المؤلفون: Arnadottir, Solrun Dogg, Pálsdóttir, Guðbjörg, Logason, Karl, Arnardóttir, Ragnheiður Harpa

المساهمون: Hjúkrunar- og ljósmóðurfræðideild, Læknadeild, Framhaldsdeild í heilbrigðisvísindum, Landspítali

مصطلحات موضوعية: Hjúkrun aðgerðasjúklinga, Bráðahjúkrun, Æðaskurðlæknisfræði, lower limb amputation, comorbidities, diabetes mellitus, peripheral arterial disease, revascularisation, risk factors, Humans, Male, Treatment Outcome, Diabetes Mellitus/diagnosis, Peripheral Arterial Disease/diagnosis, Amputation, Surgical/adverse effects, Female, Vascular Surgical Procedures/adverse effects, Iceland/epidemiology, Retrospective Studies, Lower Extremity/surgery, Almenn læknisfræði

الوصف: Publisher Copyright: © 2024 Laeknafelag Islands. All rights reserved. ; INNGANGUR Ekki eru til nýlegar rannsóknir um tíðni aflimana hérlendis. Tilgangur þessarar rannsóknar var að athuga fjölda og aðdraganda aflimana ofan ökkla á grunni útæðasjúkdóms og/eða sykursýki á Íslandi 2010-2019. EFNIVIÐUR OG AÐFERÐIR Afturskyggn rannsókn, byggð á sjúkraskrárgögnum allra aflimaðra ofan ökkla á Landspítala og á Sjúkrahúsinu á Akureyri á rannsóknartímanum. Útilokaðir frá rannsókn voru fullorðnir aflimaðir vegna annars en ofangreindra sjúkdóma og börn. Tveir tímapunktar voru skoðaðir í aðdraganda aflimunar varðandi einkenni, mat á blóðflæði og lyfjanotkun. Annars vegar við fyrstu komu á sjúkrahús vegna blóðþurrðareinkenna og/eða sáramyndunar og hins vegar fyrir síðustu aflimun. Einnig voru skráðar áður framkvæmdar æðaaðgerðir og aflimanir. NIÐURSTÖÐUR Alls voru 167 einstaklingar aflimaðir á rannsóknartímanum, þar af 134 (80%, meðalaldur 77 ± 11 ár, 93 karlmenn og 41 kona) á grunni sykursýki og/eða útæðasjúkdóms. Aflimunum vegna sjúkdómanna fjölgaði úr að meðaltali 4,1/100.000 íbúa 2010-2013 í 6,7/100.000 2016-2019 (p=0,04). Algengustu áhættuþættir voru háþrýstingur 84% og reykingasaga 69%. Langvinn tvísýn blóðþurrð var í 71% tilfella ástæða fyrstu komu á sjúkrahús. Æðaaðgerðir voru framkvæmdar hjá 101 einstaklingi (66% innæðaaðgerðir). Með útæðasjúkdóm án sykursýki voru 52% en þeir voru sjaldnar skráðir á blóðfitulækkandi lyf en þeir sem voru með sykursýki (45:26, p<0,001). ÁLYKTUN Sykursýki og/eða útæðasjúkdómur eru helstu ástæður aflimana neðri útlima ofan ökkla á Íslandi. Aflimunum fjölgaði á tímabilinu, en tíðnin er lág í alþjóðlegum samanburði. Í flestum tilfellum eru æðaaðgerðir gerðar áður en til aflimunar kemur. Sykursýki er undirliggjandi í tæpum helmingi tilfella sem er svipað eða lægra en í öðrum löndum. Möguleg sóknarfæri varðandi greiningu og forvarnir eru hjá einstaklingum með útæðasjúkdóm án sykursýki. ; INTRODUCTION: No recent studies exist on lower extremity amputations (LLAs) in Iceland. The aim of this ...

