Comparison of Lower Extremity Alignment among Taekwondo Athletes of Various Subdisciplines.

Background and Objectives: Studies analyzing lower extremity alignment (LEA) LEA among taekwondo subdisciplines athletes are lacking. This study compared LEA in the dominant and nondominant legs intaekwondo athletes. Materials and Methods: Twelve measurements of LEA were analyzed for 157 athletes (63 sparring, 50 demonstration, and 44 poomsae athletes) registered with the Korea Taekwondo Association. LEA was measured in the standing, supine, and prone positions using alignment application, a goniometer, a bubble inclinometer, a height gage, and a palpation meter. Results: The analysis revealed that the dominant leg of poomsae athletes showed greater genu valgum alignment than that of sparring athletes (p < 0.01), whereas the dominant leg of sparring athletes showed greater rearfoot varum alignment than that of demonstration athletes (p < 0.01). Furthermore, the nondominant leg of poomsae athletes showed greater genu valgum alignment than that of sparring and demonstration athletes (p < 0.01), whereas the nondominant leg of sparring athletes showed greater rearfoot varum alignment than that of demonstration athletes (p < 0.01). In addition, demonstration athletes had better forefoot varus alignment than poomsae athletes (p < 0.01). Conclusions: This study revealed that LEA characteristics vary among taekwondo athletes according to their subdiscipline. The results of this study would help in designing training programs tailored to each subdiscipline that would best address their LEA characteristics and help to prevent injuries.

Study protocol for a prospective cohort study describing the injury characteristics in elite gymnasts in TeamGym: the Swedish TeamGym Injury Cohort - STIC.

INTRODUCTION: Gymnastics consists of several different disciplines, whereof TeamGym is one. TeamGym is a young discipline with sparse research. The aim of the study is to investigate the injury characteristics in Swedish elite gymnasts competing in TeamGym including training load and other physical and psychological factors associated with injury. METHODS AND ANALYSIS: The Swedish TeamGym Injury Cohort is a longitudinal prospective cohort study for 52 weeks that includes the junior (15-17 years) and senior (≥18 years) Swedish female and male national teams in TeamGym. A baseline questionnaire will be sent out in an online application (SmartaBase) regarding demographics, previous injuries, gymnastics-related factors, for example, time at elite level and psychosocial factors such as stress, athletic identity, coping skills, personality traits and coach-athlete relation. A weekly questionnaire will be sent out in SmartaBase every Sunday and will monitor injuries using the Oslo Sports Trauma Research Centre Overuse Questionnaire, gymnastics-related factors, for example, landing surfaces, stress, recovery and training load. A test battery for the lower extremity will be performed. Data for ankle dorsiflexion, hop tests and ankle plantarflexion strength/endurance will be collected. ETHICS AND DISSEMINATION: This project was approved by the Swedish Ethical Review Authority (2023-06653-01) and is performed according to the Declaration of Helsinki. The results will be published in peer-reviewed journals, scientific conferences and shared with the Swedish Gymnastics Federation.

Uso tópico de sevoflurano en heridas complejas de miembro inferior / Topical use of sevoflurane in complex lower limb wounds

El dolor crónico asociado a heridas de larga evolución en miembros inferiores constituye una situación de conflicto con características angustiantes que compromete seriamente la calidad de vida e interfiere en el proceso de reparación tisular, estableciendo un cuadro propio en el cual la herida se transforma en un componente más de esta compleja condición y no el motivo en sí de la consulta. Dadas las limitaciones y efectos negativos de las terapias usuales para el alivio del dolor crónico en heridas, se establece una apertura a nuevas propuestas adyuvantes. Motivo de ello es el propósito del presente trabajo, a través del uso de sevoflurano tópico para evaluar el incremento de la analgesia en una población con úlceras en miembro inferior de diverso origen etiológico.

Effects of different lower limb strengthening protocols on muscle activity, strength and power in sedentary and physically inactive subjects: a systematic review / Efectos de diferentes protocolos de fortalecimiento de miembro inferior sobre la fuerza, potencia y actividad muscular en sujetos sedentarios y físicamente inactivos: una revisión sistemática

The purpose of this systematic review was: a) to determine the quality of evidence from studies assessing the effects of different lower limb strengthening protocols on muscle activity, strength, and power in sedentary and/or physically inactive subjects; and b) to determine the effectiveness of lower extremity strengthening protocols on muscle activity, strength, and power in sedentary and/or physically inactive subjects. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statements were followed using keywords associated with strength training, lower limb, sedentary, and physical inactivity. Four databases were used: Medline via PubMed, Web of Science, Scopus and SPORTDiscus. Methodological quality was assessed using the PEDro scale. A total of 164 articles were retrieved, six included in this review. Four studies were classified as fair methodological quality, and two were considered of good methodological quality. Due to the heterogeneity in methodological aspects and the limited number of articles including the variables under study, it was not possible to establish a measure of effectiveness of lower limb strengthening protocols on muscle activity, strength, or power. In conclusion, strength training in the lower limb seems to improve the levels of strength, power, and muscular activity in sedentary subjects. However, due to the limited number of articles, methodological variability, and training methods used, it is necessary to conduct new studies that control these variables.(AU)

