1/13. Myofasciocutaneous expansion in the tegumentary rehabilitation of the amputation stump.In post-traumatic amputations, in particular in leg amputations, the presence of an unstable scar or of ulcerous areas that are difficult to heal in the site of the amputation stump constitutes a repair problem that is not easily solved. In this specific field of reconstruction skin expansion has earned significant agreement, and is even considered to be a safe and reliable method for the surgical rehabilitation of the amputation stump, allowing us to obtain high-quality tegumentary covering, with no excessive thickness, that adapts well to the prosthesis and to the underlying skeleton, and that is characterized by good sensitivity of protection. Tegumentary amplification may, in some cases, also become myocutaneous, allowing us to obtain more tissue thickness for protection in patients submitted to chronic loading that lasts longer and in those with thin teguments, in which traditional expansion could determine excessive narrowing of the tegumentary covering, following atrophy caused by compression of the subcutaneous adipose tissue.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
2/13. Osseous overgrowth after post-traumatic amputation of the lower extremity in childhood.Severe accidents in children may cause extreme destruction of the lower extremities. In some cases, there is no possibility to preserve the limbs. Initially, a weight-bearing stump cannot be achieved after amputation due to unstable local and soft tissue conditions. This critical situation is often complicated by one of the leading problems in the limb-deficient child - the development of osseous overgrowth. Bizarre overgrowth of the stump may lead to skin perforation, pressure ulcers, and difficulties with the prosthesis. Since 1993, we have been able to follow five pediatric and adolescent patients (2 years to 17 years old) with six post-traumatic amputations of the lower extremities. Four of these cases developed osseous overgrowth. One child treated with initial autologous stump-capping had excellent soft tissue conditions and no problems with the artificial limb. We also report on a case of bizarre and extensive new bone formation. We conclude that close follow-up visits after post-traumatic amputations in children are essential because of new bone formation which may endanger the soft tissue situation of the stump. Unfortunately, surgical revisions have to be performed quite often. To avoid several surgical corrections, an initial stump-capping with autologous material from the injured limb can be performed. Thus, the number of secondary procedures may be reduced drastically.- - - - - - - - - - ranking = 6keywords = post-traumatic (Clic here for more details about this article) |
3/13. Salvage of major amputation stumps of the lower extremity with latissimus dorsi free flaps.In some severe lower limb injuries, the level of bone trauma enables preservation of the knee joint or adequate length of the femoral stump only if the soft tissues can be reconstructed over the exposed bone. The options for soft-tissue reconstruction of an amputation stump are to use a flap from the amputated distal part, a local flap possibly after tissue expansion or a free flap. To preserve an adequate length of stump we reconstructed 10 stumps with latissimus dorsi free flaps: above the knee in one patient and below the knee in nine. The reconstructions were done during an acute post-traumatic phase in five and for late problems with the stump in four patients. In one patient the reconstruction was done nine weeks after a below-knee amputation for ischaemic necrosis after septicaemia. All flaps survived, but the venous anastomosis had to be revised in three patients in the early postoperative period. All patients regained adequate ambulation for their daily activities. The flap was secondarily debulked in three patients. Every effort should be made to preserve an adequate stump length, particularly in young patients with crushing injuries of the extremities and when there is severe or recurrent late stump ulceration. A latissimus dorsi musculocutaneous soft-tissue reconstruction is a reliable and durable option for stump defects.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
4/13. clostridium septicum bacteremia without gas gangrene as a late consequence of a contaminated wound.BACKGROUND: clostridium septicum is an unusual human pathogen associated with colorectal malignancy and gas gangrene. methods: A case compilation and literature review are presented. RESULTS: We report the case of an individual with a comminuted tibial fracture complicated by a superficial surgical site infection with C. septicum nine weeks after the original injury and internal fixation, which was complicated by a secondary bacteremia. CONCLUSIONS: This is a unique case in the literature, but it is suggested that the use of cephalosporins as prophylaxis for contaminated wounds may be inferior to penicillins to prevent clostridial infections.- - - - - - - - - - ranking = 0.00014609694531191keywords = malignancy (Clic here for more details about this article) |
