Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fra...Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.展开更多
Since its introduction,extralevator abdominoperineal excision(ELAPE)in the prone position has gained significant attention and recognition as an important surgical procedure for the treatment of advanced low rectal ca...Since its introduction,extralevator abdominoperineal excision(ELAPE)in the prone position has gained significant attention and recognition as an important surgical procedure for the treatment of advanced low rectal cancer.Most studies suggest that because of adequate resection and precise anatomy,ELAPE could decrease the rate of positive circumferential resection margins,intraoperative perforation,and may further decrease local recurrence rate and improve survival.Some studies show that extensive resection of pelvic floor tissue may increase the incidence of wound complications and urogenital dysfunction.Laparoscopic/robotic ELAPE and trans-perineal minimally invasive approach allow patients to be operated in the lithotomy position,which has advantages of excellent operative view,precise dissection and reduced postoperative complications.Pelvic floor reconstruction with biological mesh could significantly reduce wound complications and the duration of hospitalization.The proposal of individualized ELAPE could further reduce the occurrence of postoperative urogenital dysfunction and chronic perianal pain.The ELAPE procedure emphasizes precise anatomy and conforms to the principle of radical resection of tumors,which is a milestone operation for the treatment of advanced low rectal cancer.展开更多
文摘Intracapsular fractures of the proximal femur are one of the most common fractures of the lower limbs. Most cases require osteosynthesis with suitable implants, and intraoperative positioning of the patient on the fracture table is a prerequisite to facilitate fracture manipulation, traction, reduction and fluoroscopy assessment. However, positioning the limbs of bilateral above-knee amputees for internal fixation of related proximal femoral fractures is a difficult task, which requires customized inventory for effective limb positioning and fracture manipulation. This study reported a rare case following a crush injury of bilateral lower limb in a road traffic accident, and described some technical tips of acute femoral neck fractures in bilateral above-knee amputation. The patient was managed with immediate guillotine amputation and later secondary wound closure followed by internal fixation of the right-sided femoral neck fracture with multiple cancellous cannulated screws.
文摘Since its introduction,extralevator abdominoperineal excision(ELAPE)in the prone position has gained significant attention and recognition as an important surgical procedure for the treatment of advanced low rectal cancer.Most studies suggest that because of adequate resection and precise anatomy,ELAPE could decrease the rate of positive circumferential resection margins,intraoperative perforation,and may further decrease local recurrence rate and improve survival.Some studies show that extensive resection of pelvic floor tissue may increase the incidence of wound complications and urogenital dysfunction.Laparoscopic/robotic ELAPE and trans-perineal minimally invasive approach allow patients to be operated in the lithotomy position,which has advantages of excellent operative view,precise dissection and reduced postoperative complications.Pelvic floor reconstruction with biological mesh could significantly reduce wound complications and the duration of hospitalization.The proposal of individualized ELAPE could further reduce the occurrence of postoperative urogenital dysfunction and chronic perianal pain.The ELAPE procedure emphasizes precise anatomy and conforms to the principle of radical resection of tumors,which is a milestone operation for the treatment of advanced low rectal cancer.
