconstruction method is useful, with a high rate of successful limb salvage and a good long-term functional outcome. Cite this article: 2017;99-B:1237-43.
[Mh] Termos MeSH primário: Neoplasias Ósseas/cirurgia
Fíbula/transplante
Ossos da Perna/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Sarcoma/cirurgia
Neoplasias de Tecidos Moles/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Neoplasias Ósseas/patologia
Criança
Feminino
Fíbula/irrigação sanguínea
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Recidiva Local de Neoplasia
Estadiamento de Neoplasias
Complicações Pós-Operatórias
Estudos Retrospectivos
Sarcoma/patologia
Neoplasias de Tecidos Moles/patologia
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170902
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B9.BJJ-2017-0219.R1


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[PMID]:28767568
[Au] Autor:Shen H; Shen XQ; Lv Y; Lu H; Xu JH; Wu SC
[Ad] Endereço:aDepartment of Hand Surgery and Microsurgery Center, The First Affiliated Hospital, College of Medicine, ZheJiang University bThe Children's Hospital, Zhejiang University School of Medicine cDepartment of Plastic Surgery, The First Affiliated Hospital, College of Medicine, ZheJiang University, HangZhou, ZheJiang Province, China.
[Ti] Título:Three-dimensional virtual planning in precise chimeric fibula free flap for metacarpal defects: A case report.
[So] Source:Medicine (Baltimore);96(31):e7364, 2017 Aug.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Metacarpal and phalanx defects with soft tissue loss were suggested to be reconstructed by vascularized bone flap. The fibular osteocutaneous flap is a preferred method. Three-dimensional virtual planning has successfully applied in mandibular reconstruction with fibular free flap. We applied three-dimensional virtual planning in precise fibula flap harvest to maintain the continuity of the fibula and to achieve accurate metacarpal and phalanx reconstruction. PATIENT CONCERNS: A 35-year-old male presented with extensive soft tissue defects and first metacarpal defect involving the first metacarpophalangeal joint. DIAGNOSES: There were 4 cm of first metacarpal defect involving the first metacarpophalangeal joint and soft tissue defects of 5cm × 3cm + 3cm × 2cm. INTERVENTIONS: By combining three-dimensional virtual planning, we harvested a chimeric fibular flap. The precise fibula partial osteotomies were performed with cutting guides designed in virtual planning. OUTCOMES: All the chimeric flaps survived and no significant donor-site morbidity was noted. Michigan Hand Outcome Questionnaire scores indicated acceptable functional results. LESSONS: Our preliminary experience with the approach of three-dimensional virtual planning in precise chimeric fibula free flap is practical and efficient. Although more cases and follow-up are needed to evaluate it, this approach is expected to benefit patients.
[Mh] Termos MeSH primário: Fíbula/transplante
Retalhos de Tecido Biológico
Ossos Metacarpais/diagnóstico por imagem
Ossos Metacarpais/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Cirurgia Assistida por Computador
[Mh] Termos MeSH secundário: Adulto
Lesões por Esmagamento/diagnóstico por imagem
Lesões por Esmagamento/cirurgia
Retalhos de Tecido Biológico/irrigação sanguínea
Traumatismos da Mão/diagnóstico por imagem
Traumatismos da Mão/cirurgia
Seres Humanos
Imagem Tridimensional
Masculino
Ossos Metacarpais/lesões
Procedimentos Cirúrgicos Reconstrutivos/métodos
Interface Usuário-Computador
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007364