وصف الملف: 20-27

العلاقة: Læknablaðið; 110(1); http://www.scopus.com/inward/record.url?scp=85180755340&partnerID=8YFLogxKTest; Arnadottir , S D , Pálsdóttir , G , Logason , K & Arnardóttir , R H 2024 , ' Aflimanir ofan ökkla 2010-2019 vegna útæðasjúkdóms og/eða sykursýki Aðdragandi og áhættuþættir ' , Læknablaðið , bind. 110 , nr. 1 , bls. 20-27 . https://doi.org/10.17992/lbl.2024.01.776Test; 215143887; fefeb823-3106-4cd4-a1f6-067ab54125b0; 85180755340; unpaywall: 10.17992/lbl.2024.01.776; https://hdl.handle.net/20.500.11815/4717Test

الإتاحة: https://doi.org/20.500.11815/4717Test
https://doi.org/10.17992/lbl.2024.01.776Test
https://hdl.handle.net/20.500.11815/4717Test

المؤلفون: Ignatiussen, Martha Etlm, Pedersen, Poul, Holm, Gitte, Thomsen, Morten Grove, Kristensen, Morten Tange

المصدر: Ignatiussen , M E , Pedersen , P , Holm , G , Thomsen , M G & Kristensen , M T 2023 , ' Daytime and scheduled surgery for major dysvascular lower extremity amputation ' , Danish Medical Journal , vol. 70 , no. 3 , A07220435 . < https://ugeskriftet.dk/dmj/daytime-and-scheduledTest-surgery-major-dysvascular-lower-extremity-amputation >

مصطلحات موضوعية: Humans, Aged, 80 and over, Amputation, Surgical, Diabetes Mellitus, Lower Extremity/surgery, Knee Joint, Atherosclerosis, Risk Factors, Retrospective Studies

الوصف: INTRODUCTION. Patients undergoing a major dysvascular lower extremity amputation (LEA) often have a poor outcome with a high risk of complications and mortality despite improvements in care and perioperative programmes. We evaluated whether scheduled surgery would reduce the failure rate in patients with a major LEA. METHODS. A total of 328 consecutive patients undergoing a major LEA from 2016 to 2019 were enrolled at a single centre. Early failure was defined as re-amputation or revision within 30 days of the index amputation. In 2018, a new regime comprising two scheduled surgery days was implemented. The risk of failure comparing the two cohorts (2016-2017, n = 165 versus 2018-2019, n = 163) was calculated for amputation on scheduled versus non-scheduled days and for other potentially influencing factors. RESULTS. The median (25-75% quartiles) age of all patients was 74 (66-83) years, 91% had an American Society of Anesthesiologists (ASA) grade ≥ 3 and 92% had atherosclerosis or diabetes mellitus. The index amputee levels were 36% below-knee, 60% transfemoral and 4% bilateral transfemoral. In the intervention cohort, 59% were amputated on the scheduled days versus 36% in the control group (p < 0.001). Correspondingly, more patients (72.4% versus 57.6%, p = 0.005) were amputated during daytime and the 30-day failure rate was reduced to 11.0% (n = 18) versus 16.4% (n = 27) (p = 0.2). Risk of failure on scheduled days in the intervention group was 8.3% versus 14.9% on any other day (p = 0.2). Correspondingly, daytime surgery reduced the risk of failure (6.8% versus 22.2%, p = 0.005). CONCLUSION. Daytime and scheduled surgery for major LEA may possibly reduce early risk of failure. FUNDING. none. TRIAL REGISTRATION. not relevant. ; INTRODUCTION: Patients undergoing a major dysvascular lower extremity amputation (LEA) often have a poor outcome with a high risk of complications and mortality despite improvements in care and perioperative programmes. We evaluated whether scheduled surgery would reduce the failure ...

وصف الملف: application/pdf

الإتاحة: https://curis.ku.dk/portal/da/publications/daytime-and-scheduledTest-surgery-for-major-dysvascular-lower-extremity-amputation(f33018fb-4a51-4755-8668-a2db1534d4c6).html
https://curis.ku.dk/ws/files/364054108/A07220435_WEB_1.pdfTest
https://ugeskriftet.dk/dmj/daytime-and-scheduledTest-surgery-major-dysvascular-lower-extremity-amputation

المساهمون: Sang Geun Jung, Sang Hee Im, Migang Kim, Min Chul Choi, Won Duk Joo, Seung Hun Song, Chan Lee, Hyun Park, Im, Sang Hee

