Pelvic discontinuity in revision total hip arthroplasty presents problems with component fixation and union. A construct was proposed based on bicolumnar fixation for transverse acetabular fractures. Each of 3 reconstructions was performed on 6 composite hemipelvises: (1) a cup-cage construct, (2) a posterior column plate construct, and (3) a bicolumnar ...

ABSTRACT: An essential step in the navigation procedure is the recording of markers required for the triangulation of the intraoperative navigation system. The aim of this study was to describe the procedure and preliminary results of a simple methodology for the application of dental markers to achieve good triangulation of ...

This study examined the fatigue behavior of 2 types of nickel-titanium (NiTi) instruments made from a novel controlled memory NiTi wire (CM wire) under various environment conditions. Three conventional superelastic NiTi instruments of ProFile (Dentsply Maillefer, Ballaigues, Switzerland), Typhoon (Clinician's Choice Dental Products, New Milford, CT), and DS-SS0250425NEYY (Clinician's Choice ...

Objective: Basal joint arthritis is a common cause of pain and disability, particularly in elderly women. Corticosteroid injection with splinting provides a reliable long-term relief for patients with mild arthritis. Proper location of the basal joint with anatomic landmarks can facilitate diagnosis and treatment of basal joint arthritis while avoiding ...

OBJECTIVE: Decreased bone mineral density has been implicated in schizophrenic patients for long years. The purpose of this study was to assess the relationship between bone mass and prolactin levels in schizophrenic patients. METHODS: In this study, bone mass was measured using quantitative ultrasound densitometry of the calcaneus in 114 ...

Chronic tibial subluxation is a rare and complicated problem that requires careful evaluation and planning to achieve the desired outcome and patient satisfaction. Reconstruction of catastrophic knee injury requires obtaining a balance in 2 opposing goals: stability and range of motion. Complete understanding of the impact of each of the ...

Combined anterior cruciate ligament, posterior cruciate ligament, and lateral-sided injuries of the knee most often occurs secondary to a forced varus moment or after knee dislocation. Management controversies include the optimal timing of surgery, operative techniques, and postoperative rehabilitation. Recent systematic literature reviews have demonstrated higher rates of failure with ...

We present a review of the literature looking at the anatomy of the Anterior Cruciate Ligament, the biomechanical aspects of ACL reconstruction, review the outcomes of single and double bundle ACL reconstruction and present the current techniques for anatomic single bundle reconstruction.

Diagnosis and management of multiple-ligament knee injuries has evolved over the years, and now treatment often includes surgical intervention. Rehabilitation after multiple-knee ligament reconstruction requires a precarious balance between restoring range of motion and function to the knee without compromising the static stability and integrity of the grafted tissues. It ...

The anterior cruciate ligament (ACL) consists of two primal functional bundles, anteromedial bundle and posterolateral bundles. Those two bundles play different functional roles and contribute differently to knee stability throughout the range of motion. Recent advancement in studies of anatomy and biomechanics of ACL has led surgeons to perform double-bundle ...

KD-IIIM knee injuries are challenging injuries that can do well when anatomic reconstruction techniques are used. This article describes the authors preferred reconstructions, timing of surgery, and rehabilitation techniques. The reconstructions are generally initiated 3 or 4 weeks after the injury when the local soft tissue injury allows and associated ...

Recurrent dislocation secondary to posterior soft tissue deficiency is a challenging complication of total hip arthroplasty. We describe the use of an Achilles allograft sling to improve hip stability. Eight patients treated with the sling were followed an average of 5 years. Seven patients had no recurrent instability and good ...

STUDY DESIGN: Retrospective case series. OBJECTIVE: To evaluate the outcome of treating acute thoracolumbar burst fractures using anterior corpectomy and reconstruction with a mesh cage and instrumentation. SUMMARY OF BACKGROUND DATA: There is increasing interest in using an anterior mesh cage with instrumentation after corpectomy for burst fractures. However, there ...

BACKGROUND: Deformities of the external valve (lateral crus) are an occasional problem following rhinoplasty. One of the most notable problems is when the posterior aspect of the lateral crus curls around into the vestibule. It not only obstructs the airway but can be aesthetically displeasing to the patient. Traditional correction ...

Wide, complex defects of the scalp caused by various insults always represent reconstructive challenges for surgeons. Our study group consisted of 18 patients (14 males and 4 females) with a mean age of 40.2 years. Nineteen free-tissue transfers were used to reconstruct the scalp defects. The selected cases included 8 ...

OBJECTIVES:: Defects of the scalp and lateral temporal bone (LTB) represent a unique challenge to the reconstructive surgeon. Simple reconstructive methods such as skin grafts, locoregional flaps, or tissue expanders are often not feasible owing to a myriad of reasons. Vascularized free tissue transfer coverage offers distinct advantages in managing ...