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[PMID]:28678130
[Au] Autor:Houdek MT; Rose PS; Bakri K; Wagner ER; Yaszemski MJ; Sim FH; Moran SL
[Ad] Endereço:1Department of Orthopedic Surgery (M.T.H., P.S.R., K.B., E.R.W., M.J.Y., F.H.S., and S.L.M.) and Division of Plastic and Reconstructive Surgery (K.B. and S.L.M.), Mayo Clinic, Rochester, Minnesota.
[Ti] Título:Outcomes and Complications of Reconstruction with Use of Free Vascularized Fibular Graft for Spinal and Pelvic Defects Following Resection of a Malignant Tumor.
[So] Source:J Bone Joint Surg Am;99(13):e69, 2017 Jul 05.
[Is] ISSN:1535-1386
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Following resection of malignant tumors of the spine and pelvis, reconstructive surgeons often face large structural defects. Unlike reconstruction in the extremities, wherein a free vascularized fibular graft (FVFG) is a highly utilized option for segmental osseous reconstruction, there are limited data on the use of an FVFG in the spine and pelvis. The aim of this study was to review our institution's experience with reconstruction with use of an FVFG following oncological resection in the spine and pelvis. METHODS: We reviewed 24 cases involving the use of an FVFG in reconstruction of segmental osseous defects of the spine and pelvis following oncological resection from 2000 to 2015. The cohort consisted of 12 male and 12 female patients with a mean age of 37 years and a mean follow-up of 5 years. Fifty-four percent of the reconstructions were spinopelvic or sacropelvic. RESULTS: The overall 2, 5, and 10-year rate of survival was 76%, 55%, and 37%, respectively. With regard to disease-free survival, the overall 2, 5, and 10-year rate was 81%, 72%, and 48%. The overall rate of union was 86%, with a mean time to union of 7 months. Complications were common, with 83% of the patients sustaining at least 1 postoperative complication. Following the procedure, the mean Musculoskeletal Tumor Society rating was 53%. CONCLUSIONS: An FVFG provides a durable means of reconstruction of osseous defects in the spine and pelvis. Although patient function was acceptable following these large reconstructions, the rate of postoperative complications was high. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
[Mh] Termos MeSH primário: Neoplasias Pélvicas/cirurgia
Neoplasias da Coluna Vertebral/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Autoenxertos
Transplante Ósseo/métodos
Feminino
Fíbula/transplante
Seguimentos
Sobrevivência de Enxerto
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Reconstrutivos/métodos
Estudos Retrospectivos
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170825
[Lr] Data última revisão:
170825
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170706
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.16.01458


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[PMID]:28600917
[Au] Autor:Liang Y; Jiang C; Wu L; Wang W; Liu Y; Jian X
[Ad] Endereço:Surgeon-in-Charge, Department of Oral Maxillofacial Surgery, Xiangya Hospital, Central South University, Changsha, China.
[Ti] Título:Application of Combined Osteotomy and Reconstruction Pre-Bent Plate Position (CORPPP) Technology to Assist in the Precise Reconstruction of Segmental Mandibular Defects.
[So] Source:J Oral Maxillofac Surg;75(9):2026.e1-2026.e10, 2017 Sep.
[Is] ISSN:1531-5053
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To introduce and evaluate the clinical effects of digital surgical guide plate technology in the combined osteotomy and reconstruction pre-bent plate position (CORPPP) technique during mandibular segmental resections. MATERIALS AND METHODS: Seven cases of mandibular segmental resection with simultaneous vascularized free fibula flap reconstruction by oral and maxillofacial surgery were selected (Xiangya Hospital, Changsha, China; June 2015 through December 2015). Cone-beam computed tomographic (CBCT) and spiral CT scans of mandibles and fibular donor sites, respectively, were collected. Surgical simulations were conducted after data collection. Pre-bent titanium plates were placed within the predicted mandibular models. The samples were scanned by CBCT to obtain the positional relations. Then, CORPPP surgical guide plates with location holes were designed and fabricated on pre-bent titanium plates. The CORPPP surgical guide plates were applied in osteotomy and the placement of pre-bent titanium plates during surgery. CBCT scans were obtained 2 weeks after surgery to examine the reconstructed composite models composed of mandibles and titanium plates. Then, the scans were compared with the preoperatively designed models. In addition, the deviation of the integral and characteristic structure loci was analyzed. RESULT: The 7 cases with placed pre-bent titanium plates exhibited good recovery in occlusal relations and the contour of the reconstructed mandibles. The absolute deviations in the integral analysis were 0.89 ± 0.96 mm (mandibles) and 0.33 ± 0.36 mm (titanium plates). The absolute deviations on the diseased side were 1.78 ± 0.35 mm (condylar head), 2.43 ± 0.29 mm (gonion), 2.22 ± 0.22 mm (gnathion), and 2.66 ± 0.36 mm (mesial inferior margin of the fibula). CONCLUSION: The results of this study suggest that mandibular segmental resections and the precise orientation of pre-bent titanium plates could be simultaneously assisted by CORPPP digital surgical guide plates. The use of these guide plates should be expanded.
[Mh] Termos MeSH primário: Placas Ósseas
Reconstrução Mandibular/métodos
Osteotomia/métodos
[Mh] Termos MeSH secundário: Adulto
Idoso
Tomografia Computadorizada de Feixe Cônico
Feminino
Fíbula/transplante
Seres Humanos
Masculino
Reconstrução Mandibular/instrumentação
Meia-Idade
Osteotomia/instrumentação
Desenho de Prótese
Cirurgia Assistida por Computador/métodos
Retalhos Cirúrgicos
Titânio
Tomografia Computadorizada por Raios X
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
D1JT611TNE (Titanium)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:AIM; D; IM
[Da] Data de entrada para processamento:170611
[St] Status:MEDLINE


