Asunto(s)
Alargamiento Óseo/métodos , Tibia/cirugía , Fracturas de la Tibia/cirugía , Humanos , MasculinoRESUMEN
The length of the stump and the quality of the soft tissue coverage are important for prosthesis fitting and mobility. In a high traumatic femoral amputation soft tissue reconstruction with a free musculocutaneous latissimus dorsi (LD) flap was performed to preserve bone length and provide proper tissue coverage. The extremely short stump was later on lengthened using a motorized intramedullary nail (Fitbone), and the achieved bone-lengthening was 14 cm. With the combined modalities of an LD-flap and Fitbone lengthening of the stump, the patient now has a useful limb function.
Asunto(s)
Traumatismos por Explosión/cirugía , Alargamiento Óseo/métodos , Clavos Ortopédicos , Fémur , Amputación Quirúrgica , Muñones de Amputación , Traumatismos por Explosión/patología , Fémur/lesiones , Fémur/patología , Fémur/cirugía , Humanos , Masculino , Colgajo Miocutáneo , Implantación de Prótesis , Adulto JovenRESUMEN
Physiotherapy is an important part of the treatment of reflex dystrophy or Complex Regional Pain Syndrome (CRPS)-type I, but this treatment is very painful. We report two cases of reflex dystrophy: a child with recurrent episodes and an adult. Both patients were treated with continuous peripheral nerve block in addition to physiotherapy. The method allows complete pain relief. At follow up (at 2 and 5 months) the results were excellent. By decreasing pain and thereby improving the ability to tolerate physical therapy, this method may have an advantage compared to other treatment modalities.
Asunto(s)
Bloqueo Nervioso Autónomo , Distrofia Simpática Refleja/terapia , Niño , Femenino , Estudios de Seguimiento , Traumatismos de los Pies/complicaciones , Traumatismos de los Pies/terapia , Humanos , Persona de Mediana Edad , Modalidades de Fisioterapia , Distrofia Simpática Refleja/etiología , Resultado del TratamientoRESUMEN
We report on a father and a son with nasal and limb defects characteristic of Laurin-Sandrow syndrome (LSS) excluding for the first time X-linked inheritance in this rare condition. Based on a search for genes expressed late during nose formation and early in limb formation we identified retinoic acid receptor B (RARB) and retinoic acid receptor G (RARG) as possible candidate genes and sequenced bidirectionally including all exons and intron-exon bounders. We identified a single nucleotide substitution in intron 2 of RARB, which is conserved in human, chimp, dog, mouse, rat, and chicken. However, it was located 83 bp from exon 2, suggesting it is a rare polymorphism which does not account for the phenotype. No other mutations were found. This suggests that another yet unknown gene is responsible for the condition.