مصطلحات موضوعية: Female, Genital Neoplasms, Female* / complications, Female* / pathology, Female* / surgery, Humans, Lower Extremity / surgery, Lymph Node Excision / adverse effects, Lymph Nodes / pathology, Lymph Nodes / surgery, Lymphedema* / epidemiology, Lymphedema* / etiology, Lymphedema* / surgery, Male, Retrospective Studies, Lymphedema, gynecologic neoplasms, lower limb, lymph node dissection, sentinel lymph node biopsy

الوصف: Purpose: While the risk of lower limb lymphedema (LLE) after radical surgery for gynecologic malignancies is multifactorial, the limited assessment of lymph nodes (LNs), such as sentinel LN biopsy, has been incorporated into a standard procedure. We assessed the relationship between the number of LNs retrieved from the hemipelvis and the incidence of ipsilateral LLE (iLLE). Methods: This retrospective study included 103 women with gynecologic cancer who had LNs removed with minimally invasive surgery between January 2014 and December 2018. For early detection of LLE, the patients were followed up by a lymphedema specialist who complied with the International Society of Lymphedema criteria. Potential risk factors for LLE were collected, and the risk factors were further investigated according to the number of LNs removed in a side-specific manner. Results: LLE was diagnosed in 32 (31.1%) patients, and most of them were diagnosed with unilateral (n = 22) LLE rather than bilateral (n = 10). The number of pelvic LNs removed (p = 0.018), no lymphatic mapping (p = 0.034), and radiation (p = 0.020) were associated with the development of one or both LLEs. A side-specific analysis revealed that the incidence of iLLE increased significantly when four or more LNs were removed from the hemipelvis compared with three or fewer LNs (22.9% vs. 8.3%, p = 0.048). Conclusions: The number of pelvic LNs retrieved was associated with the incidence of LLE in patients with early gynecologic cancer. We identified the cutoff number per hemipelvis through side-specific analysis that could minimize the risk of iLLE. Further studies are needed to validate our results. ; restriction

العلاقة: JOURNAL OF INVESTIGATIVE SURGERY; J01471; OAK-2022-03407; https://ir.ymlib.yonsei.ac.kr/handle/22282913/189573Test; T202203003; JOURNAL OF INVESTIGATIVE SURGERY, Vol.35(5) : 978-983, 2022-05

الإتاحة: https://doi.org/10.1080/08941939.2021.1980160Test
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189573Test

المؤلفون: Ghneim, Mira, Kufera, Joseph, Zhang, Ashling, Penaloza-Villalobos, Liz, Swentek, Lourdes, Watras, Jill, Smith, Alison, Hahn, Alexandra, Mederos, Dalier Rodriguez, Dickhudt, Thimothy John, Laverick, Paige, Cunningham, Kyle, Norwood, Scott, Fernandez, Luis, Jacobson, Lewis E., Williams, Jamie M., Lottenberg, Lawrence, Faris, Azar, Shillinglaw, William, Slivinski, Andrea, Nahmias, Jeffry, Donnelly, Megan, Bala, Miklosh, Egodage, Tanya, Zhu, Clara, Udekwu, Pascal O., Norton, Hannah, Dunn, Julie A., Baer, Robert, Mcbride, Katherine, Santos, Ariel P., Metzner, Caleb J., Murphy, Jade M., Schroeppel, Thomas J., Stillman, Zachery, O'Connor, Rick, Johnson, Dirk, Berry, Cherisse, Ratner, Molly, Reynolds, Jessica K., Humphrey, Mackenzie, Scott, Mark, Hickman, Zachary L., Twelker, Kate, Legister, Candice, Glass, Nina E., Siebenburgen, Christa, Palmer, Brandi, Semon, Gregory, Lieser, Mark, Mcdonald, Hannah, Bugaev, Nikolay, Leclair, Madison J., Stein, Deborah, the Brain vs. Bone Study Group

المصدر: Department of Surgery Faculty Publications

مصطلحات موضوعية: Brain, Adolescent, Brain Injuries, Traumatic/complications, Traumatic/surgery, Fracture Fixation, Intramedullary/methods, Human, Leg Injuries, Lower Extremity/surgery, Retrospective Studies, Tibial Fractures/complications, Tibial Fractures/surgery, Treatment Outcome, Medical Specialties, Medicine and Health Sciences, Surgery

