Hydatid disease of the soft tissues of the lower limb: findings in three cases

1993 ◽  
Vol 22 (7) ◽  
Author(s):  
Julio Martin ◽  
Vicente Marco ◽  
Ahmed Zidan ◽  
Constancio Marco
Keyword(s):  
Hydatid Disease ◽  
Lower Limb ◽  
Soft Tissues

Relapsing hydatid disease involving the vertebral body and paravertebral soft tissues

2002 ◽  
Vol 43 (2) ◽  
pp. 192-193 ◽  
Author(s):  
M. Basak ◽  
A. Ozel ◽  
O. Yildirim ◽  
M. Erturk
Keyword(s):  
Hydatid Disease ◽  
Vertebral Body ◽  
Soft Tissues

Extraction of Quasi-Linear Viscoelastic Parameters for Lower Limb Soft Tissues From Manual Indentation Experiment

1999 ◽  
Vol 121 (3) ◽  
pp. 330-339 ◽  
Author(s):  
Y. P. Zheng ◽  
A. F. T. Mak
Keyword(s):  
Lower Limb ◽  
Soft Tissues ◽  
Model Parameters ◽  
Viscoelastic Parameters ◽  
Fitting Procedure ◽  
Ultrasound Indentation ◽  
Initial Modulus ◽  
Linear Viscoelastic ◽  
Young Subjects ◽  
Three Body

A manual indentation protocol was established to assess the quasi-linear viscoelastic (QLV) properties of lower limb soft tissues. The QLV parameters were extracted using a curve-fitting procedure on the experimental indentation data. The load-indentation responses were obtained using an ultrasound indentation apparatus with a hand-held pen-sized probe. Limb soft tissues at four sites of eight normal young subjects were tested in three body postures. Four QLV model parameters were extracted from the experimental data. The initial modulus E0 ranged from 0.22 kPa to 58.4 kPa. The nonlinear factor E1 ranged from 21.7 kPa to 547 kPa. The time constant τ ranged from 0.05 s to 8.93 s. The time-dependent material parameter α ranged from 0.029 to 0.277. Large variations of the parameters were noted among subjects, sites, and postures.

scholarly journals Multifocal cutaneous epithelioid hemangiodothelioma on the same lower limb

2021 ◽  
Vol 7 (4) ◽  
pp. 578
Author(s):  
Mehdi Khallaayoune ◽  
Elgaitibi Fatima Azzahra ◽  
Meziane Mariame ◽  
Senouci Karima
Keyword(s):  
Young Patient ◽  
Lower Limb ◽  
Soft Tissues ◽  
Epithelioid Hemangioendothelioma ◽  
Low Grade ◽  
Vascular Tumour ◽  
Cutaneous Involvement

<p class="abstract">Epithelioid hemangioendothelioma (EHE) is a rare low-grade vascular tumour mainly affecting bones, deep soft tissues and exceptionally the skin. Multifocal cutaneous involvement is uncommon and should raise suspicion for metastasizing extracutaneous epithelioid hemangiodothelioma. Hereby we report the case of a young patient with multifocal cutaneous EHE involving the same lower limb. We emphasize the necessity for dermatologists to evoke the diagnosis of EHE in patients presenting with nonspecific tumours of the extremities. Prompt management and diagnosis are essential in this potential aggressive tumour.</p>

scholarly journals Restricted Kinematic Alignment, the Fundamentals, and Clinical Applications

2021 ◽  
Vol 8 ◽  
Author(s):  
Pascal-André Vendittoli ◽  
Sagi Martinov ◽  
William G. Blakeney
Keyword(s):  
Lower Limb ◽  
Soft Tissues ◽  
Computer Navigation ◽  
Patient Specific ◽  
Control Group ◽  
Kinematic Alignment ◽  
Knee Anatomy ◽  
Normal Knee ◽  
Patient Specific Instrumentation ◽  
Patient Reported