We present a 10-year retrospective study at a tertiary center designed to evaluate the advantages, complications, and comparative results using lateral circumflex femoral artery (LCFA) system free flaps for cranial base reconstruction. In this study, a cranial base defect refers to exposed intracranial contents to the skin, paranasal sinuses, nasopharynx, ...

OBJECTIVE:: Regional vascularized flaps, such as the pericranial and temporoparietal fascia flaps, are currently used for reconstruction of skull base defects after endoscopic endonasal surgery whenever local vascularized flaps, such as the nasoseptal flap, are not available. Two different transposition pathways, infratemporal transpterygoid and subfrontal, have been proposed for regional ...

One of the major challenges of cranial base surgery is reconstruction of basal dural defects. Ineffective reconstruction may result in potentially life-threatening complications such as cerebrospinal fluid leak, meningitis, and tension pneumocephalus. Goals of reconstructive procedures are to repair the dural defect and to separate intracranial contents from bacteria-laden secretion ...

Reconstruction of defects of the cervical esophagus is a challenge in head and neck surgery. Several methods have been used: flaps with local tissues, pharyngogastric anastomosis, deltopectoral skin flaps, skin muscle transplant from the pectoralis major, and microvascularized free skin fascial and small intestine flaps. A 81-year-old patient who has ...

INTRODUCTION:: In 1997, Morykwas et al introduced negative pressure dressings to manage complicated wounds; since its introduction, the vacuum-assisted closure (VAC) system has been successfully used in the fields of general surgery, orthopedic surgery, plastic surgery, and gynecology. Recently, some authors described this technique to manage complex wounds in the ...

Arteriovenous malformations (AVMs) are uncommon errors of vascular morphogenesis. Hemodynamically, they are high-flow lesions. Approximately 50% of AVMs are located in the craniofacial region. The successful treatment of vascular anomalies depends on the profound knowledge of the biologic behavior of vascular lesions and their correct classification. Vascular malformations that persist ...

We describe the procedure for reconstruction of a defect on the buccal mucosa and the prolabium with a buccal mucosal transposition flap and an artificial dermis graft. The preparation of the flap started with an incision extending from the border of the defect to the corner of the mouth. The ...

PURPOSE OF REVIEW: The corneal flap laser in-situ keratomileusis (LASIK) is among the most important determinants in the successful outcome of the surgery. Femtosecond lasers have evolved over the last decade to all but replace the mechanical microkeratome as the preferred method to create these flaps. With improvements in femtosecond ...

BACKGROUND: Meniscal tears often occur in association with anterior cruciate ligament (ACL) lesions or in chronically lax knees. It is also known that meniscal repairs are less likely to heal in ACL-deficient knees. PURPOSE: To test the effect of different knee joint motion and loading conditions on the gapping behavior ...

PURPOSE: An extensive traumatic defect at the level of the proximal phalanx of the thumb presents difficulty in replantation. We report bilobed second dorsal metacarpal artery-based island flap harvested from both the index and middle fingers for reconstruction of the defect and preservation of the normal thumb length. METHODS: From ...

Introduction: Post-traumatic ear reconstruction still remains a great challenge for plastic surgeons. In this article, we present the technique of post-traumatic ear reconstruction using a postauricular fascial flap combined with an expanded skin flap. Methods: From May 2007 to June 2009, 91 cases of post-traumatic ear defect were treated using ...

Reconstruction of the anterior cruciate ligament is a frequently performed procedure that has had outstanding results. Outcomes are dependent upon an early postoperative physical therapy program that stresses early motion. Early rehabilitation demands rigid intraoperative mechanical fixation of the graft since therapy begins before biologic incorporation of the graft in ...

BACKGROUND:: A lower abdominal midline scar is known to restrict the amount of tissue that can be included in a deep inferior epigastric perforator (DIEP) flap. However, reconstructive demands have occasionally led us to include substantial territory beyond the scar. The purpose of this study is to review our experience ...

The anterolateral thigh (ALT) flap has been used to cover defects between the proximal third of the leg and lower abdomen, and with modification, may cover epigastric defects. We used the ALT flap to cover a full-thickness defect of over half the anterior abdominal wall. We conclude that abdominal wall ...

We report the use of a transposition flap raised from the dorsum of the proximal phalanx for coverage of soft tissue defects on the dorsum of the middle phalanx and proximal interphalangeal joint involvement. From October 2005 to November 2008, we treated 16 digits in 16 patients in our unit. ...

The introduction of the pedicled nasoseptal flap (NSF) has decreased postoperative cerebrospinal fluid (CSF) leak rates from >20% to <5% during expanded endoscopic skull base surgery. The NSF must be raised at the beginning of the operation to protect the posterior pedicle during the expanded sphenoidotomy. However, in most pituitary ...

Dorsal reduction (humpectomy) is a simple maneuver in principle, yet it commonly results in irregularities and general inaccuracies, along with occasional internal valve compromise. Traditionally, spreader grafts have been applied to reconstruct an internal valve disrupted during dorsal reduction. Imbricating the dissected ends of the upper lateral cartilages at their ...