الوصف: OBJECTIVE This study aimed to determine whether lower extremity fracture fixation technique and timing (≤24 vs. >24 hours) impact neurologic outcomes in TBI patients. METHODS A prospective observational study was conducted across 30 trauma centers. Inclusion criteria were age 18 years and older, head Abbreviated Injury Scale (AIS) score of >2, and a diaphyseal femur or tibia fracture requiring external fixation (Ex-Fix), intramedullary nailing (IMN), or open reduction and internal fixation (ORIF). The analysis was conducted using analysis of variamce, Kruskal-Wallis, and multivariable regression models. Neurologic outcomes were measured by discharge Ranchos Los Amigos Revised Scale (RLAS-R). RESULTS Of the 520 patients enrolled, 358 underwent Ex-Fix, IMN, or ORIF as definitive management. Head AIS was similar among cohorts. The Ex-Fix group experienced more severe lower extremity injuries (AIS score, 4–5) compared with the IMN group (16% vs. 3%, p = 0.01) but not the ORIF group (16% vs. 6%, p = 0.1). Time to operative intervention varied between the cohorts with the longest time to intervention for the IMN group (median hours: Ex-Fix, 15 [8–24] vs. ORIF, 26 [12–85] vs. IMN, 31 [12–70]; p < 0.001). The discharge RLAS-R score distribution was similar across the groups. After adjusting for confounders, neither method nor timing of lower extremity fixation influenced the discharge RLAS-R. Instead, increasing age and head AIS score were associated with a lower discharge RLAS-R score (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.002–1.03 and OR, 2.37; 95% CI, 1.75–3.22), and a higher Glasgow Coma Scale motor score on admission (OR, 0.84; 95% CI, 0.73–0.97) was associated with higher RLAS-R score at discharge. CONCLUSION Neurologic outcomes in TBI are impacted by severity of the head injury and not the fracture fixation technique or timing. Therefore, the strategy of definitive fixation of lower extremity fractures should be dictated by patient physiology and the anatomy of the injured extremity and ...

العلاقة: https://corescholar.libraries.wright.edu/surg/826Test

الإتاحة: https://doi.org/10.1097/TA.0000000000004095Test
https://corescholar.libraries.wright.edu/surg/826Test

المؤلفون: Schmiegelow, Morten T., Sode, Nikolaj, Riis, Troels, Lauritzen, Jes Bruun, Duus, Benn R., Lindberg-Larsen, Martin

المصدر: Schmiegelow , M T , Sode , N , Riis , T , Lauritzen , J B , Duus , B R & Lindberg-Larsen , M 2018 , ' Re-amputations and mortality after below-knee, through-knee and above-knee amputations ' , Danish Medical Journal , vol. 65 , no. 12 , A5520 . < http://ugeskriftet.dk/dmj/re-amputations-and-mortality-after-below-knee-through-knee-and-above-knee-amputationsTest >

مصطلحات موضوعية: Adult, Aged, 80 and over, Amputation/adverse effects, Denmark, Female, Humans, Knee Joint, Lower Extremity/surgery, Male, Middle Aged, Reoperation/statistics & numerical data, Retrospective Studies, Severity of Illness Index, Survival Rate, Time Factors, Treatment Outcome

