Journal articles: 'Anatomical defects'

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Song, Seung Han, Hyeokdong Kwon, Sunje Kim, Joo Hak Kim, Hyun Woo Kyung, Sang-Ha Oh, Ho Jik Yang, and Yooseok Ha. "Propeller Dorsal Intercostal Artery Perforator Flap for an Extensive Defect on the Back Following Malignant Peripheral Nerve Sheath Tumor Resection: A Case Report." Archives of Hand and Microsurgery 26, no. 1 (March 1, 2021): 63–67. http://dx.doi.org/10.12790/ahm.20.0068.

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Posterior trunk defects have been a challenging anatomical area to cover in reconstructive surgery. The use of local myocutaneous flaps has been described extensively in the literature to cover these defects, but these techniques are associated with significant donor-site morbidity, including functional loss of muscle units. Freestyle perforator flaps enable local tissue recruitment with skin of a similar color and texture in diverse anatomic areas, but there is a shortage of case series on posterior trunk defects using propeller dorsal intercostal artery perforator (DICAP) flaps, particularly when the defects are extensive. In this report, the authors present a successful case of a DICAP propeller flap for an extensive defect on the upper back following a malignant peripheral nerve sheath tumor resection.

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Kamali, Y., No author No author, Z. Khaksar, A. Sharaki, and B. Kajbafi. "A detailed systematic anatomical study of monocephalic conjoined symmetric twin lambs." Open Veterinary Journal 5, no. 2 (2014): 124. http://dx.doi.org/10.5455/ovj.2014.v4.i2.p124.

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A case of conjoined twins with monocephalus, thoracopagus, partial abdominopagus, tetrabrachius and tetrascelus in lambs complicated with several defects of skeletal, cardiovascular, gastrointestinal, and urogenital systems is reported. The twins were dead and delivered by cesarean section. This case report highlights the detailed anatomical study of defects in different systems due to an abnormal birth defect.

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Rao, Kavitha S., Vasumathi Kameswaran, and Benoit G. Bruneau. "Modeling congenital heart disease: lessons from mice, hPSC-based models, and organoids." Genes & Development 36, no. 11-12 (June 1, 2022): 652–63. http://dx.doi.org/10.1101/gad.349678.122.

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Congenital heart defects (CHDs) are among the most common birth defects, but their etiology has long been mysterious. In recent decades, the development of a variety of experimental models has led to a greater understanding of the molecular basis of CHDs. In this review, we contrast mouse models of CHD, which maintain the anatomical arrangement of the heart, and human cellular models of CHD, which are more likely to capture human-specific biology but lack anatomical structure. We also discuss the recent development of cardiac organoids, which are a promising step toward more anatomically informative human models of CHD.

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Ladutko, D. Yu, V. N. Podhaisky, Yu N. Ladutko, A. V. Pekar, O. P. Kezlya, А. V. Selitsky, and A. V. Gubicheva. "Algorithm of surgical treatment of large bone defects of long tubular bones by vascularized bone grafting." Issues of Reconstructive and Plastic Surgery 24, no. 3-4 (January 20, 2022): 63–75. http://dx.doi.org/10.52581/1814-1471/78/06.

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The purpose of this study was to develop a clinical classification of large defects of long tubular bones of the extremities and protocols for surgical treatment by vascularized bone grafting.Material and methods. The results of treatment of 51 patients with large defects of the long tubular bones of the upper and lower extremities were analyzed. In 25 cases, along with bone defects, there were significant defects of the soft tissues of the limb with trophic and scar changes. In order to replace the bone defect vascularized grafts were used: bone-muscular fibular, bone-cutaneous fibular, bone-cutaneous iliac, bone-cutaneous radial, bone-cutaneous tibial, and combined bone-cutaneous fibular with an allograft from the tibia. The results of treatment of patients were evaluated according to the clinical criteria of R. Johner, O. Wruhs (1983), proposed for the lower limb. The DASH questionnaire was use to evaluate the results of treatment for upper limb defects.The results and discussion. The classification is based on 4 variable criteria: the size, anatomical localization of the bone defect, the size of the soft tissue defect and the shortening of the damaged limb segment. The size and anatomical location of the defect in the long tubular bone is important in choosing a bone flap. Based on the anatomical localization of the bone defect, soft tissue damage and limb shortening, the patients were classified into 4 types. The first 3 types were divided into 2 subtypes, depending on the size of bone damage and soft tissues defect of the limb. Based on the proposed classification, we have developed protocols for microsurgical reconstruction of large bone defects of the extremities for each subtype of bone defect.Conclusion. The application of the developed clinical classification of large bone defects of long tubular bones and protocols for their surgical treatment by vascularized bone grafting made it possible to restore limb function in 96% of cases.

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Tabery, Stefania, and Otto Daniëls. "How classical are the clinical features of the “ostium secundum” atrial septal defect?" Cardiology in the Young 7, no. 3 (July 1997): 294–301. http://dx.doi.org/10.1017/s1047951100004182.

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AbstractSome patients with so called “secundum” atrial septal defect within the oval fossa show a large defect on the echocardiogram, although they do not have all the classical clinical features. Until now, a large atrial septal defect was thought to be characterized by a large shunt (functional defect). Experience indicates, nonetheless, that such large defects in size (anatomical defect) are not always accompanied by large shunts. In order to assess how often the classical clinical features of an atrial septal defect exist, and to investigate whether the surgical indication for closure of the defect are anatomical or functional, we carried out a retrospective study. We evaluated the records of 161 patients, with birth dates from 1973 to 1994 (age between 0 and 21 years), so as to study the classical clinical features (history, physical examination, electrocardiogram, chest X-ray, echo-Doppler studies, cardiac catheterization, surgery). Only patients with an atrial septal defect found in isolation were included.We discovered that the classical clinical features are often not present when there is a large defect, be it functional or anatomical. The anticipated features are present in roughly two-thirds of the patients. There is also a discrepancy between the anatomical and the functional sizes of the defect. This finding creates a fundamental problem for the future, namely the indications fot closure of atrial septal defects within the oval fossa. Further studies are needed to answer this important question

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Jenasamant, Saumya Sekhar, Manish V. Jawarkar, Swarnika Srivastava, Ajit Kumar Padhy, and Muhammad Abid Geelani. "Surgical challenge in situs inversus with dextrocardia and Lutembacher syndrome." Asian Cardiovascular and Thoracic Annals 26, no. 9 (March 6, 2017): 690–93. http://dx.doi.org/10.1177/0218492317697449.

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Situs inversus with dextrocardia and Lutembacher syndrome is a rare cardiac anomaly. It is associated with other complex cardiac anomalies and anatomical defects. A 30-year-old woman with this condition underwent mitral valve replacement and closure of a secundum atrial septal defect. We describe the surgical approach, position of the surgeon, and bicaval cannulation technique for this anatomical aberration.

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Iorio, Caitlin Boling, J. Jared Christophel, and Stephen S. Park. "Nasal Reconstruction: Defects that Cross Anatomical Subunits." Facial Plastic Surgery 36, no. 01 (February 2020): 091–101. http://dx.doi.org/10.1055/s-0040-1701519.

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AbstractThe nose plays a crucial role in the human experience, both aesthetically and functionally. The biomechanics of covering flaps, the importance of a firm framework, and the anatomical basis for aesthetic subunits are imperative concepts as one proceeds through the algorithm of reparative options. The subunits consist of three paired units—the ala, soft tissue facets (also known as soft tissue triangles), and sidewall, as well as three unpaired units—the dorsum, tip, and columella. Because many defects cross aesthetic subunits, it is critical to understand when to adapt the subunit principle and how or when to use a combination of techniques. It can be more challenging to apply the subunit principle to small grafts and local flaps of the nose. Convex subunits, such as the nasal tip and alar lobule, more frequently follow the subunit principle. In our practice, we adhere to a teaching of producing “straight lines and sharp corners.” This applies to local flaps and grafts and focuses on keeping scar lines inconspicuous. In this article, we discuss approaches we follow for various defects along with technical pearls for performing these reconstructions. The subunit principle is more of a practice of thinking of resultant scars within a background of existing lines, reflections, and contour inflections.