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[PMID]:28552927
[Au] Autor:Marvan J; Horak Z; Vilimek M; Horny L; Kachlik D; Baca V
[Ad] Endereço:Department of Orthopedics and Traumatology, Third Faculty of Medicine, Charles University, Ruska 87, 10000 Prague, Czech Republic.
[Ti] Título:Fixation of distal fibular fractures: A biomechanical study of plate fixation techniques.
[So] Source:Acta Bioeng Biomech;19(1):33-39, 2017.
[Is] ISSN:1509-409X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:Ankle fractures are complex injuries with variable prognoses that depend upon many factors. The aim of the treatment is to restore the ankle joint biomechanical stability with maximum range of motion. Most ankle fractures are fibular fractures, which have a typical oblique fracture line in the distal fibula located in the area of the tibiofibular syndesmosis. The aim of this study was to simulate numerically several fixation techniques of the distal fibular fractures, evaluate their stability, determine their impact on surrounding tissue load, and correlate the results to clinical treatment experience. The following three models of fibular fracture fixation were used: (a) plate fixation with three screws attached above/below and lag screws, (b) plate fixation with two screws attached above/below and lag screws, and (c) three lag screws only. All three fracture fixation models were analyzed according to their use in both healthy physiological bone and osteoporotic bone tissue. Based on the results of Finite Element Analysis for these simulations, we found that the most appropriate fixation method for Weber-B1 fibular fractures was an unlocked plate fixation using six screws and lag screws, both in patients with physiological and osteoporotic bone tissue. Conversely, the least appropriate fixation method was an unlocked plate fixation with four screws and lag screws. Although this fixation method reduces the stress on patients during surgery, it greatly increased loading on the bone and, thus, the risk of fixation failure. The final fixation model with three lag screws only was found to be appropriate only for very limited indications.
[Mh] Termos MeSH primário: Fraturas do Tornozelo/fisiopatologia
Fraturas do Tornozelo/cirurgia
Placas Ósseas
Fíbula/lesões
Fíbula/fisiopatologia
Fixação Interna de Fraturas/instrumentação
Modelos Biológicos
[Mh] Termos MeSH secundário: Força Compressiva
Simulação por Computador
Análise de Falha de Equipamento
Fíbula/cirurgia
Fixação Interna de Fraturas/métodos
Fricção
Seres Humanos
Desenho de Prótese
Estresse Mecânico
Resistência à Tração
Resultado do Tratamento
Suporte de Carga
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170530
[St] Status:MEDLINE



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