الوصف: INTRODUCTION: From January 2013, we changed the surgical strategy in our department and ceased to perform the through-knee amputation (TKA). The primary aim of this study was to investigate re-amputation rates ≤ 90 days after non-traumatic major lower-extremity amputations performed before and after this change of practice. Furthermore, we reported mortality before and after the change of practice. METHODS: All non-traumatic major lower-extremity amputations performed in a single centre in two study periods (before and after the change of practice); 2009-2012 (cohort A) and 2014-2015 (cohort B) were included. Re-amputations and all-cause mortality ≤ 90 days after the index amputations were analysed. RESULTS: Cohort A: Included 180 amputations with 27 below-knee amputations (BKA), 68 TKAs and 85 above-knee amputations (AKA). 86.7% of patients were American Society of Anesthesiologists (ASA) score 3-5. The re-amputation rate ≤ 90 days was 29.6% (95% confidence interval (CI): 12.7-47.3%) after BKA, 33.8% (95% CI: 22.7-45.3%) after TKA, 9.4% (95% CI: 2.9-15.1%) after AKA and 21.6% (95% CI: 15.6-27.6%) overall. The overall mortality ≤ 90 days was 35.2% (95% CI: 26.2-44.2%). Cohort B: Included 116 amputations with 21 BKA and 95 AKA. 92.7% of patients were ASA score 3-5. The re-amputation rate ≤ 90 days was 19.1% (95% CI: 7.7-40.0%) after BKA, 2.1% (95% CI: 0.6-7.4%) after AKA and 5.2% (95% CI: 2.4-10.8%) overall. The overall mortality ≤ 90 days was 32.8% (95% CI: 26.2-44.2%). CONCLUSIONS: The overall re-amputation rate ≤ 90 days following major lower-extremity amputation decreased significantly from 22% to 5% after cessation of the TKA procedures, but mortality remained unchanged.

وصف الملف: application/pdf

العلاقة: https://portal.findresearcher.sdu.dk/da/publications/75bbd8e9-a963-468c-9a96-8bd29b49a558Test

الإتاحة: https://portal.findresearcher.sdu.dk/da/publications/75bbd8e9-a963-468c-9a96-8bd29b49a558Test
https://findresearcher.sdu.dk/ws/files/146400680/Re_amputations_and_mortality_after_below_knee_through_knee_and_above_knee_amputations.pdfTest
http://ugeskriftet.dk/dmj/re-amputations-and-mortality-after-below-knee-through-knee-and-above-knee-amputationsTest

المؤلفون: Jensen, Pia Søe, Petersen, Janne, Kirketerp-Møller, Klaus, Poulsen, Ingrid, Andersen, Ove

المصدر: Jensen , P S , Petersen , J , Kirketerp-Møller , K , Poulsen , I & Andersen , O 2017 , ' Progression of disease preceding lower extremity amputation in Denmark : a longitudinal registry study of diagnoses, use of medication and healthcare services 14 years prior to amputation ' , BMJ Open , vol. 7 , no. 11 , e016030 , pp. e016030 . https://doi.org/10.1136/bmjopen-2017-016030Test

مصطلحات موضوعية: Diabetes Mellitus/epidemiology, Comorbidity, Humans, Middle Aged, Risk Factors, Hypertension/epidemiology, Male, Disease Progression, Atherosclerosis/epidemiology, Denmark/epidemiology, Drug Prescriptions/statistics & numerical data, Aged, 80 and over, Female, Registries, Retrospective Studies, Early Diagnosis, Longitudinal Studies, Lower Extremity/surgery, Amputation/statistics & numerical data, atherosclerosis, lower extremity amputation, healthcare services, diabetes

الوصف: OBJECTIVES: Patients with non-traumatic lower extremity amputation are characterised by high age, multi-morbidity and polypharmacy and long-term complications of atherosclerosis and diabetes. To ensure early identification of patients at risk of amputation, we need to gain knowledge about the progression of diseases related to lower extremity amputations during the years preceding the amputation. DESIGN: A retrospective population-based national registry study. SETTING: The study includes data on demographics, diagnoses, surgery, medications and healthcare services from five national registries. Data were retrieved from 14 years before until 1 year after the amputation. Descriptive statistics were used to describe the progression of diseases and use of medication and healthcare services. PARTICIPANTS: An unselected cohort of patients (≥50 years; n=2883) subjected to a primary non-traumatic lower extremity amputation in 2010 or 2011 in Denmark. RESULTS: The prevalence of atherosclerosis, hypertension and diabetes was 70%, 53% and 49%, respectively. Among patients with atherosclerosis, 42% had not received cholesterol-lowering treatment even though 87% had visited their general practitioner within the last year prior to amputation. Further, 16% were diagnosed with diabetes at the time of the amputation. The prevalence of cardiovascular diseases increased from 22% to 70%, atherosclerosis from 5% to 53% and diabetes from 17% to 35% over the 14 years preceding major amputation. Of all patients, 64% had been in contact with the hospital or outpatient clinics within the last 3 years, and 29% received a prescription of opioids 3 years prior to the amputation. CONCLUSION: Among patients with non-traumatic lower extremity amputation, one-third live with undiagnosed and untreated atherosclerosis and one-sixth suffer from undiagnosed diabetes despite continuous contacts to general practitioner and the hospital. This study emphasises a need for enhanced focus, among both hospital clinicians and general practitioners, on the ...