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Sun, Yu, Heike Helmholz, and Regine Willumeit-Römer. "Surgical Classification for Preclinical Rat Femoral Bone Defect Model: Standardization Based on Systematic Review, Anatomical Analysis and Virtual Surgery." Bioengineering 9, no. 9 (September 15, 2022): 476. http://dx.doi.org/10.3390/bioengineering9090476.

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Though surgical techniques profoundly influence in vivo experiments, significant heterogeneity exists in current surgeries for inducing rat femoral bone defects. Such variations reduce the reproducibility and comparability of preclinical studies, and are detrimental to clinical translation. The purposes of this study were: (1) to conduct a systematic review of rat femoral defect models, summarizing and analyzing the surgical techniques; (2) to analyze surgical design and potential pitfalls via 3D anatomy and virtual surgeries for fostering future precision research; and (3) to establish a surgical classification system, for improving the reproducibility and comparability among studies, avoiding unnecessary repetitive experiments. The online database PubMed was searched to identify studies from January 2000 to June 2022 using keywords, including rat, femur, bone defect. Eligible publications were included for a review of surgical methods. Anatomical analysis and virtual surgeries were conducted based on micro-CT reconstruction of the rat femur for further investigation and establishment of a classification system. A total of 545 publications were included, revealing marked heterogeneity in surgical methods. Four major surgical designs were reported for inducing defects from the proximal to distal femur: bone tunnel, cortical window, segmental defect, and wedge-shaped defect. Anatomical analysis revealed potential pitfalls hindering efficient clinical translation. A classification system was established according to the anatomical region, surgical design, and fixation devices. This systematic review in combination with 3D analysis and virtual surgery provides a general overview of current surgical approaches to inducing femoral defects in rats, and establishes a surgical classification facilitating preclinical research of quality and translational value.

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Schmitz, HC, CC Egidy, H. Al-Khateeb, G. Cárdenas, T. Gehrke, and D. Kendoff. "Importance of Preoperative Imaging in Acetabular Revision Surgery - A Case Report." Open Orthopaedics Journal 6, no. 1 (May 30, 2012): 215–19. http://dx.doi.org/10.2174/1874325001206010215.

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Acetabular defects, particularly as a result of protrusion of acetabular components into the hemipelvis, may cause serious complications during revision procedures as a result of iatrogenic injury to surrounding anatomical structures. In these challenging cases, we advocate the utilisation of preoperative three dimensional imaging. MRI and CT- imaging offer superior understanding of the three-dimensional quality of bony defects and the relationship of implants to important anatomical structures. Appropriate preoperative planning may also prevent major complications during the removal of the pre-existing hardware, prior to re-implantation of implants. Potential complications include injury of nerves, blood vessels and other intrapelvic structures.In our case, a major bony defect of the acetabulum was a result of the protrusion of an implanted reinforcement ring. A preoperative, contrast-enhanced CT scan showed that the urethra was in close proximity to the hook of the reinforcement ring.The preoperative imaging aided in identifying and understanding the potential complications that could occur intraoperatively. Additionally, it delineated the intact anatomic structures prior to surgery, which could have medico-legal implications.The importance of preoperative imaging and the existing literature is discussed within this case description.

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Almusharraf, Abdullah, and Andrew Whyte. "Task-based defect management: anatomical classification." Built Environment Project and Asset Management 6, no. 3 (July 4, 2016): 345–58. http://dx.doi.org/10.1108/bepam-02-2015-0006.

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Purpose – Studies on the construction defects and quality deviations have been commissioned and published in many countries, showing the global status of the issues related with construction defects. Therefore, the quality of the adapted practices in construction projects can be improved if the pattern of the sub-task, specifically the quality deviations and construction defects from the requirements and specifications is identified and understood. The purpose of this paper is to improve understanding of the behavior and pattern of the more sensitivity sub-task requirements (STRs) through the anatomy process of a particular task. Design/methodology/approach – Six criteria have been classified for the levels of the estimated STRs quality deviations. The proposed study classifications were examined through the 3,030 cases of 17 STRs from compression concrete members (i.e. column). Findings – Most of the STRs were found to be prone to deviations and the sensitivities of the STRs toward deviations and defects are varied across all STRs. The study reveals that three of the 17 STRs were observed as perfect works, ten STRs as acceptable works and four STRs as defective works. Originality/value – The study found that the sub-task deviation patterns cannot be generalized and must be individually studied to recommend the appropriate proactive measures.

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Mahajan, Ravi Kumar, Krishnan Srinivasan, Abhiskek Bhamre, Mahipal Singh, Prakash Kumar, and Ankush Tambotra. "A retrospective analysis of latissimus dorsi–serratus anterior chimeric flap reconstruction in 47 patients with extensive lower extremity trauma." Indian Journal of Plastic Surgery 51, no. 01 (January 2018): 024–32. http://dx.doi.org/10.4103/ijps.ijps_121_17.

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ABSTRACT Background: Many flaps have been described for reconstruction of lower extremity defects, including, Latissimus Dorsi, Rectus abdominis, Anterolateral thigh perforator flaps, each having advantages and disadvantages. The defect location, size and specific geometric pattern of defect influences the type of flap that can be used. In this case series, we describe the specific situations where the use of chimeric latissimus dorsi–serratus anterior (LD + SA) free flaps are of advantage in providing complete wound cover. Materials and Methods: Case records of all patients who underwent LD + SA free flap transfer for lower extremity trauma at Amandeep Hospital, from Feb 2006 to Feb 2017 were reviewed. Patients were categorised based on the anatomical location and size of defect. The method of usage of the chimeric segments, recipient vessels and type of anastomosis were noted. Flap complications, if any were reviewed. Result: 47 patients with lower limb defects were included in the study. All cases were post traumatic in nature. Defect size ranged from 180 sq cm to 1050 sq cm. Average defect size was 487.70 sq cm. All patients underwent soft tissue reconstruction with LD + SA flap. Complete wound cover was obtained. Conclusion: Latissimus dorsi + Serratus anterior free tissue transfer is an effective, reliable method of providing cover to extensive lower limb traumatic defects with minimal donor site morbidity, with added freedom of inset and flap positioning. Specific use is seen in patients with broad proximal defect, long defect in the leg, defects involving adjacent anatomical areas and in large defect with dead space.

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MURAD-REGADAS, Sthela Maria, Iris Daiana DEALCANFREITAS, Francisco Sergio Pinheiro REGADAS, Lusmar Veras RODRIGUES, Graziela Olivia da Silva FERNANDES, and Jacyara de Jesus Rosa PEREIRA. "DO CHANGES IN ANAL SPHINCTER ANATOMY CORRELATE WITH ANAL FUNCTION IN WOMEN WITH A HISTORY OF VAGINAL DELIVERY?" Arquivos de Gastroenterologia 51, no. 3 (September 2014): 198–204. http://dx.doi.org/10.1590/s0004-28032014000300006.