: Reconstruction of large defects in the temporal region can be performed with skin grafts or pedicled or free flaps. Results are often not optimal because of the patch of a skin graft, lack of availability of local flaps, and distant skin from free flaps. A technique for reconstruction of ...

End-stage elbow arthritis in young, active patients presents a challenging problem to the upper extremity surgeon. Total elbow arthroplasty is not a viable option in this population because of functional restrictions, limited implant survivorship, and the lack of an adequate salvage option. With the appropriate surgical indication, interposition arthroplasty can ...

A recent randomized controlled trial compared early anterior cruciate ligament reconstruction with a program of initial rehabilitation, with delayed anterior cruciate ligament reconstruction if needed. The authors reported that the improvement in Knee Injury and Osteoarthritis Outcome Scores was nearly identical in both groups and concluded that in young, active ...

: Detailed knowledge of the vasculature of the medial aspect of the foot has rarely been reported, but it is of tremendous importance for harvesting the flap in this area to cover defects of the foot and hand. Repair of soft-tissue defects at the dorsal forefoot remains a challenge in ...

The purpose of this study was to describe a one-stage operation for posterior cruciate ligament reconstruction with use of an Achilles tendon-bone allograft and a posterolateral corner reconstruction with use of two different methods, with a comparison of clinical outcomes in the two groups. Our study included forty-six patients who ...

: In craniofacial microsomia, patients with severely hypoplastic mandibles (Pruzansky type III) require replacement of the ramus and condyle unit. Autogenous costocartilaginous rib graft and distraction osteogenesis are the most important techniques used, but long-term results need to be looked at to determine optimal management. : Of the 485 patients ...

We present the anatomic and cadaveric foundations for novel modifications of the occipital galeopericranial flap for reconstruction of ventral skull base defects. Anatomic description. Using cadaveric dissections and measurements, we investigated the feasibility of transposing pedicled occipital galeopericranial flaps into the nasal cavity and skull base. Two fresh and five ...

Elbow arthrodesis (EA) is a procedure reserved for the salvage of failed elbow reconstruction or elbow injuries that defy reconstruction of a useful joint. Although arthrodesis of some joints is often straightforward and predictable, EA is technically difficult and associated with a high rate of complications. Furthermore, a successful EA ...

: Vulvar defects after tumor extirpation always require immediate reconstruction. Transferring a skin flap from a distant region may be required for large defects. Although the anterolateral thigh flap has gained popularity in other types of oncoplastic surgery, it has rarely been reported for vulvar reconstruction. The aims of this ...

Chondrocutaneous (ChC) grafts have been used for nasal alar reconstruction for years. One of the consequences for using these grafts is the restriction in dimensions. In this study, we presented our results in which ChC grafts bigger than 20 mm in length have been used in conjunction with a dermal ...

Medial column fusion is becoming increasingly popular for flatfoot reconstruction. The authors describe a new technique for medial column arthrodesis via tension band mesh plating. Plating on the tension side would provide dynamic compression of the arthrodesis sites via weightbearing. This technique may be useful to allow patients to bear ...

PURPOSE: The purpose of this study was to evaluate and compare the resulting knee kinematics and stability of an anatomic superficial MCL (sMCL) reconstruction and a non-anatomic sMCL reconstruction. METHODS: In a cadaveric model, normal knee stability and kinematics were compared with sMCL deficient knees and with two experimental sMCL ...

Abstract Objective: Free non-vascularized alveolar bone grafting in severe defects of the cleft region often results in poor implant bed conditions. Here an alternative augmentation technique using a new technique of vascularized bone transfer is described. Design: In five patients with uni- (4) or bilateral (1) clefts of the lip, ...

OBJECTIVE: In 1981, Moore introduced a new classification for dislocation-type fractures caused by high-energy mechanisms. The most common medial Moore-type fractures are entire condyle fractures with the avulsion of the median eminence (tibial anterior cruciate ligament (ACL) insertion). They are usually associated with a posterolateral depression of the tibial plateau ...

BACKGROUND:: We evaluate the clinical results of reconstructing massive juxta-articular defects of the distal femur (mean, 16.4 cm) with series-connected double-strut free-vascularized fibular grafting (FVFG) and external fixator fixation. METHODS:: We retrospectively reviewed a consecutive series of 19 patients, who underwent FVFG transfer because of massive juxta-articular defects of distal ...

A 29-year-old man, who had been diagnosed with myelodysplastic syndrome 1 year before, developed a wound on his thigh and knee due to necrotising fasciitis. Forty h after a free thoracodorsal artery perforator flap transfer, the colour of the flap changed from pink to purple, starting from the peripheral margin ...

Unicompartmental knee replacement (UKR) is an option for the treatment of isolated medial compartment osteoarthritis. A commonly perceived potential advantage is that revision of a UKR is straightforward. The purpose of this study was to determine the early outcomes and the level of complexity of revisions of Oxford UKRs performed ...