1,721,186 research outputs found
Severe Forearm Osteomyelitis Management with Microvascular Fibular Flaps
No full textSevere infections at the forearm level are difficult to treat not only in terms of sterilization but also in terms of functional restitution. Traditional radical debridement is very important, and sometimes the reconstruction of the excised tissues it s difficult with conventional techniques. At the forearm level, local flaps generally are not sufficient in covering big defects. Conventional bone grafts may be resorbed or they cannot help healing when placed in infected and hypovascular tissue bed. Therefore, bone reconstruction is a real challenge. Development of microsurgical techniques has increased the possibilities of treatment when those severe infections occur. Re- construction of large soft tissue defects can be achieved by choosing the appropriate free flap. Vascularized fibular grafts allow the use of a segment of diaphyseal bone which is structurally similar to the radius and the ulna, and of length that would suffice to reconstruct most skeletal defects. In the upper limbs the vascularized fibular graft is indicated for patients in whom conventional bone grafting has failed or large bone defects are p- resent (extending beyond 5 cm). When contemporary soft tissue reconstruction is needed, the fibula may give osteocutaneous and osteomyocutaneous grafts to be transferred. We report the results of a series of 22 cases of severe chronic osteomyelitis of the radius and/or the ulna treated with free vascularized fibula bone grafts. All patients were reviewed at a mean follow-up of 3 years (10-93 months); in all cases the infection never re- curred.We report only one bone resorption, in the case of a double-barrel fibular transfer, which probably oc- curred due to vascularization failure. Even in this case, the patient was able to resume previous occupation
Manuale di microchirurgia. Dalle tecniche di base a quelle avanzate
No full textManuale di microchirurgia. Dalle tecniche di base a quelle avanzat
Response to "The ulnar palmar perforator flap: Anatomical study and clinical application"
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Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
The little finger ulnar palmar digital artery perforator flap: anatomical basis
Full text linkPURPOSE:
The aim of this study was to explore the cutaneous vascularization of the hypothenar region and investigate the anatomical basis for perforator propeller flaps for coverage of the flexor aspect of the little finger.
METHODS:
The area between the pisiform and the base of the little finger was studied in 14 hands of fresh cadavers injected with red latex. An oval flap 1.5 cm large was raised along the axis between these two points. Perforators going into the flap were dissected up to their origin from the ulnar palmar digital artery of the little finger, and their distance from the proximal edge of the A1 pulley was recorded.
RESULTS:
The mean number of perforator arteries entering the flap was 5.8 (range 4-8). A constant sizeable perforator was identified within 0.7 cm from the proximal margin of the A1 pulley in all 14 specimens. In the majority of cases (64 %), the most distal perforator was located at this level. Dissection of the flap was carried out suprafascially on the most distal perforator and 180° rotation allowed the flap to reach the flexor surface of the fifth finger. The donor site was closed primarily.
CONCLUSION:
Distal perforators of the ulnar palmar digital artery of the little finger are constantly found. Our anatomical findings support the possibility of raising a propeller perforator flap from the hypothenar region for coverage of the flexor aspect of the little finger. Its clinical application could provide a quick and straightforward single-stage option with a negligible donor-site morbidity for reconstruction of such defects
Microsurgery in bone and soft tissues tumors
No full textSoft tissue and bone sarcomas include more than 50 distinct heterogeneous histologic subtypes of mesenchymal origin which are classified based on the histological and genetic features of the mature tissue they most resemble. Overall, they are very rare tumors whose incidence is estimate between 4-5 and 1 per 100, 000 per year, for soft tissue and bone sarcomas, respectively. They make up for approximately 1% of all malignancies and about 50% to 60% of sarcomas occur in the extremities. The aim of the article was to provide an overview on the main sarcoma affecting the limb with the principles of reconstructive microsurgery both for bone and soft tissues
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