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Objectives To evaluate anal sphincter anatomy using three-dimensional ultrasonography (3-DAUS) in incontinent women with vaginal delivery, correlate anatomical findings with symptoms of fecal incontinence and determine the effect of vaginal delivery on anal canal anatomy and function. Methods Female with fecal incontinence and vaginal delivery were assessed with Wexner’s score, manometry, and 3DAUS. A control group comprising asymptomatic nulliparous was included. Anal pressure, the angle of the defect and length of the external anal sphincter (EAS), the anterior and posterior internal anal sphincter (IAS), the EAS + puborectal and the gap were measured and correlated with score. Results Of the 62, 49 had fecal incontinence and 13 were asymptomatic. Twenty five had EAS defects, 8 had combined EAS+IAS defects, 16 had intact sphincters and continence scores were similar. Subjects with sphincter defects had a shorter anterior EAS, IAS and longer gap than women without defects. Those with a vaginal delivery and intact sphincters had a shorter anterior EAS and longer gap than nulliparous. We found correlations between resting pressure and anterior EAS and IAS length in patients with defects. Conclusions Avaliar a anatomia do esfíncter anal usando ultra-sonografia tridimensional (3D-US) em mulheres incontinentes com parto vaginal, correlacionar os achados anatômicos com sintomas de incontinência fecal e, determinar o efeito do parto vaginal sobre a anatomia e função do canal anal.

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Bouceiro-Mendes, Rita, M. Mendonça-Sanches, M. Alpalhão, P. Filipe, and J. N. Maia Silva. "The Bilobed Flap as an Option for Large Neck." Journal of the Portuguese Society of Dermatology and Venereology 78, no. 2 (July 14, 2020): 167–69. http://dx.doi.org/10.29021/spdv.78.2.1188.

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The bilobed flap has been extensively used in the reconstruction of distal nasal defects. It is a local flap that recruits skin from areas where there is relative skin mobility to close defects in areas where the skin has less plasticity. Besides its usefulness in the reconstruction of small to moderate cutaneous nasal defects it can also be used to reconstruct large defects located in other anatomical areas. We present a clinical case in which the bilobed skin flap was employed to reconstruct a large surgical defect of the neck resulting from excision of a basal cell carcinoma, with excellent functional and cosmetic results.

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ÖZDEMİR, Erdinç, Taha Can TUMAN, Abdurrahman EMİR, Safa ÇELİK, and Uğur ÇAKIR. "Psychotic and Anatomical Defects of Choking: Case Report." Turkiye Klinikleri Journal of Forensic Medicine 12, no. 1 (2015): 33–36. http://dx.doi.org/10.5336/forensic.2015-46132.

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Sretenovic, N., M. Colic, R. Lazic, S. Bosic, and N. Stojadinovic. "Gangrena Fournier i rekonstrukcija nastalih defekata." Acta chirurgica Iugoslavica 53, no. 3 (2006): 95–99. http://dx.doi.org/10.2298/aci0603095s.

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Fournier?s gangrene is remarkably rare but severe, life threatening condition. Thanks to better early recognition of disease in past few years, the percentage of patients which survive this condition is considerable, but consequence of this fact is large number of patients with defects of cutis and subcutis in perineal and scrotal regions. Reconstruction of this defects is complicate and require healthy, well vascularised tissue from another anatomical region which is not involved in gangrenous process. Authors present two cases of reconstruction of defects in perineal and scrotal regions. First case is large defect which is covered by transposition of musculus gracilis musculo-cutaneous flap. Second case is lesser defect which is enclosed by mobilization of local skin flaps. .

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Zheng, Jianxiong, Hua Liao, Jie Li, Lingjian Zhuo, Gaohong Ren, Ping Zhang, and Jijie Hu. "Double-pedicle propeller flap for reconstruction of the foot and ankle: anatomical study and clinical applications." Journal of International Medical Research 47, no. 10 (August 5, 2019): 4775–86. http://dx.doi.org/10.1177/0300060519865625.

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Objective Reconstruction of soft tissue defects in the foot and ankle remains challenging. This study was performed to investigate the technical points and clinical effects of a double-pedicle propeller flap for repair of foot and ankle soft tissue defects. Methods We used five fresh calf specimens to investigate the anatomical and operative aspects of a double-pedicle propeller flap. Eighteen patients with soft tissue defects in the foot and ankle subsequently underwent defect repair with double-pedicle propeller flaps. Results The anatomical study showed that the peroneal artery perforators and the sural nerve bundle (two blood supply systems) provided the theoretical anatomical basis for the double-pedicle propeller flap. The relative positions of the peroneal artery perforators and the sural nerve bundle differ according to the peroneal artery perforating level. Flap rotation in different directions can reduce or prevent the pedicles from compressing each other. All flaps survived, and three flaps developed local epidermal necrosis at the proximal end; these flaps healed after 1 to 2 weeks of dressing changes. The other 15 patients healed well. Conclusions The double-pedicle propeller flap can enhance the blood supply and venous return in the “big paddle” region of the flap, reducing the distal necrosis rate.

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Abd-Al-Moktader, Magdy. "Distally Based Peroneus Brevis Muscle Flap for Large Leg, Ankle, and Foot Defects: Anatomical Finding and Clinical Application." Journal of Reconstructive Microsurgery 34, no. 08 (June 28, 2018): 616–23. http://dx.doi.org/10.1055/s-0038-1661366.

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Background Peroneus brevis muscle flap is a distinguished, distally based safe flap that can be manipulated to cover small defects in the leg and ankle. For large-sized defects, a more distal, larger flap is required either locally or distantly. Methods Forty-two distally based peroneus brevis muscle flaps were elevated in 42 patients (30 males and 12 females) with major lower leg, ankle, and proximal foot defects of 6 to 15 cm in length and 6 to 12 cm in width. Anatomical findings were recorded as number, size, and sources of blood supply, entry sites, the lowermost two arterial supplies, internal distribution of blood supply to the muscle, the relationship between external and internal distribution of the blood vessels, the length of the muscle, the entry site of the main artery, and the splitting of the proximal portion of the peroneus brevis muscle to increase its width to sufficiently cover large defects. Results The anatomical findings suggested that the muscle can be safely extended to cover a large defect in the leg, ankle, or proximal foot. In addition, the longitudinal splitting of the muscle increases its width by up to three times, making it an excellent long-surviving flap to cover a large defect. Conclusion A distally based peroneus brevis muscle flap has a rich blood supply and safely reaches the proximal foot, with a secure splitting to cover large defects in the leg, ankle, and proximal foot.

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Ananthakrishna Pillai, Ajith, Amarnath Upadhyay, Saranya Gousy, and Amit Handa. "Impact of modified techniques of transcatheter closure in large atrial septal defects (⩾30 mm) with anatomic complexities." Cardiology in the Young 28, no. 10 (July 23, 2018): 1122–33. http://dx.doi.org/10.1017/s1047951118001099.

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AbstractObjectiveThe outcome of transcatheter closure in ostium secundum atrial septal defects is determined by the morphology of the defects. Modified techniques such as balloon assistance, pulmonary vein deployment, left atrial roof technique, and so on are used for circumventing the anatomic complexities and increasing the success rates.MethodsWe planned a prospective study looking at the outcomes of transcatheter closure in secundum atrial septal defects with modified techniques in different anatomic complexities identified in transoesophageal echocardiography and their association with outcome of transcatheter closure.ResultsTranscatheter closure was successful in 295 out of 346 (82%) patients with modified techniques. Balloon-assisted technique offered a success rate of 87%. The mean defect size was 34.7±2.78 mm (95% confidence interval (CI) 30.67–43.1 mm) with success and 40.16±4.5 mm (95% CI 32.16–44.7) with failure (p = 0.02). The mean total septal length was 38.11±0.63 (95% CI 35.21–40.56 mm) with success and 42.54±0.34 (95% CI 38.79–43.21 mm) with failure. The defect to septal ratios were 0.82 and 0.94 in success and failure groups, respectively (p=0.02). However, the absence of a retro-aortic margin, septal aneurysm, and multiple defects did not affect the success rate. Deficient inferior vena caval margin, deficient posterior margin, and size⩾40 mm had a high risk of failure with transcatheter closure. The odds ratio for procedural failure was 25.3 (4.3–143.8) in patients with malaligned septum, 8.3(1.4–48.5) with deficient inferior vena caval margin, and 4.1(2.5–19) for size⩾40 mm.ConclusionsThe modified techniques for device deployment offer substantial chances of success in transcatheter closure of secundum atrial septal defects with anatomical complexity (82%). Variants such as defect size of⩾40 mm and deficient inferior and posterior margins have high failure rates with a modified technique.

