Objectives: This study aims to evaluate clinical and radiological findings of a series of patients with avascular necrosis of the femur head (ANFH) treated by core decompression and vascular pedicled iliac crest grafting.
Patients And Methods: This retrospective study included 26 hips of 22 patients (14 males, 8 females; mean age 36 years; range 16 to 48 years) with ANFH using the vascularized iliac bone grafting between March 2003 and July 2010 in our clinic. The main predisposing factor was steroid use in 13 patients. All patients were assessed clinically according to the Harris hip score and by radiographs by the Association Internationale de Recherche sur la Circulation Osseuse (ARCO) staging system.
Results: The mean follow-up was 36 (range 14 to 62) months. Eleven hips (42%) had stage II and 15 hips (58%) had stage III ANFH. The mean Harris scores increased from 52 (range 31 to 63) to 82.8 (range 62 to 90) after surgery. Based on clinical outcomes, 18 hips (69%) were presented as excellent and good, while eight hips presented fair and poor. According to the ARCO staging system, satisfactory results were provided in 17 (65%) of the 26 hips. Two of four hips at preoperatively stage II progressed to stage III, two other hips to stage IV. Five hips at stage III preoperatively progressed to stage IV and these hips had to undergo hip replacement.
Conclusion: Our results suggest that core decompression and the vascular pedicled iliac bone grafting are effective in early stages of ANFH.
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http://dx.doi.org/10.5606/ehc.2014.02 | DOI Listing |
J Vis Exp
December 2024
Center for Engineering in Medicine and Surgery, Massachusetts General Hospital, Harvard Medical School; Shriners Children's Boston;
To date, uterus transplantation is the only option for women with absolute uterine infertility, such as those with Rokitansky syndrome, to experience pregnancy and give birth. Despite the growing interest in uterus transplantation in recent years, several issues still require further research, including ischemia-reperfusion injury and its impact on graft quality and rejection. Recent literature has highlighted a thrombotic complication rate of up to 20% following uterus transplantation.
View Article and Find Full Text PDFHead Neck
January 2025
Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Background: Flow-through flaps (FTFs) are an advanced technique in which a free flap is anastomosed to the pedicle of another free flap to reconstruct extensive head and neck defects when recipient vessels are scarce.
Methods: A multi-institutional cohort of FTFs used for head and neck reconstruction were reviewed. For comparison, FTF outcomes were compared to free flaps that required vein grafts (VG) to reach distant recipient vessels.
J Clin Aesthet Dermatol
December 2024
Mr. Dahabreh and Drs. Hazan and Khorasani are with the Department of Dermatology, Icahn School of Medicine at the Mount Sinai Medical Center in New York, New York.
V-to-Y advancement flap is a successful repair technique that preserves vascular and tissue integrity adopted after Mohs micrographic surgery to repair cutaneous defects on the head and neck. However, defects at the lateral distal nasal ala requires large extension beyond cosmetic margins that increase risk of skin webbing, an undesired result on a cosmetically sensitive location to the patient. In this article, we present a novel approach to modifying the procedure employing the V-to-Y advancement flap by truncated the trailing end of the island pedicle to allow for successful healing and better patient satisfaction.
View Article and Find Full Text PDFJ Surg Case Rep
January 2025
School of Medicine, College of Health Sciences, Addis Ababa University, Tikur Anbessa Specialized Hospital, Churchill Avenue, Lideta Sub-City, P.O. Box 5657, Addis Ababa, Ethiopia.
Volvulus is the rotation or twisting of the intestine around its vascular pedicle. The occurrence of descending volvulus after sigmoidectomy is extremely rare. We report a case of a 35-year-old male who presented with abdominal distention, cramping, and no passage of feces or gas for three days.
View Article and Find Full Text PDFMicrosurgery
January 2025
Division of Plastic, Reconstructive and Aesthetic Surgery, University Hospital Bonn, University of Bonn, Bonn, Germany.
Open abdomen treatment (OAT) is associated with significant morbidity and mortality. In cases where primary or delayed fascial closure cannot be achieved, vacuum-assisted wound closure and mesh-mediated fascial traction are indicated, which often result in a planned ventral hernia. If secondary skin closure is not feasible, common treatment of granulated abdominal defects involves split-thickness skin-grafting or healing by secondary intention leading to significant scarring and sometimes mutilating defects.
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