BACKGROUND Glomus tumors are rare neoplasms,usually found on the fingers or toes.Glomus tumours that occur in the lower leg are even rarer and is likely to be misdiagnosed or underdiagnosed.This article will document ...BACKGROUND Glomus tumors are rare neoplasms,usually found on the fingers or toes.Glomus tumours that occur in the lower leg are even rarer and is likely to be misdiagnosed or underdiagnosed.This article will document the diagnosis,treatment,and follow-up of a rare glomus tumor of the lower leg,which had been misdiagnosed for up to 15 years.CASE SUMMARY The patient was a A 36-year-old woman who had suffered from localized pain in her left lower leg for 15 years.After a complete physical examination,a glomus tumor on her lower leg was considered and removed surgically.The specimen was pathologically diagnosed as a glomus tumor.There was no relapse at a 4-year follow-up.CONCLUSION Correct diagnosis and complete removal of the glomus tumor is important.展开更多
Blood flow in the lower leg was determined in 50 cases of non-insulin dependent diabetesmellitus using an XLJ-2 bipolar rheoencephalometry impedance rheogram. In patients with leg pain (85legsi and diabetic foat (15 l...Blood flow in the lower leg was determined in 50 cases of non-insulin dependent diabetesmellitus using an XLJ-2 bipolar rheoencephalometry impedance rheogram. In patients with leg pain (85legsi and diabetic foat (15 legs3, the blood flow of the lower leg was decreased as compared withhealthy legs (P<0. 01￣0. 001) . The group with diabetic foot showed a bigger decrease compared withthe leg pain group (PMO. 051 . Atter treatment with the principle of vitalizing blood and solubilizing throm-bus, 22 cases with leg pain (32 legs) showed a significant increase of blood flow in the lower leg (P<0. 001). The group with diabetic foot failed to show any significant increase, indicating the importance ofearly treatment. This method of determining blood flow in the lower leg will help early discovery of abnor-mal changes of blood supply in the lower leg. Treatment with the principle of vitalizing blood and solubiliz-ing thrombus can help improve the conditions of the patients.展开更多
Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time take...Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay;lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.展开更多
Introduction: Coverage of defects of the distal lower extremity and foot remains a challenging reconstructive prcedure. Free tissue transfer remains the standard for the management of these defects. However, there are...Introduction: Coverage of defects of the distal lower extremity and foot remains a challenging reconstructive prcedure. Free tissue transfer remains the standard for the management of these defects. However, there are some disadvantages like;longer operative times, bulky contour, and the need for highly skilled expertise. The reverse superficial sural artery flap (RSSAF) is a distally based fasciocutaneous or adipo-fascial flap that is used for coverage of defects that involve the distal third of the leg, ankle, and foot. A significant advantage of this flap is a constant blood supply that does not require sacrifice of a major artery. Methods: Twenty RSSAF flaps were harvested for reconstruction of different traumatic soft tissue defects of the lower third of leg, ankle and foot. Follow up for 6 months postoperative. Results: Twenty Patients;twelve males and eight females underwent reconstruction of different soft tissue defects over the foot and ankle using RSSAF. The overall complications occurred in 6 flaps;4 minor and 2 major complications. The remaining 14 flaps passed an uneventful follow up. Conclusions: The reverse superficial sural artery flap RSSAF can be used as a reliable alternative to free tissue transfer in reconstruction of defects over the lower third of leg, ankle, and foot. Venous congestion is the major threat to the flap but its incidence can be minimized by wide pedicle, less kink of the flap, and keep the venae comitants around the artery.展开更多
Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applie...Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applied for coverage of the soft tissue defects over the lower one-third of the leg,the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The larges area of the soft tissue defect was 5 cm × 7 cm. The smallest was 3 cm × 4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion ThisChina Medical Abstracts(Surgery) technigue is a simple and complication are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue展开更多
[目的]为低于身高均值2个标准差以下的成人矮身材、侏儒症、有增高愿望的志愿者实施双下肢延长术,满足患者对合理身高的追求,以增加他们的自信和融入社会(求职、婚姻等)的机遇.[方法]根据Ilizarov提出的牵拉成骨技术(distraction osteog...[目的]为低于身高均值2个标准差以下的成人矮身材、侏儒症、有增高愿望的志愿者实施双下肢延长术,满足患者对合理身高的追求,以增加他们的自信和融入社会(求职、婚姻等)的机遇.[方法]根据Ilizarov提出的牵拉成骨技术(distraction osteogenesis,DO),应用自行研制的带锁髓内钉与外固定延长器系统[1](locking intramedullary nail with external fixator for limbs lengthening,IEFL),为638例矮身材和侏儒症实施双下肢延长术.术后第8d始,以0.5～1.0 mm/d的速度延长,达到所需增加高长度后,插入髓内钉远端锁钉,拆除延长器.在延长期和骨功能重建期内,增加应力刺激,进行规范有益的功能训练,促进骨和肢体功能恢复.[结果]本组病例随访时间2.5～8a,平均4 a,增加身高8～26 cm,平均9.6 cm.根据客观、功能、主观、症状4个指标评分评定,优99.53%,良0.31%,差0.16%.发生并发症48例(56个肢体),占7.52%,其中轻度5.96%,中度1.09%,重度0.47%,至今尚未发现后遗症.[结论]IEFL技术是在Ilizarov生物学理论、技术和器械基础上的重大创新与完善,是进行大幅度(＞10%)肢体延长(增高)的一种安全、有效方法,对伴有膝内翻者还能同期矫正畸形.展开更多
文摘BACKGROUND Glomus tumors are rare neoplasms,usually found on the fingers or toes.Glomus tumours that occur in the lower leg are even rarer and is likely to be misdiagnosed or underdiagnosed.This article will document the diagnosis,treatment,and follow-up of a rare glomus tumor of the lower leg,which had been misdiagnosed for up to 15 years.CASE SUMMARY The patient was a A 36-year-old woman who had suffered from localized pain in her left lower leg for 15 years.After a complete physical examination,a glomus tumor on her lower leg was considered and removed surgically.The specimen was pathologically diagnosed as a glomus tumor.There was no relapse at a 4-year follow-up.CONCLUSION Correct diagnosis and complete removal of the glomus tumor is important.