Introduction: After a better understanding of normal knee anatomy and physiology, the Kinematic Alignment (KA) technique was introduced to improve clinical outcomes of total knee arthroplasty (TKA). The goal of the KA technique is to restore the pre-arthritic constitutional lower limb alignment of the patient. There is, however, a large range of normal knee anatomy. Unusual anatomies may be biomechanically inferior and affect TKA biomechanics and wear patterns. In 2011, the leading author proposed the restricted kinematic alignment (rKA) protocol, setting boundaries to KA for patients with an outlier or atypical knee anatomy.Material and Equipment: rKA aims to reproduce the constitutional knee anatomy of the patient within a safe range. Its fundamentals are based on sound comprehension of lower limb anatomy variation. There are five principles describing rKA: (1) Combined lower limb coronal orientation should be ± 3° of neutral; (2) Joint line orientation coronal alignment should be within ± 5° of neutral; (3) Natural knee's soft tissues tension/ laxities should be preserved/restored; (4) Femoral anatomy preservation is prioritized; (5) The unloaded/most intact knee compartment should be resurfaced and used as the pivot point when anatomical adjustment is required. An algorithm was developed to facilitate the decision-making.Methods: Since ~50% of patients will require anatomic modification to fit within rKA boundaries, rKA is ideally performed with patient-specific instrumentation (PSI), intra-operative computer navigation or robotic assistance. rKA surgical technique is presented in a stepwise manner, following the five principles in the algorithm.Results: rKA produced excellent mid-term clinical results in cemented or cementless TKA. Gait analysis showed that rKA TKA patients had gait patterns that were very close to a non-operated control group, and these kinematics differences translated into significantly better postoperative patient-reported scores than mechanical alignment (MA) TKA cases.Discussion: Aiming to improve the results of MA TKA, rKA protocol offers a satisfactory compromise that recreates patients' anatomy in most cases, omitting the need for extensive corrections and soft tissue releases that are often required with MA. Moreover, it precludes the reproduction of extreme anatomies seen with KA.

Dynamic Modeling of Knee Mechanics

2011 ◽  
Author(s):  
Daniel P. Nicolella ◽  
Barron Bichon ◽  
W. Loren Francis ◽  
Travis D. Eliason
Keyword(s):  
Finite Element ◽  
Multibody Dynamics ◽  
Lower Limb ◽  
Muscle Activation ◽  
Soft Tissues ◽  
Contact Forces ◽  
Joint Mechanics ◽  
Mechanical Environment ◽  
Leg Extension ◽  
Knee Mechanics

It is widely accepted that the mechanical environment within the knee, or more specifically, increased or altered stresses or strains generated within the cartilage, is a leading cause of knee osteoarthritis (OA). However, a significant unfulfilled technological challenge in musculoskeletal biomechanics and OA research has been determining the dynamic mechanical environment of the cartilage (and other components) resulting from routine and non-routine physical movements. There are two methods of investigating musculoskeletal joint mechanics that have been used to date: 1) forward and inverse multibody dynamic simulations of human movement and 2) detailed quasi-static finite element modeling of individual joints. The overwhelming majority of work has been focused on musculoskeletal multibody dynamics modeling. This method, in combination with experimental motion capture and analysis, has been integral to understanding torques, muscle and ligament forces, and reaction forces occurring at the joint during activities such as walking, running, squatting, and jumping as well as providing key insights into musculoskeletal motor control schemes. However, multibody dynamics simulations do not allow for the detailed continuum level analysis of the mechanical environment of the cartilage and other knee joint structures (meniscus, ligaments, and underlying bone) within the knee during physical activities. This is a critical technology gap that is required to understand the relationship between functional or injurious loading of the knee and cartilage degradation. We have developed a detailed neuromuscularly activated dynamic finite element model of the human lower body and have used this model to simultaneously determine the dynamic muscle forces, joint kinematics, contact forces, and detailed (e.g., continuum) stresses and strains within the knee (cartilage, meniscus, ligaments, and bone) during several increasingly complex neuromuscularly controlled and actuated lower limb movements. Motion at each joint is controlled explicitly via deformable cartilage-to-cartilage surface contact at each articular surface (rather than idealized as simple revolute or ball and socket joints). The major muscles activating the lower limb are explicitly modeled with Hill-type active force generating springs using anatomical muscle insertion points and geometric wrapping. Muscle activation dynamics were determined via a constrained optimization scheme to minimize muscle activation energy. Time histories of the mechanical environment of all soft tissues within the knee are determined for a simulated leg extension.