5/13. delayed diagnosis of post-traumatic arteriovenous fistula from trip wire-detonated booby trap in vietnam.Traumatic arteriovenous fistulas are very common, especially with penetrating injuries. Undiagnosed traumatic arteriovenous fistulas for long periods, as in this case, however, are less frequent because the patient often experiences clinical manifestations associated with arteriovenous shunting. This patient denied any history of problems that might be associated with this arteriovenous shunting. He was operated on for the arteriovenous fistula and had an uneventful postoperative course.- - - - - - - - - - ranking = 4keywords = post-traumatic (Clic here for more details about this article) |
6/13. bowen's disease arising in a scar--a case report and review of the relationship between trauma and malignancy.A 55-year-old female presented with a 1-year history of bowen's disease on the leg at the site of a scar from an injury that occurred at 5 years-of-age. The clinical features in this case suggest a causal relationship, although trauma may have been acting as a co-carcinogenic factor to an unknown primary-cause. The relationship between trauma and malignancy is reviewed and proposals for further investigation are discussed.- - - - - - - - - - ranking = 0.00073048472655953keywords = malignancy (Clic here for more details about this article) |
7/13. magnetic resonance imaging of a post-traumatic arteriovenous fistula in the lower extremity.Currently, magnetic resonance (MR) is most useful as a means of providing distinct images of gross abnormalities in major blood vessels. While new advances and further refinements will continue, MR has proven its value as a convenient and effective diagnostic tool for the recognition and delineation of vascular abnormalities, such as acquired arteriovenous fistulae (AVFs). We report a case of a chronic, post-traumatic AVF, in which MR angiography provided excellent anatomic detail and angiographic correlation.- - - - - - - - - - ranking = 5keywords = post-traumatic (Clic here for more details about this article) |
8/13. Traumatic pseudoaneurysm of the anterior tibial artery simulating soft tissue malignancy.Two patients presenting with false aneurysm of the anterior tibial artery are illustrated. Presentation was remote from the time of trauma and the diagnosis of neoplasm was initially considered in both because of the bony and soft tissue changes. The purpose of this report is to bring attention to the possibility of delayed vascular injury simulating tumor by describing the radiographic features of these two proven cases.- - - - - - - - - - ranking = 0.00058438778124763keywords = malignancy (Clic here for more details about this article) |
9/13. Controlled environment treatment for limb surgery and trauma (a preliminary report).This paper demonstrates a new approach to postsurgical and post-traumatic wound management in the lower limbs. Our own results of 20 below-knee amputations are documented. A less detailed report is then given of experience with an additional 20 amputees: this second group includes experience not only here at Seattle but at five other centers in the united states. The same method for wound management and for control of edema was employed in all cases. The method, Controlled environment Treatment (CET), uses filtered air as a dressing medium, with a control console to maintain the pressure, constant or varying, according to a preset program. temperature and humidity are also controllable, as is gas composition. The limb, together with its controlled environment, is contained with a pliable, transparent, treatment bag, which permits inspection and palpation of the wound site without disturbing the bacteriologically sterile air within the chamber. A special seal reduces air leakage yet avoids constriction of the limb. This CET system was originally developed by the Department of health and social security, Biomechanical research and Development Unit, Roehampton, england. Subsequent developments are also noted of an improved Mark II CET Unit and of simpler, related, management systems for conditions not requiring sterile environments.- - - - - - - - - - ranking = 1keywords = post-traumatic (Clic here for more details about this article) |
10/13. Psychosomatic treatment of phantom limb pain with post-traumatic stress disorder: a case report.The successful treatment of severe left lower limb phantom pain is reported. hypnosis and antidepressant drugs were the basis for the treatment which controlled the phantom limb pain and an associated post-traumatic stress disorder.- - - - - - - - - - ranking = 5keywords = post-traumatic (Clic here for more details about this article) |
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