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Pampado Di Santis, Érico. "Rhomboid Flap: An Option to Many Anatomical Regions." Journal of Advanced Plastic Surgery Research 1, no. 1 (October 16, 2015): 14–18. http://dx.doi.org/10.31907/2414-2093.2015.01.4.

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Introduction: The rhomboid transposition flap can be used at any region on the body surface, and is widely used on reconstructive surgery. When it is used for surgical procedures in order to correcting facial defects, the Limberg’s flap produces good functional and aesthetic results, particularly when scars are positioned between the aesthetic units of the face. This article will describe the rhomboid flap technique and discuss the versatility, safeness, applicability and complications of Limberg’s flap for cutaneous reconstruction, which can be in a huge part of body segments Results and Discussion: The Limberg’s flap is a rhomboid transposition flap. The flaps are made by taking into account size and location of the original defect and elasticity of the surrounding tissue. From the resection defect resulting, a lozenge is drawn with internal angles of 60 degrees and 120 degrees and the closure is completed by transposing the flap towards the defect. This flap provides very good results to be executed with predictability, high safeness degree and low rate of complications. Keywords: Flap, Limberg, Reconstruction, Rhomboid, Surgery.

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Zygouris, Panagiotis, Adamantios Michalinos, Vassilis Protogerou, Evangelos Kotsiomitis, Antonios Mazarakis, Ioannis Dimovelis, and Theodore Troupis. "Use of Lateral Calcaneal Flap for Coverage of Hindfoot Defects: An Anatomical Appraisal." Plastic Surgery International 2015 (November 11, 2015): 1–5. http://dx.doi.org/10.1155/2015/212757.

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Lateral calcaneal flap is an established surgical option for coverage of lateral calcaneum and posterior heel defects. Lateral calcaneal flap vascularization and innervations are based on lateral calcaneal artery neurovascular bundle, that is, lateral calcaneal artery, small saphenous vein, and sural nerve. Anatomical research has allowed exploration of its many advantages but can also lead to its various modifications, permitting a wide variety of clinical applications. In this paper the authors report an anatomical and clinical study on lateral calcaneal artery course and lateral calcaneal flap clinical applications. Anatomic part of our study focused on lateral calcaneal artery course and optimization of surgical technique for flap harvesting. Data were used for design of lateral calcaneal flap in 5 patients. Our results were satisfactory in terms of coverage adequacy, perioperative morbidity, and functional and aesthetical outcome.

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Gregori, Markus, Lukas Eichelberger, Claudia Gahleitner, Stefan Hajdu, and Michael Pretterklieber. "Relationship between the Thickness of the Coracoid Process and Latarjet Graft Positioning—An Anatomical Study on 70 Embalmed Scapulae." Journal of Clinical Medicine 9, no. 1 (January 12, 2020): 207. http://dx.doi.org/10.3390/jcm9010207.

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Background: The Latarjet procedure is a popular technique with the aim of the reconstruction of glenoid cavity bone defects in patients with chronic anterior shoulder instability. Studies have shown that the Congruent arc Latarjet procedure is better able to reconstruct larger defects than the Classic Latarjet, but there is a lack of information on the limitations of both methods. Methods: The dimensions of the glenoid width and the native coracoid process of two groups with 35 Formol-Carbol embalmed scapulae each were measured using a digital caliper. The relationship between the coracoid graft and the anterior-posterior diameter of the glenoid cavity was calculated to determine the maximum defect size of the glenoid cavity width, which can be treated by both Latarjet techniques. Results: The average restorable defect size of the anterior segment of the glenoid cavity was 28.4% ± 4.6% (range 19.2%–38.8%) in the Classic Latarjet group, and 45.6% ± 5.2% (range 35.7%–57.1%) in the Congruent arc Latarjet group. Based on our results, the feasibility of the Classic Latarjet procedure to reconstitute the anatomical width of the glenoid cavity was 86% in a 25% bone loss scenario, and only 40% in a 30% bone loss scenario. Conclusion: Based on our results we are unable to define a clear threshold for the optimal Latarjet graft position. In glenoid cavity defects <20%, the Classic Latarjet technique usually provides enough bone stock for anatomical reconstruction. Defects ≥35% of the glenoid cavity width should only be treated with a coracoid graft in the Congruent arc position. In the critical area between 20% and 35% of bone loss, we suggest the preoperative assessment of coracoid dimensions, based on which the graft position can be planned to restore the anatomical anterior-posterior diameter of the glenoid cavity.

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Alev, Aydin Atis, Acar Zuhat, Topbas Selcuki Fitnat, Gurbuz Sümeyye, Ece Ermin, and Acar Hicran. "Amniotic Band Syndrome with Cranial Anomalies; Review of Two Cases." International Journal of Clinical Case Reports and Reviews 10, no. 4 (February 7, 2022): 01–05. http://dx.doi.org/10.31579/2690-4861/198.

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Amniotic band sequence (ABS) results from in utero entrapment of fetal parts by fibrous bands, which leads to malformations that can affect multiple organ systems including the limbs, craniofacial regions and trunk, and central nervous system. These bands can adhere to anatomical structures of the fetus and cause vascular disruption which results in the amputation of the involved anatomic part. We present two cases of ABS both of which presented with craniofacial defects associated with ABS; one with apical encephalocel and extremity defects, the other one with schizencephaly with extremity defects and cleft lip & palate. ABS may represent itself not only with extremity defects but atypical forms in cranial vault. ABS must be kept in mind and sonography must be detailed when rare deformities like schizencephaly and extremity defects identified.

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Jain, Mohit, R. K. Basant, Shivam Madeshiya, D. Kumar, Vikas Dwivedi, and Nandan Rai. "Anatomical and clinical evaluation of perforator-based flaps of lower limb." International Surgery Journal 6, no. 2 (January 28, 2019): 381. http://dx.doi.org/10.18203/2349-2902.isj20185505.

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Background: Wound of lower leg have a poor and delayed healing due to paucity of blood supply. Coverage of defects of leg and foot has always posed a problem for reconstructive surgeon. The objective of this study was to evaluate anatomical basis of various perforator-based flaps in lower limb and their clinical outcome and usefulness.Methods: All patients with post traumatic defects with exposed bones/tendons in the leg and ankle region presenting in MLN Medical college, Allahabad from August 2011 to July 2012 were included in the study.Results: A total 12 patients were included in study. Majority of cases are of compound fracture following accidents involving lower one third of leg. Majority of flaps were based on peroneal artery (5) and posterior tibial artery (5), only 2 flaps were based on anterior tibial artery. Maximum flap length was 21cm and maximum flap rotation was 180º. Complications occurred more in cases having maximum rotation. Result were good in 11 patients and satisfactory in 1 patient with coverage of the defect leading to healing of the wound. More time gap between injury and flap reconstruction leads to more complications and longer hospital stay. Graft site complication occur in 5 cases include partial flap necrosis, infection and venous congestion. There was no complication at the donor site.Conclusions: Perforator based flaps can be used for all large lower leg defects provided there is correct measurement and anatomical knowledge of various perforators, with good functional and cosmetic results.

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Y., Raghavendra A., Arunachalam Kumar, Pratik Tarvadi, and Harsha C. R. "ANATOMICAL STUDY OF THE MODERATOR BAND." Journal of Health and Allied Sciences NU 03, no. 04 (December 2013): 078–81. http://dx.doi.org/10.1055/s-0040-1703707.