scholarly journals Abdominal Hydatidosis-A Rare Presentation

2018 ◽  
Vol 8 (1) ◽  
pp. 37-40
Author(s):  
Hensan Khadka ◽  
Saroj Sharma ◽  
Sanjay Bikram Shrestha
Keyword(s):  
Hydatid Disease ◽  
Peritoneal Cavity ◽  
Rare Case ◽  
Soft Tissues ◽  
The Body ◽  
Genital Organ ◽  
Hydatid Cysts ◽  
Rare Presentation ◽  
Abdominal Hydatidosis

Hydatid disease may develop in almost any part of the body. Approximately 70% of the hydatid cysts are located in the liver followed by the lung (25%). The kidneys, spleen, mesentery, peritoneum, soft tissues and brain are uncommon locations for hydatid cysts. Involvement of pelvis is very rare, with ovary the most frequently involved genital organ. We report a rare case of abdominal  hydatidosis with cysts in the liver, spleen, peritoneal cavity and ovary.

Open Fragility Fractures

2020 ◽  
pp. 141-144
Keyword(s):  
Lower Limb ◽  
Soft Tissues ◽  
Fragility Fractures ◽  
Surgical Interventions ◽  
Safe Delivery ◽  
Non Union ◽  
Energy Mechanism ◽  
Healthcare Needs ◽  
Envelope Reconstruction ◽  
Additional Support

Open fractures of the lower limb are increasingly common in older patients in whom surgical reconstruction is complicated by poor-quality bone and soft tissues, and whose complex healthcare needs are exacerbated by frailty and the presence of multiple co-morbidities. These challenges are likely to increase as the Office for National Statistics predicts that the number of people aged 75 and over in the UK will rise from 5.2 million in 2014 to 9.9 million in 2039. The majority of open fragility fractures of the lower limb occur in the tibia and ankle of older women as a result of a fall from standing. Despite the low-energy mechanism there is a high incidence of Gustilo–Anderson III (predominantly IIIA) injuries. This reflects the frailty of this patient group and the combined effects that osteoporosis and skin ageing have upon the quality of the bone and integrity of the surrounding soft tissue envelope. Reconstruction is complicated by higher rates of malunion, non-union, necessity for amputation, and mortality as compared with younger patients with similar injuries. These patients may have complex ongoing healthcare needs requiring additional support that influence safe delivery of the established ‘best practice’ surgical interventions.

scholarly journals Surgical treatment of noniatrogenic trauma of the femoral arteries

1996 ◽  
Vol 114 (1) ◽  
pp. 1079-1082
Author(s):  
Nelson Wolosker ◽  
Alvaro Guadêncio ◽  
Sérgio Kuzniec ◽  
Ruben Aizín Rosoky ◽  
Claudio Kalume ◽  
...  
Keyword(s):  
Lower Limb ◽  
Soft Tissues ◽  
Penetrating Trauma ◽  
Multiple Organ ◽  
High Rate ◽  
Venous Graft ◽  
Femoral Arteries ◽  
Penetrating Wound ◽  
Lower Limb Muscles ◽  
Severe Ischemia

