Cases reported "Necrosis"

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21/36. vasculitis presenting as chronic unilateral painful leg swelling.

    We describe 2 patients who presented with chronic painful indurated swelling of one lower limb, thought at the time of referral to be due to chronic venous insufficiency. Reassessment because of marked periostitis of the tibia and fibula as well as laboratory indices consistent with an inflammatory process revealed acute necrotizing arteritis in one patient and granulomatous arteritis in the other. Clinicians should be aware of this unusual presentation of treatable vasculitic diseases.
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ranking = 1
keywords = tibia
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22/36. Compartment syndrome with muscle necrosis following repair of hernia of tibialis anterior. Case report.

    Repair of a hernia of m. tibialis anterior was followed by acute compartment syndrome with complete muscular necrosis. If surgical treatment of a muscle hernia is found to be justified, it should consist of fasciotomy and not closure of the fascial defect.
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ranking = 5
keywords = tibia
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23/36. Compartment syndrome as a complication of the Hauser procedure.

    A compartment syndrome developed in eleven patients who had undergone the Hauser procedure. The residual disabilities ranged from mild weakness and contracture of the muscles in the anterior compartment of the leg to complete muscle necrosis necessitating above-the knee amputation in two patients. Dissections of ten cadaver limbs demonstrated that the anterior tibial recurrent vessels have numberous leash-like branches that terminate along the lateral border of the tibial tubercle. When these vessels are sectioned they retract laterally and distally under the fascia and within the muscles of the anterior compartment. It is postulated that continued postoperative bleeding from these vessels after the Hauser procedure may lead to an ischemic compartment syndrome in the leg.
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ranking = 2
keywords = tibia
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24/36. Management of open tibial fractures.

    A prospective study was undertaken to accurately classify open tibial fractures and to evaluate the benefit of muscle flaps in the management of these injuries. From 191 open tibial fractures, 59 type III and 14 type IV open fractures were identified and managed prospectively. Fractures managed with open-wound techniques have a much higher complication rate than those closed with flaps. Results with flap coverage are affected by the biologic phase of the wound. The best results are seen in the acute flap coverage group and are thought to be secondary to removal of devitalized tissue with provision of a vascularized soft-tissue envelope prior to wound colonization. Flap coverage of the colonized subacute wound is subject to invasive infection with additional tissue loss. The subacute wound should be managed with open-wound technique until the parameters of a chronic localized wound are established, at which time flap coverage is again indicated. Microvascular free flaps are the preferred cover for type IV wounds because the local tissues are too ischemic and devitalized for transfer. With meticulous wound care and adherence to the enumerated surgical procedures, limb salvage may be achieved in most injuries.
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ranking = 6
keywords = tibia
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25/36. A case of tibial fracture with skin loss and bone infection treated by Papineau's method.

    A case of open fracture of the tibia with skin loss and osteitis is reported. It was successfully treated by Papineau's method, which deals with the infection and bone loss before restoring the skin cover.
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ranking = 5
keywords = tibia
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26/36. Chronic anterior tibial compartment syndrome. A light-microscopic, histochemical and electronmicroscopic analysis.

    A case of chronic anterior tibial compartment syndrome is reported where the entity was accompanied with a primary neurogenic type of muscle atrophy. histology, histochemistry and electronmicroscopy indicated the diagnosis. The authors concluded that in a moderate case of leg trauma with peroneal nerve involvement, when it is complicated by intermittent arterial spasm, the anterior tibial compartment syndrome may develop chronically.
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ranking = 6
keywords = tibia
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27/36. Spontaneous rupture of the posterior tibial tendon secondary to chronic nonspecific tenosynovitis.

    Presented is a case history of complete rupture of the posterior tibial tendon and its subsequent surgical repair. Treatment included tendon repair followed by physical therapy and orthotic devices. Nine months after repair the patient was experiencing considerably reduced symptomatology but demonstrated significant posterior tibial muscle weakness and moderate subtalar joint pronation with forefoot abduction, with the deformity appearing to progress. This may indicate the need for additional surgical procedures to halt progression and lessen the chance of persistent pronation deformity.
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ranking = 6
keywords = tibia
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28/36. knee salvage utilizing the myocutaneous principle.

    Two cases are presented to illustrate the potential for knee salvage in popliteal artery occlusion from plateau fracture. In both cases, the time interval from injury to exploration precluded revascularization of the lower leg. Because of the necrosis of the deep leg muscles and the nonvital nature of the foot, amputation was required. Careful evaluation of the myocutaneous circulation of the gastrocnemius skin island provides a means of knee salvage. Extensive debridement, salvage of the tibial fragment as a bone graft, and coverage with the vital gastrocnemius and its skin provide a functioning below-the-knee stump that can be fitted with a prosthesis. In this way, a more satisfactory functional result and rehabilitation can be obtained than with an above-the-knee amputation.
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ranking = 1
keywords = tibia
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29/36. Management of massive defects in radius and ulna following wringer injury. A case report.

    An unusual case of wringer injury in a 29-month-old child demonstrates extensive loss of the diaphysis of both the radius and ulna. Reconstruction consisted of cortico-cancellous autogenous tibial bone grafting of the radius and ulna in two stages. Follow-up of 24 years showed remodeling and good alignment of the entire radius and ulna, culminating in a good functional and cosmetic result. Extensive soft tissue damage and decreased blood supply result in bone necrosis. There is no reason to bone graft the radius and ulna at the same time.
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ranking = 1
keywords = tibia
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30/36. pyoderma-gangraenosum-like ulcers associated with lupus anticoagulant.

    A 45-year-old women presented with a deep ulcerative lesion of the left breast. Two months later, a new cutaneous necrotic lesion located in the right pretibial areas was observed. The only serum abnormality was the presence of circulating lupus anticoagulant. Clinical features suggested the diagnosis of pyoderma gangraenosum and histologic examination showed microthrombosis in the dermal capillary vessels adjacent to a dense, mixed inflammatory infiltrate with some degree of vascular damage. Although thrombosis may be the result of vasculitis, it is likely that in our patient the presence of a lupus anticoagulant activity played a role in the pathogenesis of the cutaneous ulcers.
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ranking = 1
keywords = tibia
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