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AbstractModerator band is a muscular trabecula which extends from interventricular septal wall to the base of anterior papillary muscle in right ventricle of heart. This study was conducted on 20 hearts from adult human cadavers. Out of 20 specimens of heart we could observe the presence of moderator band in 17 and in rest 3 it was not visible for record. Origin length, thickness and distance from tricuspid valve were noted. The average length of the moderator band was 13.82cm with the SD of 3.94 and the average thickness being 4.46cm with the SD of 1.36. The average distance from tricuspid valve was 3.6cm with the SD of 1.01. As the moderator bands, or other large trabeculations, can be major obstacle for the repair of apical ventricular septal defects, the morphometric study of moderator band may help the surgeons during surgical procedures conducted for correction of such defects.

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Grebinichenko, G. O., I. Y. Gordienko, O. K. Sliepov, and A. O. Zhuravel. "Anatomical variants of congenital diaphragmatic hernia, their clinical significance and feasibility of prenatal differentiation." UKRAINIAN JOURNAL OF PERINATOLOGY AND PEDIATRICS, no. 4(84) (December 30, 2020): 19–27. http://dx.doi.org/10.15574/pp.2020.84.19.

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Purpose — to present verified typical anatomical variants of isolated congenital diaphragmatic hernia and clinical outcomes in newborns depending on the type of pathology, to compare with data of prenatal examination, and to assess feasibility of prenatal differentiation of congenital diaphragmatic hernia. Materials and methods. The data of operation protocols and autopsy results of newborn patients with isolated congenital diaphragmatic hernia for the period 2007–2020 were analyzed, and then compared with prenatal exam data and clinical outcomes. Data from different anatomical variants of congenital diaphragmatic hernia were analyzed using descriptive statistics methods. Results. Anatomical data were evaluated in 67 cases with the following typical variants: left-sided non-communicating defect (20.9%), left-sided communicating with herniation of intestine (19.4%), intestine and stomach (26,9%), intestine, stomach and liver (19.4%, 13/67), right- sided communicating with intestine and liver herniation (10.4%), right- sided non-communicating (1.5%), bilateral communicating defects (1.5%). Mortality at the stage of stabilization in these variants was 0%, 0%, 11.1%, 30.8%, 71.4%, 0% and 100%, postoperative mortality, respectively, 7.1%, 0%, 12.5%, 44.4%, 0%, 0% (excluding bilateral hernia), total mortality 7.1%, 0%, 22.2%, 61.5%, 71.4%, 0%, 100%. Comparison of lung indices in patients with left-sided hernias showed their similarity in groups with non-communicating defects and communicating with herniation of intestine. Significant differences were found in the groups with herniation of the intestine and stomach, and intestines, stomach and liver. The mean liver-to-lung ratio in right-sided communicating defects was 3.7±1.9, in left-sided communicating defects 1.7±0.8 and in non-communicating 0.44±0.25, the difference between all groups was highly significant. Patterns of stomach position in different variants of pathology were determined. Conclusions. Analysis of postnatally verified cases of diaphragmatic hernia showed marked anatomical variability. The highest mortality and the lowest rate of surgical correction registered was in communicating right-sided defects, and in communicating left-sided with simultaneous herniation of the intestine, stomach and liver. The best outcomes were found in non-communicating defects, or in communicating with herniation of intestine. Prenatal evaluation of stomach position may be the basis to differentiation between clinico-anatomical variants of the pathology. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the Institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: congenital diaphragmatic hernia, congenital malformations, prenatal diagnosis.

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Cano, Jaime J. Morales De, Llorenç Guillamet, and Arturo Perez Pons. "ACETABULAR RECONSTRUCTION IN PAPROSKY TYPE III DEFECTS." Acta Ortopédica Brasileira 27, no. 1 (February 2019): 59–63. http://dx.doi.org/10.1590/1413-785220192701187313.

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ABSTRACT Objectives: Severe pelvic deficiency presents a difficult problem in hip arthroplasty. Specifically, the goals are to restore the pelvic bone stock, place the acetabular component in the correct anatomical position, and optimize joint stability. Currently, many surgical techniques have been developed for prosthetic revision surgery for acetabular complex defects, but no consensus has been reached on the best treatment. The objective of this study was to review mid-term cases of severe bone defect (Paprosky type III) treated with a bone allograft and ring Bursch-Schneider anti-protrusion cage (BSAC). Methods: A retrospective consecutive series review of the first 23 complex acetabular reconstructions performed between 2006 and 2011 was conducted. The series included the learning curve of the procedure and a minimum 5-year follow-up. Conclusion: Our study confirmed the efficacy of using a frozen morselized allograft combined with a metal ring-type BSAC for acetabular reconstruction. The anatomical location of the center of rotation of the hip must be recovered for long-term success. In massive loosening cases, the anatomical center of rotation can only be restored by bone density reconstruction using a graft protected by a ring to improve the centering of the head. Level of Evidence IV, Case Series.

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Goldsmith, Ira. "Chest Wall Reconstruction With 3D Printing: Anatomical and Functional Considerations." Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery 17, no. 3 (May 2022): 191–200. http://dx.doi.org/10.1177/15569845221102138.

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Large chest wall defects, as a result of wide local excision of chest wall pathology, require skeletal and soft-tissue reconstruction to restore the anatomical shape, structure, and respiratory function of the thorax. Reconstruction is challenging and requires the surgical reconstructive team to understand the anatomic and physiologic morbidity related to the defect and the choice of reconstructive techniques available to restore form and function. Rapidly emerging 3-dimensional (3D) printing technology allows the reconstructive surgical team to customize the therapeutic process of skeletal reconstruction by accurately mimicking the shape and structure of the chest wall being replaced. An integrated knowledge of the anatomy, physiology, mechanics of breathing, and respiratory tests is important to restore form and function. The focus of this article is to review the anatomy, physiology, and assessment of respiratory function from the classical textbooks and integrate this knowledge with the precise anatomy of the chest wall created by 3D printing technology. By doing so, this article will demonstrate how 3D printing may help the reconstructive team to understand the anatomic and physiologic morbidity related to the chest wall defect and the importance of taking each of these aspects into consideration when undertaking chest wall reconstruction of the thorax.

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Kudasova, E. O., E. V. Kochurova, and V. N. Nikolenko. "THE ROLE OF DIFFERENT METHODS OF RADIOLOGY IN PATIENTS WITH ACQUIRED MAXILLOFACIAL DEFECTS." Russian Electronic Journal of Radiology 11, no. 1 (2021): 63–71. http://dx.doi.org/10.21569/2222-7415-2021-11-1-63-71.

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Purpose. To compare radiological methods in clinical dental practice of the patients with acquired defects of the maxillofacial region after tumor treatment manipulations. The search of literature has been done in the date bases SCOPUS, Web of Science, Pubmed, Russian Science Citation Index. The usage of different radiology methods combined with IT-technology makes it possible to improve prosthetic dental treatment of the patients with acquired defects of the maxillofacial region, especially of large anatomical size. However, difficult clinical condition and complicated anatomical relations of the acquired defect do not always allow to choose the specific method or technology. This fact effects on quality of the future dental prosthetic denture. Conclusion. According to the obtained data, both visual analysis and semi-quantitative assessment of 18Ffluorodeoxyglucose PET/CT images showed a good diagnostic performance in the detection of PV IE. The optimal parameter for the diagnosis of IE PV is the SUVratio using aorta with threshold of 1.95 (AUC=0.961).

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al Zaghal, A. M., J. Li, R. H. Anderson, C. Lincoln, D. Shore, and M. L. Rigby. "Anatomical criteria for the diagnosis of sinus venosus defects." Heart 78, no. 3 (September 1, 1997): 298–304. http://dx.doi.org/10.1136/hrt.78.3.298.