العلاقة: https://pure.au.dk/portal/en/publications/f146559b-5c9c-41d2-9233-ab3e8a9c8e60Test

الإتاحة: https://doi.org/10.1136/bmjopen-2017-016030Test
https://pure.au.dk/portal/en/publications/f146559b-5c9c-41d2-9233-ab3e8a9c8e60Test

المؤلفون: Laura A. Prosser, Emily L. McGinley, Liliana E. Pezzin, Timothy R. Dillingham, Mitra McLarney

المصدر: Prosthetics & Orthotics International. 45:115-122

مصطلحات موضوعية: medicine.medical_specialty, Lower extremity surgery, business.industry, Incidence (epidemiology), Rehabilitation, MEDLINE, Retrospective cohort study, Health Care Costs, Health Professions (miscellaneous), United States, Lower limb, body regions, Insurance claims, Insurance, Lower Extremity, Prevalence, National study, Physical therapy, Humans, Medicine, Observational study, Longitudinal Studies, Child, business, Retrospective Studies

الوصف: Although the incidence of major pediatric lower limb loss secondary to either congenital deficiencies or acquired amputations is relatively low, the prevalence of lower limb loss among children in the United States (US) remains unknown.To estimate the prevalence of major lower limb loss, and the associated prosthetic services use and costs among commercially-insured children in the US.Observational, retrospective, longitudinal cohort study.The IBM MarketScan®Commercial Database was used to identify children (18 years) with major lower limb loss in the US between 2009 and 2015. Descriptive statistics were used to characterize pediatric cases according to sociodemographic and limb loss characteristics. Multivariate models assessed factors associated with annual prosthetic visits, prosthetic-related costs, and overall medical costs.Of the 36.5 million children in the MarketScan database, 14,038 had a major lower limb loss, yielding a prevalence estimate of 38.5 cases per 100,000 commercially insured children in the US during the 7-year study period. Congenital deficiencies accounted for 84% of cases, followed by 13.5% from trauma. Only 10.1% had at least one prosthesis-related visit during any 12-month period following their cohort entry. Among those, the mean annual prosthetic-related costs ranged from $50 to $29,112 with a median annual cost of $2778 (interquartile range = $4567). Annual coinsurance and copays for prosthetic services accounted for nearly half of the overall annual out-of-pocket outlays with medical care for these children.Pediatric lower limb loss results in lifelong prosthetic needs. This study informs insurers and policy-makers regarding the prevalence of these patients and the medical costs for their care.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::2cb3f89008484be536644c95acd705cbTest
https://doi.org/10.1177/0309364620968645Test

المؤلفون: Martineau, J., Guillier, D., Maruccia, M., Guiotto, M., Borens, O., Raffoul, W., di Summa, P.G.

المصدر: Journal of plastic, reconstructive & aesthetic surgery, vol. 75, no. 9, pp. 3190-3196

مصطلحات موضوعية: Analgesics, Opioid/therapeutic use, Humans, Lower Extremity/surgery, Morphine Derivatives, Nerve Block/methods, Pain, Postoperative/drug therapy, Postoperative/etiology, Postoperative/prevention & control, Retrospective Studies, Free flap, Locoregional anesthesia, Lower limb reconstruction, Opioids consumption, Pain management, Peripheral nerve block

