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Histologically, bone ingrowth at the screw interface was also shown to significantly increase with healing time. Vazegepant price Improvements in fracture healing, indicated by an increase in bone fraction and decrease in void space at the osteotomy, were also observed with healing time. CONCLUSION The results demonstrate the effectiveness of the SRT as a method for improved screw retention in a rescue-screw type scenario. Georg Thieme Verlag KG Stuttgart · New York.OBJECTIVE The aim of this study was to evaluate objective limb function using force plate gait analysis after tibial plateau levelling osteotomy (TPLO) in small breed dogs with cranial cruciate ligament rupture (CCLR). MATERIALS AND METHODS Small breed dogs (15 kg or less) with unilateral CCLR treated with TPLO were evaluated using symmetry index (SI) of peak vertical force (PVF), vertical impulse and vector magnitude at PVF performed preoperatively and at 1, 2, 4 and 6 months postoperatively after routine TPLO surgery. RESULTS Twelve dogs met the inclusion criteria. Hindlimb function was markedly improved after TPLO, with all three postoperative SI significantly higher after a month than preoperative values (p less then 0.01). At 2 months after surgery, the SI was nearly normalized to 1.0 (preoperative SI 0.50 ± 0.20, 0.44 ± 0.19 and 0.51 ± 0.19, and 2 months postoperative SI 0.92 ± 0.16, 0.90 ± 0.18 and 0.92 ± 0.16 respectively). Complications were noted in two dogs (fibular fracture and a partial implant failure), neither of which required a revision surgery for acceptable functional recovery. CONCLUSION The objective limb function of the affected hindlimb improved continuously after surgery and reached a near normal value at 6 months after surgery. It was suggested that TPLO for small breed dogs had good outcomes based on force plate gait analysis. Georg Thieme Verlag KG Stuttgart · New York.BACKGROUND The versatile application of local perforator flaps for coverage throughout the lower extremity has already been well proven. Often a "free-style" approach has been used to design these flaps, as conventional imaging devices for perforator identification may be too expensive or unavailable. The recent adaptation of Smartphone thermal digital imaging may now prove to be a cheaper and more readily available means for identifying the requisite perforators that will sustain these local flaps. METHODS Over the past year, a prospective study was undertaken of all patients having a local perforator flap for coverage of a lower extremity defect. Twenty-eight local perforator flaps involving all subtypes were utilized in 25 patients. Smartphone thermography was used in all patients preoperatively to identify preferable perforator or vascular network "hot spots" that allowed appropriate flap design. Intraoperative and postoperative monitoring was similarly done for all flaps to determine outcomes. RESULTS ted. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.BACKGROUND In the pediatric population, bony defects of the extremities pose a significant challenge for which free vascularized fibular grafts (FVFGs) represent a valuable reconstructive option. The purpose of this study was to explore surgical outcomes, complications, and long-term functionality of FVFG for this patient group. METHODS Using MEDLINE and PubMed databases, studies were identified of pediatric extremity reconstruction using FVFG which reported functional outcomes and/or complications. The operative logs at a tertiary pediatric center were then reviewed for cases of FVFG between January 2000 and 2017. Demographic characteristics, surgical indications, operative details, graft survival, bony union, complications, and functionality of the reconstruction were recorded. RESULTS A total of 366 studies were identified with 23 ultimately meeting inclusion criteria in the systematic review. In the institutional series, 29 patients were included with mean age of 9.7 years (1-17 years). Indications for counseled regarding this expectation. Though technically challenging, excellent long-term graft viability and functional recovery can be achieved in the large majority of patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.BACKGROUND This study aims to directly compare measurements of tissue oxygenation obtained using the Intra.Ox (Vioptix Inc., Fremont, CA) near infrared spectrometer with the perfusion assessment of the indocyanine green (ICG)-based SPY Elite imaging system (Stryker Co., Kalamazoo, MI) in a porcine bowel model. METHODS Two live minipigs underwent laparotomy and isolation of a 30-cm segment of a large bowel. Standardized oximetry measurements were taken along the segment of bowel immediately before, after, and serially for 30 minutes following transection. A 0.5 mg/kg dose of ICG was then injected intravenously and the SPY Elite system was used to visualize and quantify tissue perfusion. Pearson's correlation coefficients were calculated using the outcomes. RESULTS Transected and ligated bowel yielded mean Intra.Ox measurements of 61% oxygenation at the proximal base of the limb and 27.8% at the distal edges. Analysis of the relative ICG fluorescence using the SPY Elite's proprietary software yielded perfusion estimates of 64.8% proximally and 6.8% distally. Intra.Ox and SPY Elite measurements demonstrate a Pearson product-moment correlation of 0.929. Repeat measurements at 15-mm intervals along the tissue yielded decreasing Intra.Ox measurements along the length of the flap that correlate to SPY Elite measurements (r = 0.645). CONCLUSION Both the Intra.Ox and the SPY detected clinically relevant changes in bowel oxygenation following transection and ligation. The use of intravenous ICG dye did not appear to affect measurements of tissue oxygenation obtained using the Intra.Ox. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.BACKGROUND As deep inferior epigastric artery perforator (DIEP) flaps have gained popularity in breast reconstruction, the postoperative care of these patients, including the appropriate hospital length-of-stay and the need for intensive care unit (ICU) admission, has become a topic of debate. At our institution, we have adopted a pathway that aims for discharge on postoperative day 3, utilizing continuous tissue oximetry without ICU admission. This study aims to evaluate outcomes with this pathway to assess its safety and feasibility in clinical practice. METHODS A retrospective review was performed of patients undergoing DIEP flap breast reconstruction between January 2013 and August 2014. Data of interest included patient demographics and medical history as well as complication rates and date of hospital discharge. RESULTS In total, 153 patients were identified undergoing 239 DIEP flaps. The mean age was 50 years (standard deviation [SD] = 10.2) and body mass index (BMI) 29.4 kg/m2 (SD = 5.2). Over the study period, the flap failure rate was 1.
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