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Manandhar, Sunil Raja, Ashish Lal Shrestha, Sabina Shrestha, and Rydam Basnet. "Diaphragmatic Hernia in a Preterm with Congenital Heart Defects with Successful Outcome: A Case Report." Journal of Nepal Medical Association 60, no. 250 (June 1, 2022): 565–68. http://dx.doi.org/10.31729/jnma.7462.

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Congenital diaphragmatic hernia is an anatomical defect of the diaphragm that is often associated with serious cardiopulmonary complications. It can also be associated with many other problems like multi systemic anomalies, chromosomal aneuploidy and prematurity. Of these, cardiac defects, liver herniation and prematurity seem to have a pivotal role in affecting the outcomes of repair. We hereby present a preterm newborn with such multiple defects repaired on 15th day of life and post operatively managed in a Neonatal Intensive Care Unit with a successful outcome. The key learning objective for our team in this case was to identify the steps taken that led to a successful management of a low birth weight preemie with multiple defects in a resource limited set up.

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Krasemann, Thomas, Lennie van Osch-Gevers, and Pieter van de Woestijne. "Cyanosis due to an isolated atrial septal defect: case report and review of the literature." Cardiology in the Young 30, no. 11 (August 24, 2020): 1741–43. http://dx.doi.org/10.1017/s1047951120002656.

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AbstractIsolated atrial defects usually lead to left-to-right shunt and right ventricular volume load. Descriptions of cyanosis with this congenital heart defect are rare.We describe a rare case of inferior caval vein flow directed through an atrial septal defect in the fossa ovalis leading to severe cyanosis, but without any additional intracardiac anatomical abnormalities. The baby with clinical features of Marfan’s syndrome had an eventration of the right-sided diaphragm. Surgical closure of the defect resolved the cyanosis, but the child died 10 weeks later of severe valvar dysfunction, related to Marfan’s syndrome.Mechanisms of cyanosis in patients with atrial septal defects are discussed. Echocardiographic bubble studies both from the lower and upper half of the body may help to clarify the mechanism of an otherwise unexplained cyanosis.

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Hirst, Cara Stella, S. White, T. Siek, and A. Gasparik. "Honeycomb sterna: an unusual case of a developmental abnormality in the sternum." Surgical and Radiologic Anatomy 42, no. 1 (October 31, 2019): 91–94. http://dx.doi.org/10.1007/s00276-019-02350-4.

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Abstract This report details an unusual case of a human sternal developmental abnormality of an anatomical specimen part of the skeletal collection curated by University College London, Anthropology Department skeletal collection. This rarely reported developmental abnormality is caused by the non-fusion of lateral ossification centres in the sternebrae, resulting in the mesosternum having a honeycomb-like appearance. Sternal defects are typically underreported in the clinical literature as many cases being asymptomatic that they are typically diagnosed incidentally, as such there is a dearth in our current understanding of the development and anatomical variants of the sternum. Although in recent years, large-scale CT studies have investigated the prevalence of sternal developmental abnormalities, these studies have not reported sternal defects similar to the individual presented in this report. While most sternal defects are clinically uneventful, the lack of awareness of these variants can result in misinterpretation of radiological and pathological findings as such an understanding of anatomical variants even when asymptomatic is vital.

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Xu, Yan, Mingchang Wu, Xianghui Nie, Zhenjun Feng, Liang Li, and Fengping Yang. "Performance Test and Cause Analysis of Girth Weld with Defects." Journal of Physics: Conference Series 2355, no. 1 (October 1, 2022): 012067. http://dx.doi.org/10.1088/1742-6596/2355/1/012067.

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Abstract In this study, the performance test and defect anatomy analysis were carried out for a girth weld of the pipeline. The results of the girth weld tensile test, groove hammer break test and Vickers hardness test showed no obvious abnormality, and the impact toughness and bending test results were not ideal. In the conventional inspection process, it was found that there were tiny unfused girth welds at 6 o 'clock and 9 o 'clock positions, and the maximum direction size of defects on the wall thickness section was 1.57 mm. The defects at the position from 6 o 'clock to 7 o 'clock found by on-site X-ray detection were identified as the existing non-fusion defects by anatomical analysis, and should be considered as the root of incomplete welding defects that could not be completely eliminated during repair welding. The length and height of the defects are 9 mm and 1.38 mm.

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Hamilton, Kimberly M., Andrea L. Wiens, and Daniel H. Fulkerson. "Lateral posterior fossa encephalocele with associated migrational disorder of the cerebellum in an infant." Journal of Neurosurgery: Pediatrics 8, no. 5 (November 2011): 479–83. http://dx.doi.org/10.3171/2011.8.peds11218.

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Encephaloceles are acquired or congenital defects in which intracranial contents protrude through a defect in the calvaria. The embryogenesis of these lesions is incompletely understood. The vast majority of lesions occur at or near the anatomical midline. The authors present an extremely rare case of a laterally oriented, pathologically proven encephalocele associated with a posterior fossa cyst and cerebellar migrational defect in an infant. The authors review past and current theories of encephalocele formation as it relates to this case.

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Mandolini, Marco, Agnese Brunzini, Eleonora Brandoni Serrani, Mario Pagnoni, Alida Mazzoli, and Michele Germani. "Design of a Custom-Made Cranial Implant in Patients Suffering from Apert Syndrome." Proceedings of the Design Society: International Conference on Engineering Design 1, no. 1 (July 2019): 709–18. http://dx.doi.org/10.1017/dsi.2019.75.

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AbstractThis study defines a methodological procedure for the design and manufacturing of a prosthetic implant for the reconstruction of a midsagittal bony-deficiency of the skull due to the Apert congenital disorder. Conventional techniques for craniofacial defects reconstruction rely on the mirrored-image technique. When the cranial lesion extends over the midline or in case of bilateral defects, other approaches based on thin plate spline interpolation or constrained anatomical deformation are applied.The proposed method uses the anthropometric theory of cranial landmarks identification for the retrieval of a template healthy skull, useful as a guide in the successive implant design. Then, anatomical deformation of the region of interest and free-form modelling allow to get the customized shape of the implant. A full bulk and a porous implant have been provided according to the surgeon advises.The models have been 3D printed for a pre-surgical analysis and further treatment plan. They fulfilled the expectancies of the surgeon thus positive results are predictable.This methodology results to be reproducible to any other craniofacial defect spanning over the entire skull.

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Tatara, Alexander M., Gerry L. Koons, Emma Watson, Trenton C. Piepergerdes, Sarita R. Shah, Brandon T. Smith, Jonathan Shum, et al. "Biomaterials-aided mandibular reconstruction using in vivo bioreactors." Proceedings of the National Academy of Sciences 116, no. 14 (March 18, 2019): 6954–63. http://dx.doi.org/10.1073/pnas.1819246116.

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Large mandibular defects are clinically challenging to reconstruct due to the complex anatomy of the jaw and the limited availability of appropriate tissue for repair. We envision leveraging current advances in fabrication and biomaterials to create implantable devices that generate bone within the patients themselves suitable for their own specific anatomical pathology. The in vivo bioreactor strategy facilitates the generation of large autologous vascularized bony tissue of customized geometry without the addition of exogenous growth factors or cells. To translate this technology, we investigated its success in reconstructing a mandibular defect of physiologically relevant size in sheep. We fabricated and implanted 3D-printed in vivo bioreactors against rib periosteum and utilized biomaterial-based space maintenance to preserve the native anatomical mandibular structure in the defect site before reconstruction. Nine weeks after bioreactor implantation, the ovine mandibles were repaired with the autologous bony tissue generated from the in vivo bioreactors. We evaluated tissues generated in bioreactors by radiographic, histological, mechanical, and biomolecular assays and repaired mandibles by radiographic and histological assays. Biomaterial-aided mandibular reconstruction was successful in a large superior marginal defect in five of six (83%) sheep. Given that these studies utilized clinically available biomaterials, such as bone cement and ceramic particles, this strategy is designed for rapid human translation to improve outcomes in patients with large mandibular defects.