الوصف: Opioid-based analgesia is often used in the management of postoperative pain in arthroplasty cases. This article analyses the safety of single-shot peripheral nerve block (PNB) and potential analgesic benefits in patients undergoing lower limb free flap reconstruction. A retrospective review including all patients undergoing lower limb reconstruction with free flaps between October 2017 and April 2020 was performed. Patients were divided into two groups based on PNB utilization. The use of oral opioids, post-operative pain scores, flap-related outcomes, patient morbidity, and length of hospital stay (LOS) were compared between groups. Thirty-one patients who underwent lower limb reconstruction with free flaps, were finally included in the study. Preoperative PNB was performed on 14 patients, while 17 patients received general anesthesia (GA) alone. Pain at rest, measured using the visual analog scale (VAS) score, was significantly lower (2.2 ± 1.7 vs. 4.9 ± 1.7) in the PNB group on postoperative day 1 (POD). The mean [median]±SD amounts of opioids consumed in morphine milligram equivalent (MME) were significantly lower in the PNB group on both POD1 (33.5 [22.5] ± 33.9 vs. 61.6 [48.0] ± 39.0), POD2 (29.0 [15.0] ± 29.2 vs. 58.0 [52.5] ± 37.0) and cumulatively over 7 days (164.0 [197.0] ± 132.8 vs. 315.4 [225] ± 203.2). Complication rates and LOS were not statistically different between groups, although trending toward lower take-back procedures and major complications in the PNB group. Preoperative single-shot PNB significantly reduced postoperative opioid use and patient-reported pain severity and was not associated with an increase in complication rates.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/35599221; info:eu-repo/semantics/altIdentifier/eissn/1878-0539; https://serval.unil.ch/notice/serval:BIB_DA020616FFB7Test; urn:issn:1748-6815

الإتاحة: https://doi.org/10.1016/j.bjps.2022.04.027Test
https://serval.unil.ch/notice/serval:BIB_DA020616FFB7Test

المؤلفون: Barbotte, Florian, Delord, Marc, Pujol, Nicolas

المصدر: Barbotte , F , Delord , M & Pujol , N 2022 , ' Coronal knee alignment measurements differ on long-standing radiographs vs. by navigation ' , Orthopaedics & traumatology, surgery & research : OTSR , vol. 108 , no. 5 , 103112 , pp. 103112 . https://doi.org/10.1016/j.otsr.2021.103112Test

مصطلحات موضوعية: Arthroplasty, Replacement, Knee/methods, Humans, Knee Joint/diagnostic imaging, Lower Extremity/surgery, Osteoarthritis, Knee/surgery, Radiography, Retrospective Studies

الوصف: BACKGROUND: The long-standing radiograph (LSR) is the reference tool for assessing knee alignment after total knee arthroplasty (TKA). However, its value is debatable, as many factors can influence measurement accuracy. Computer-assisted surgery (CAS) provides accurate measurements. Few studies have compared LSR and computer-assisted measurements of knee alignment. The objective of this study was to compare hip-knee-ankle (HKA) angle values obtained before and after TKA on LSRs to those obtained during CAS. HYPOTHESIS: The HKA angle values measured on LSRs before and after surgery are identical to those measured during CAS. MATERIAL AND METHODS: The HKA angles of 126 knees were measured on bipedal full-weight-bearing LSRs obtained before and 3 months after TKA. The results were compared to the values obtained during CAS. RESULTS: Before surgery, the standard deviation was 2.672, with limits of agreement of {-5.391; + 5.082}. The intra-class coefficients were good for the overall measurements (0.9), good for detecting>10° varus (0.89), fair for<10° varus and valgus (0.66 and 0.71, respectively), poor for>10° valgus (0.43) and poor for normal alignment (0). Post-operatively, the standard deviation was 3.113, with limits of agreement of {-6.426; +5.776}. The intra-class coefficient was poor for the overall measurements (0.20), negative for normal alignment (-0.05) and<10° valgus (-0.05), and positive for<10° varus (0.017) and for>10° varus and valgus (0.33). CONCLUSION: Before TKA, the LSR overestimates the deformity compared to CAS. After surgery, the two methods are not comparable. These findings underline the relevance of routinely obtaining LSRs and for using LSR results to estimate costs for healthcare insurance reimbursement purposes. LEVEL OF EVIDENCE: IV, retrospective observational cohort study.