文摘Blood flow in the lower leg was determined in 50 cases of non-insulin dependent diabetesmellitus using an XLJ-2 bipolar rheoencephalometry impedance rheogram. In patients with leg pain (85legsi and diabetic foat (15 legs3, the blood flow of the lower leg was decreased as compared withhealthy legs (P<0. 01￣0. 001) . The group with diabetic foot showed a bigger decrease compared withthe leg pain group (PMO. 051 . Atter treatment with the principle of vitalizing blood and solubilizing throm-bus, 22 cases with leg pain (32 legs) showed a significant increase of blood flow in the lower leg (P<0. 001). The group with diabetic foot failed to show any significant increase, indicating the importance ofearly treatment. This method of determining blood flow in the lower leg will help early discovery of abnor-mal changes of blood supply in the lower leg. Treatment with the principle of vitalizing blood and solubiliz-ing thrombus can help improve the conditions of the patients.
文摘Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay;lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.
文摘Introduction: Coverage of defects of the distal lower extremity and foot remains a challenging reconstructive prcedure. Free tissue transfer remains the standard for the management of these defects. However, there are some disadvantages like;longer operative times, bulky contour, and the need for highly skilled expertise. The reverse superficial sural artery flap (RSSAF) is a distally based fasciocutaneous or adipo-fascial flap that is used for coverage of defects that involve the distal third of the leg, ankle, and foot. A significant advantage of this flap is a constant blood supply that does not require sacrifice of a major artery. Methods: Twenty RSSAF flaps were harvested for reconstruction of different traumatic soft tissue defects of the lower third of leg, ankle and foot. Follow up for 6 months postoperative. Results: Twenty Patients;twelve males and eight females underwent reconstruction of different soft tissue defects over the foot and ankle using RSSAF. The overall complications occurred in 6 flaps;4 minor and 2 major complications. The remaining 14 flaps passed an uneventful follow up. Conclusions: The reverse superficial sural artery flap RSSAF can be used as a reliable alternative to free tissue transfer in reconstruction of defects over the lower third of leg, ankle, and foot. Venous congestion is the major threat to the flap but its incidence can be minimized by wide pedicle, less kink of the flap, and keep the venae comitants around the artery.
文摘Objective To investigate a simple, valuable new method for coverage of the soft tissue defect over the lower one-third of the leg, ankle and the foot. Methods The distally based peroneus brevis muscle fkps were applied for coverage of the soft tissue defects over the lower one-third of the leg,the ankle and the foot. The muscle flaps were covered with split-thickness skin grafts. Results The distally based peroneus brevis muscle flaps were applied for coverage of the soft tissue defects over the lower one-third of the leg, the ankle and the foot in 16 cases. The larges area of the soft tissue defect was 5 cm × 7 cm. The smallest was 3 cm × 4 cm. Primary healing occured in 14 cases undergoing muscle flap construction, second-stage healing occured in 2 cases, no total flap necrosis occured in any cases. Conclusion ThisChina Medical Abstracts(Surgery) technigue is a simple and complication are lesser. The successful rates are higher. This muscle flap is suitable to the mudium or small soft tissue
文摘[目的]为低于身高均值2个标准差以下的成人矮身材、侏儒症、有增高愿望的志愿者实施双下肢延长术,满足患者对合理身高的追求,以增加他们的自信和融入社会(求职、婚姻等)的机遇.[方法]根据Ilizarov提出的牵拉成骨技术(distraction osteogenesis,DO),应用自行研制的带锁髓内钉与外固定延长器系统[1](locking intramedullary nail with external fixator for limbs lengthening,IEFL),为638例矮身材和侏儒症实施双下肢延长术.术后第8d始,以0.5～1.0 mm/d的速度延长,达到所需增加高长度后,插入髓内钉远端锁钉,拆除延长器.在延长期和骨功能重建期内,增加应力刺激,进行规范有益的功能训练,促进骨和肢体功能恢复.[结果]本组病例随访时间2.5～8a,平均4 a,增加身高8～26 cm,平均9.6 cm.根据客观、功能、主观、症状4个指标评分评定,优99.53%,良0.31%,差0.16%.发生并发症48例(56个肢体),占7.52%,其中轻度5.96%,中度1.09%,重度0.47%,至今尚未发现后遗症.[结论]IEFL技术是在Ilizarov生物学理论、技术和器械基础上的重大创新与完善,是进行大幅度(＞10%)肢体延长(增高)的一种安全、有效方法,对伴有膝内翻者还能同期矫正畸形.