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Kumar, Dr Akhilesh, and Dr Jasleen Kaur. "Ivemark Syndrome- A Rare Syndrome with Constellation of Anatomical Defects." IOSR Journal of Dental and Medical Sciences 16, no. 03 (April 2017): 104–5. http://dx.doi.org/10.9790/0853-160302104105.

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de Moraes, Paulo Hemerson, Sergio Olate, Mario Cantín, Adriano Freitas Assis, Edson Santos, Filipe de Oliveira Silva, and Lucas de Oliveira Silva. "Anatomical Reproducibility through 3D Printing in Cranio-Maxillo-Facial Defects." International Journal of Morphology 33, no. 3 (September 2015): 826–30. http://dx.doi.org/10.4067/s0717-95022015000300003.

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Haylen, Bernard T., Sushen Naidoo, Stephen J. Kerr, Chin H. Yong, and Warwick Birrell. "Posterior vaginal compartment repairs: Where are the main anatomical defects?" International Urogynecology Journal 27, no. 5 (November 12, 2015): 741–45. http://dx.doi.org/10.1007/s00192-015-2874-7.

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Haddad, Raymond N., Régis Gaudin, Damien Bonnet, and Sophie Malekzadeh-Milani. "Hybrid perventricular muscular ventricular septal defect closure using the new multi-functional occluder." Cardiology in the Young 30, no. 10 (August 13, 2020): 1517–20. http://dx.doi.org/10.1017/s1047951120002401.

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AbstractThe hybrid perventricular approach for the closure of trabecular ventricular septal defects is an attractive treatment modality for small children. Worldwide experience has shown that procedure success is influenced by the defect anatomical accessibility, operators’ expertise, and device technical features. In May 2018, a new promising device, the KONAR-Multi-functional™ ventricular septal defect occluder (Lifetech, Shenzhen, China), obtained CE-marking for septal defect transcatheter closure after the first-in-man implantation in 2013. Herein, this is the first report of successful perventricular closure of ventricular septal defect using this new device in a child with significant co-morbidities.

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Tanaskovic, Nenad, Sinisa Ristic, and Miroslav Lucic. "Treatment possibilities of jaws bone defects: A case report." Serbian Dental Journal 57, no. 1 (2010): 49–53. http://dx.doi.org/10.2298/sgs1001049t.

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Large bone defects in the jaws can occur as a result of previous trauma, tumor or bone destruction caused by infection. Significant loss of bone volume also may be caused by premature loss of teeth, application of inadequate extraction technique, periodontitis or trauma caused by incorrect prosthetic reconstruction. Very few of these defects are treated using materials for bone augmentation or regeneration in order to preserve the total volume of bone. Depending on the size of a defect, spontaneous bone regeneration of untreated defects is limited by proliferation of surrounding soft tissue. Bone replacement by connective tissue leads to loss of stability, reduces function and disturbs anatomical form of the jaws. The aim of the study was to present a case from clinical praxis which demonstrates bone regeneration provided by bone substitute or its combination with bone grafts.

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P.V., Zakharova, Kaitova Z.S., and Asatryan D.R. "THE USE OF COMPLEX TRANSPLANTS ON A MOBILE NEUROVASCULAR PEDICLE FOR MANDIBULAR DEFECTS." Global problems of modernity 3, no. 1 (April 20, 2022): 93–96. http://dx.doi.org/10.26787/nydha-2713-2048-2022-3-1-93-96.

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Annotation: The paper presents information about defects in the soft tissues of the face and lower jaw. Anatomical disorders of this pathology limit the functions of human viability. To date, methods for eliminating defects of the lower jaw are widely used.

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Berman, Daniel, Kelly Rogers, Justin Griffin, and Kevin Bonner. "Gender Disparity between Absolute versus Relative Size of Condylar Chondral Defects: An MRI Analysis." Journal of Knee Surgery 32, no. 05 (May 4, 2018): 448–53. http://dx.doi.org/10.1055/s-0038-1646932.

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AbstractSurgical repair of articular cartilage defects in the knee currently utilizes surgical algorithms based on absolute defect size. These algorithms, which have not been validated, are currently utilized not only by surgeons but also by insurance carriers for justification of reimbursement policy. However, current algorithms do not account for morphological differences between individual patients and defect size relative to condylar dimension. We hypothesized that a significant difference in relative defect size compared with condylar dimension may exist between individuals. A 3T magnetic resonance imaging from 220 skeletally mature patients, 110 males and 110 females, were analyzed. Exclusion criteria included degenerative arthritis, anatomical defects, poor image quality, and genetic abnormalities such as dwarfism. Utilizing a radiological curved measurement probe, the femoral condylar articular width was obtained for both the medial and lateral condyles. The mean condylar width from a reproducible anatomic location representing the maximal condylar dimension was measured. Statistical analysis was performed using a two-sample t-test. The lateral condyle articular cartilage width (mm) for males and females was 31.62 ± 3.54 and 26.53 ± 3.70, respectively (p < 0.0001). The medical condyle articular cartilage width was 27.26 ± 4.42 and 23.05 ± 4.11 (p < 0.00001). There was a width variation up to 22.66 mm between male patients and 22.10 mm between female patients. Differences up to 28.26 mm were found between males and females. A condylar defect measuring 10 mm represents as little as 24.29% of a condyle in some males versus as much as 77.46% in smaller females. Existing surgical algorithms for condylar chondral defects apply absolute size to patients regardless of individual condylar variations. Our study suggests the relative sizes of the defect vary significantly from male to female patients as well as within the same gender. Future studies may investigate clinical outcomes utilizing surgical algorithms that take into account these differences.

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Shelesko, Elizaveta Vladimirovna, Nadezhda Alekseevna Chernikova, Y. V. Strunina, S. D. Nikonova, Arslan Khanbagamaevich Abdulgamidov Arslan Khanbagamaevich Abdulgamidov, Aleksandr Dmitrievich Kravchuk, and Denis Nikolaevich Zinkevich. "Differentiated approach to plastic surgery of cerebrospinal fluid fistulas in the frontal sinus based on the analysis of computed tomograms." Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery), no. 3 (March 18, 2021): 182 (244)—194 (253). http://dx.doi.org/10.33920/med-01-2103-02.

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The choice of the method of plasty of cerebrospinal fluid fistulas in the area of the frontal sinus is an important issue in neurosurgery, since there are a large number of anatomical variations in the structure of the naso-frontal canal and the sinus itself. Endoscopic, combined and transcranial approaches are described in the literature. However, there is no clear algorithm for choosing a surgical approach for nasal liquorrhea based on anatomical features. The objective of this article is to study various anatomical variants of the structure of the frontal sinus and nasolabial pocket in relation to defects of the base of the skull of a given localization and, based on the data obtained, to establish the patterns of the influence of certain indicators on surgical tactics and the quality of plastic to complement the proposed classification. This article include a retrospective analysis of case histories and computed tomograms of 38 patients who underwent surgical treatment for skull base defects in the frontal sinus region from 2010 to 2020. The patients were divided into three groups depending on the approach used, the features of intraoperative visualization of the defect, and relapses. In a series of 38 cases, the endoscopic approach was used in 26 (68.4 %) cases, combined in 12 (31.6 %) cases. The defect was completely visualized using angled optics during surgery in 32 (84.2 %) cases, and in 6 (15.8 %) cases the defect was not visualized or partially visualized (up to 50 %) using angled optics. Relapses were observed in 6 (15.8 %) cases. The main craniometric indicators affecting the choice of surgical tactics and the quality of plastics are the distance from the center of the defect to the nasal septum, the value of the angle between the nasal septum and the line drawn through the edges of the defect, and the size of the defect. The recurrence rate is directly related to the visualization of the defect during surgery. The distance from the defect to the nasal septum can serve as an objective indicator for choosing access to intermediate defects of the frontal sinus: at a distance of more than 0.95 cm, it is advisable to perform a combined approach; at a distance of less than 0.95 cm, it is possible to achieve full visualization of the defect and perform high-quality plastic surgery with an endoscopic approach. English version of the article on pp. 244-253 is available at URL: https://panor.ru/articles/differentiated-approach-in-frontal-sinus-csf-fistula-plasty-based-on-computed-tomogram-analysis/63924.html

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Rentsch, C., B. Rentsch, S. Heinemann, R. Bernhardt, B. Bischoff, Y. Förster, D. Scharnweber, and S. Rammelt. "ECM Inspired Coating of Embroidered 3D Scaffolds Enhances Calvaria Bone Regeneration." BioMed Research International 2014 (2014): 1–15. http://dx.doi.org/10.1155/2014/217078.