الإتاحة: https://doi.org/10.1016/j.otsr.2021.103112Test
https://kclpure.kcl.ac.uk/portal/en/publications/520e0851-9002-487c-9420-ef709a073c04Test
http://www.scopus.com/inward/record.url?scp=85118275684&partnerID=8YFLogxKTest

المؤلفون: Dominique Fabre, Sacha Mussot, Philippe Brenot, Elie Fadel, Ryad Bourkaib, Dorian Verscheure, Olaf Mercier, Léonore Freycon-Tardy, Stéphan Haulon

المساهمون: Pôle des Cardiopathies Congénitales du Nouveau-Né à L'adulte - Centre Constitutif Cardiopathies Congénitales Complexes M3C, Groupe Hospitalier Paris Saint-Joseph, Hôpital Marie-Lannelongue, Inserm U999, Université Paris-Saclay

المصدر: Annals of Vascular Surgery
Annals of Vascular Surgery, Elsevier Masson, 2020, 66, pp.609-613. ⟨10.1016/j.avsg.2020.01.074⟩

مصطلحات موضوعية: Male, Time Factors, medicine.medical_treatment, Soft Tissue Neoplasms, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, Metastasis, 0302 clinical medicine, MESH: Adult, Aged, Amputation, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation / adverse effects, Blood Vessel Prosthesis Implantation / instrumentation, Popliteal Artery, MESH: Radiotherapy, Adjuvant, Retrospective Studies, Soft Tissue Neoplasms / pathology, Soft Tissue Neoplasms / surgery, Treatment Outcome, Vascular Patency, Soft tissue, General Medicine, Middle Aged, Limb Salvage, 3. Good health, Femoral Artery, medicine.anatomical_structure, Lower Extremity, Epidermoid carcinoma, Femoral triangle, Female, France, Cardiology and Cardiovascular Medicine, Adult, medicine.medical_specialty, MESH: Female, Femoral Artery / physiopathology, Femoral Artery / surgery, Humans, Iliac Artery / physiopathology, Revascularization, Malignancy, Iliac Artery, Amputation, Surgical, Blood Vessel Prosthesis Implantation, 03 medical and health sciences, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, medicine.artery, medicine, MESH: Iliac Artery / surgery, Lower Extremity / blood supply, Lower Extremity / pathology, Lower Extremity / surgery, business.industry, medicine.disease, Popliteal artery, Surgery, Radiation therapy, MESH: Neoplasms, Connective and Soft Tissue / secondary, Neoplasms, Connective and Soft Tissue / surgery, Popliteal Artery / physiopathology, Popliteal Artery / surgery, Radiotherapy, Adjuvant, business, Neoplasms, Connective and Soft Tissue

الوصف: International audience; Background: Soft tissue malignancy of lower limb can involve femoral triangle by direct tumoral invasion or secondary to ganglionic metastasis. Secondary arterial complications can appear during follow-up after initial tumoral resection and local radiation therapy. The aim of this study is to report our experience of secondary extra-anatomical lower limb revascularization following lower limb oncological resection with femoral bifurcation involvement.Methods: This is a retrospective monocentric study including patients who underwent extra-anatomical iliopopliteal bypass, with a previous treated neoplasia involving homolateral femoral bifurcation. Proximal anastomosis was performed on the iliac artery, tunnelization was made through iliac wing, and distal anastomosis was done on distal superficial femoral or popliteal artery.Results: Five patients underwent extra-anatomic iliopopliteal bypass for oncological purpose from 2008 to 2018 at our institution. Mean age at surgery time was 52 years (standard deviation = 19.3). Prosthetic graft was used in all cases. Primitive tumor involved Scarpa triangle in 3 cases (soft tissue sarcomas) and ganglionic metastasis involved Scarpa triangle in 2 cases (epidermoid carcinoma). Clinical presentation was ischemic in 4 cases and hemorrhagic in 1 case. One patient died during hospitalization. Of the 4 survivors, 3 patients had a patent bypass at the end of follow-up (2 had bypass thrombectomy, 1 patient had major amputation).Conclusions: Secondary iliopopliteal bypasses through the iliac wing following lower limb tumoral resection have acceptable results. It is a valid option for limb salvage especially after local radiation therapy and tumoral resection. Multidisciplinary management is necessary to obtain acceptable results and follow-up is mandatory.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::0e27537aa419ecb20c8d18ab95db9c18Test
https://doi.org/10.1016/j.avsg.2020.01.074Test