Trauma to the femoral arteries corresponds to 30 percent of all arterial traumas. The authors reviewed 74 patients with noniatrogenic trauma of the femoral arteries treated from January 1991 to December 1993. Ages ranged from 11 to 50 years, with a mean of 24. Seventy-one patients were male and three female. Fifty-two patients (70.2 percent) were white, 20 (27 percent) were black and two (2.8 percent) were Asian. Trauma due to firearms had the highest incidence, with 61 cases (82.4 percent). Absence of pulse was the most frequent clinical symptom (62.5 percent). Severe ischemia, with risk of loss of limb, was found in 66.2 percent of the cases. The superficial femoral artery was impaired in 77 percent of the cases. A preoperative arteriography was performed on only five patients, victims of multiple penetrating trauma or an asymptomatic penetrating wound along a vessel passage. In six cases, arterial and venous ligature was the chosen procedure. In three cases, a primary arterial anantomosis was performed. Simple arterriorraphy was feasible in one patient. In 64 of the patients, a venous graft was undertaken using a segment of the inverted great saphenous vein withdrawn from the other lower limb. Fasciotomoy was used in 32 patients (43.2 percent), all of whom exhibited pasting of the lower limb muscles at admission. One patient died during the immediate postoperative period as the result of multiple organ failure caused by polytraumatism. Preservation of the limb was attained in 72 patients (97.3 percent) Severe, previously-incurred ischemia was responsible for the only two amputations, aggravated by an exceedingly long delay between the time of injury and surgery. One of these patients, in addition to severe ischemia, had extensive injuries to the soft tissues. We conclude that trauma of the femoral arteries, attended while the limb still maintains its vitality, has a positive clinical outcome with a high rate of limb preservation. Mortality usually results from injury to other organs.

scholarly journals Microsurgery and external fixation in orthoplastic reconstruction of tibial injuries

2019 ◽  
Vol 51 (06) ◽  
pp. 484-491
Author(s):  
Francesca Toia ◽  
Giovanni Zabbia ◽  
Roberto Scirpo ◽  
Roberto Pirrello ◽  
Lorenzo Nalbone ◽  
...  
Keyword(s):  
Soft Tissue ◽  
External Fixation ◽  
Lower Limb ◽  
Soft Tissues ◽  
Treatment Time ◽  
Soft Tissue Defect ◽  
Soft Tissue Reconstruction ◽  
Microsurgical Reconstruction ◽  
Limb Reconstruction ◽  
Lower Limb Reconstruction

Abstract Background “Orthoplastics” is a relatively new approach to lower limb reconstruction, where an integration of both plastic and orthopedic expertise is required, together with the availability of well-equipped facilities. Acute shortening and long-term frames for lengthening are generally considered alternatives to length preservation and soft tissue microsurgical reconstruction, but an integration of external fixation and reconstructive microsurgery is gaining an increasing role with refinements of joint approaches. Material and methods Data on sixteen patients who underwent microsurgical lower limb reconstruction and external fixation with an orthoplastic approach, following acute or chronic tibial injury, were retrospectively reviewed. All patients presented a post traumatic soft tissue defect associated with a Gustilo III tibial fracture or a tibial septic pseudarthrosis. Data on type and timing of bone and soft tissue reconstruction, outcomes, complications and need for re-operation were extrapolated and compared to an historic group of patients treated with an orthopedic-based approach. Results In the orthoplastic group, soft tissues were reconstructed with an ALT flap in most cases; a muscle-sparing VL or ALT-VL chimeric flap was necessary in cases with a very extensive defect. In the orthopedic group, soft tissues were left to heal by second intention or patients were lately referred to plastic surgeons. Statistical comparison between the two groups has showed significant differences on the following data: time for soft tissue healing, time to bone union, number of reinterventions, post-operative deep infection rate, time to return to work. Conclusion The orthoplastic approach to complex leg defects yields shorter treatment time and better functional results compared to the orthopedic-based approach. External fixation and microsurgical reconstruction are not necessarily alternative procedures but can integrate in an orthoplastic path to address at best both soft tissue and bone reconstruction.

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