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Resorbable polymeric implants and surface coatings are an emerging technology to treat bone defects and increase bone formation. This approach is of special interest in anatomical regions like the calvaria since adults lose the capacity to heal large calvarial defects. The present study assesses the potential of extracellular matrix inspired, embroidered polycaprolactone-co-lactide (PCL) scaffolds for the treatment of 13 mm full thickness calvarial bone defects in rabbits. Moreover the influence of a collagen/chondroitin sulfate (coll I/cs) coating of PCL scaffolds was evaluated. Defect areas filled with autologous bone and empty defects served as reference. The healing process was monitored over 6 months by combining a novel ultrasonographic method, radiographic imaging, biomechanical testing, and histology. The PCL coll I/cs treated group reached 68% new bone volume compared to the autologous group (100%) and the biomechanical stability of the defect area was similar to that of the gold standard. Histological investigations revealed a significantly more homogenous bone distribution over the whole defect area in the PCL coll I/cs group compared to the noncoated group. The bioactive, coll I/cs coated, highly porous, 3-dimensional PCL scaffold acted as a guide rail for new skull bone formation along and into the implant.

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Dumitrascu, Dinu I., and Alexandru V. Georgescu. "Pedicled perforator flaps for covering the elbow region. A case report." Medicine and Pharmacy Reports 88, no. 4 (October 6, 2015): 560–62. http://dx.doi.org/10.15386/cjmed-592.

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Covering the elbow soft tissue defects is a difficult task for the plastic surgeon. Because of, the important anatomical structures situated superficially and the high tendency for stiffness of the elbow, the reconstructive method must be chosen carefully. Traditionally the free flaps were the choice method for elbow reconstruction. In our department, we use the perforator pedicled flaps for covering elbow defects, as a viable alternative to the free microsurgical transfer. This paper presents a successful case of covering an elbow soft tissue defect in a male patient. By using a local pedicled flap we replaced “like with like” to obtain a very good cosmetic result. The lack of microsurgical anastomosis allowed an early physical therapy.

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Sanniec, Kyle, Jourdan Carboy, and James Thornton. "Simplifying Lip Reconstruction: An Algorithmic Approach." Seminars in Plastic Surgery 32, no. 02 (May 2018): 069–74. http://dx.doi.org/10.1055/s-0038-1645882.

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AbstractThe authors provide an overview of lip reconstruction after Mohs surgery based on the senior author's practice. Lip reconstruction offers unique challenges to preserve not only lip function but also aesthetics. Lip reconstruction must take into consideration the three anatomical layers that comprise the lip and defects that involve the mucosa, the muscle, the skin or more than one layer will help determine the modality of repair. The authors offer an algorithm based on defect location, tissue involvement, and severity of defect to simplify an often complex decision-making process.

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Purkey, Michael, Alexander G. Chiu, Bradford A. Woodworth, and James N. Palmer. "Endoscopic Repair of Supraorbital CSF Leaks." Otolaryngology–Head and Neck Surgery 139, no. 2_suppl (August 2008): P76. http://dx.doi.org/10.1016/j.otohns.2008.05.245.

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Objective The supraorbital ethmoid and lateral frontal sinus are difficult to approach endoscopically. Their location, superior and lateral to the orbit, can make access technically challenging. In this study, we examined clinical and anatomical characteristics of patients with supraorbital CSF leaks and encepholeceles and identified specific considerations unique to their management. Methods Retrospective review of patients who underwent repair of supraorbital CSF leaks at our institution from 2003–2007. Results Eight patients were surgically treated. Seven were spontaneous leaks with an associated encepholecele and one was post-craniotomy. The majority of patients were women (5/8), middle-aged (mean: 54.9 years), and had a mean BMI of 42.3 kg/m2. Intracranial pressures were elevated in 6/8 patients and an empty sella was present in each of the 7 patients with a spontaneous leak. Anatomically, 6/8 patients had defects medial to a sagittal plane drawn through the medial orbital wall (mean distance: 4.15 mm) and 2/8 patients had defects lateral to the sagittal plane (mean distance: 8.14 mm). 7/8 were successfully repaired endoscopically and one patient with a lateral defect required conversion to a supra-orbital trephination. All defects were repaired successfully with a mean follow-up of 27.8 months. Conclusions Patients with supraorbital CSF leaks have unique clinical characteristics that include obesity and elevated ICP. Endoscopic repair produces acceptable results with low morbidity. Extension of a skull base defect lateral to a sagittal plane through the medial orbital wall is a technical obstacle to endoscopic repair and may require an adjunctive external approach.

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Fernandes, Manuela Graça, Ana Rita Mateus Loureiro, Maria João Diogo Obrist, and César Prudente. "Small Bowel Obstruction by Broad Ligament Hernia: Three Case Reports, Management and Outcomes." Acta Médica Portuguesa 32, no. 3 (March 29, 2019): 240. http://dx.doi.org/10.20344/amp.10951.

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Internal hernias are a rare cause of bowel obstruction (1%) and can be caused by broad ligament defects in 4% to 7% of the cases. These defects may be congenital or acquired and are classified according to its anatomical location. This paper reports three cases of small bowel obstruction by broad ligament hernia. The patients, three women aged from 35 to 51 years old, were admitted to the emergency department with small bowel obstruction. An exploratory laparotomy was performed during which an internal hernia through a broad ligament defect was identified. In all cases the hernia content was reduced and the defect closed. One of the patients required a segmental enterectomy. All patients had a favorable outcome. This paper aims to raise awareness about the broad ligament hernia as a cause of bowel obstruction, namely in middle-aged women with no surgical history.

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S, Naveen Raj, Ananth Prathap, Vidyashree Nandini V, David Charles P, and Thamarai Selvan. "Fabrication of an Interim Closed Hollow Bulb Obturator Prosthesis with Frozen Saline: A Modified Technique." JOURNAL OF CLINICAL PROSTHODONTICS AND IMPLANTOLOGY 1, no. 2 (December 30, 2019): 20–24. http://dx.doi.org/10.55995/j-cpi.2019011.

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Maxillary defects can be congenital or acquired in nature. Anatomical defects may be created between oral and the nasal cavity due to surgical resection and patients are usually faced with difficulties while performing normal functions such as speaking and swallowing, due to the communication formed between the cavities. Rehabilitation of the defect site with an obturator prosthesis assists in achieving these goals reducing the morbidity and thereby improving the psychological state of the patient. While rehabilitating these large defects, one of the main problems is with the weight of the prosthesis. The prosthesis may become bulky and non-retentive due to its weight. To overcome these difficulties hollow bulb obturators fabricated using different techniques. Also, a closed obturator design has been found to be advantageous over the open type as it prevented the seepage of oral and nasal secretions into the hollow space thereby helping in easy maintenance of the prosthesis. This case report deals with a simplified method for fabrication of an interim obturator with closed hollow bulb design for a 75-year-old male patient with a Class I Aramany’s defect.

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Journal articles on the topic 'Anatomical defects'

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