El propósito de esta revisión sistemática fue: a) determinar la calidad de la evidencia de los estudios que evaluaron los efectos de diferentesprotocolos de fortalecimiento de miembros inferiores sobre la actividad, la fuerza y la potencia muscular en sujetos sedentarios y/o físicamenteinactivos; y b) determinar la efectividad de los protocolos de fortalecimiento sobre la actividad, fuerza y potencia muscular de miembros infe-riores en sujetos sedentarios y/o físicamente inactivos. Se siguieron los criterios PRISMA (Preferred Reporting Items for Systematic Review andMeta-Analyse) utilizando palabras clave asociadas con el entrenamiento de fuerza, extremidades inferiores, sedentarismo e inactividad física. Serevisaron cuatro bases de datos: Medline vía PubMed, Web of Science, Scopus y SPORTDiscus. La calidad metodológica se evaluó mediante laescala PEDro. Se recuperaron 164 artículos en total, seis incluidos en esta revisión. Cuatro estudios se clasificaron como de calidad metodológicaregular y dos se consideraron de buena calidad metodológica.Debido a la heterogeneidad en los aspectos metodológicos y al escaso número de artículos que incluyeron las variables en estudio, no fue posibleestablecer una medida de efectividad de los protocolos de fortalecimiento de miembros inferiores sobre la actividad, la fuerza o la potenciamuscular. En conclusión, el entrenamiento de fuerza en el miembro inferior parece mejorar los niveles de fuerza, potencia y actividad muscular ensujetos sedentarios. No obstante, debido al número limitado de artículos, la variabilidad metodológica y los métodos de entrenamiento utilizados,es necesario realizar nuevos estudios que controlen estas variables.(AU)

High Dependency Unit Admissions among Patients with Lower Extremity Long Bone Fracture Visiting the Department of Orthopaedics in a Tertiary Care Centre.

Introduction: Lower extremity long bone, femoral and tibial shaft, fractures often have associated injuries. Patients with lower extremity long bone fractures in the Department of Orthopaedics can land up in high dependency unit admissions, mostly due to underlying complications. The study aimed to find out the prevalence of high dependency unit admissions among patients with lower extremity long bone fractures visiting the Department of Orthopaedics in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients with lower extremity long bone fractures in a tertiary care centre. The data from 1 March 2017 to 31 January 2020 was collected from the medical records from 1 August 2020 to 30 September 2020. All patients with femoral or tibial shaft fractures in isolation or a part of a multi-system injury were included. Patients with inadequate data were excluded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 507 patients with lower extremity long bone fractures, 137 (27.55%) (23.66-31.44, 95% Confidence Interval) required high dependency unit admission. Among them, 119 (86.86%) were males. A total of 71 (51.82%) cases involved 2-wheelers. Conclusions: The prevalence of high dependency unit admission among patients with lower extremity long bone fractures was high and majority of them required multidisciplinary approach. Keywords: femoral fractures; prevalence; tibial fractures; traffic accidents.

Establishment and pathophysiological evaluation of a novel model of acute compartment syndrome in rats.

BACKGROUND: Researches have used intra-compartmental infusion and ballon tourniquest to create high intra-compartmental pressure in animal models of Acute Compartment Syndrome (ACS). However, due to the large differences in the modeling methods and the evaluation criteria of ACS, further researches of its pathophysiology and pathogenesis are hindered. Currently, there is no ideal animal model for ACS and this study aimed to establish a reproducible, clinically relevant animal model. METHODS: Blunt trauma and fracture were caused by the free falling of weights (0.5 kg, 1 kg, 2 kg) from a height of 40 cm onto the lower legs of rats, and the application of pressures of 100 mmHg, 200 mmHg, 300 mmHg and 400 mmHg to the lower limbs of rats using a modified pressurizing device for 6 h. The intra-compartmental pressure (ICP) and the pressure change (ΔP) of rats with single and combined injury were continuously recorded, and the pathophysiology of the rats was assessed based on serum biochemistry, histological and hemodynamic changes. RESULTS: The ΔP caused by single injury method of different weights falling onto the lower leg did not meet the diagnosis criteria for ACS (< 30 mmHg). On the other hand, a combined injury method of a falling weight of 1.0 kg and the use of a pressurizing device with pressure of 300 mmHg or 400 mmHg for 6 h resulted in the desired ACS diagnosis criteria with a ΔP value of less than 30 mmHg. The serum analytes, histological damage score, and fibrosis level of the combined injury group were significantly increased compared with control group, while the blood flow was significantly decreased compared with control group. CONCLUSION: We successfully established a new preclinical ACS-like rat model, by the compression of the lower leg of rats with 300 mmHg pressure for 6 h and blunt trauma by 1.0 kg weight falling.

Evaluation of the lower extremity functional test to predict lower limb injuries in professional male footballers.

The Lower Extremity Functional Test (LEFT) is a reliable and valid test for the measurement of athletic fitness, fatigue resistance, and speed performance. Contradictory results exist regarding the screening value of the LEFT in predicting lower limb injuries. The purpose of this study was to investigate the screening value of the LEFT in predicting lower limb injuries in professional male footballers. One hundred and twenty-one professional male football players participated in the study. LEFT was recorded pre-season and the lower-limb injuries were recorded during a 9-month season. Logistic regression analysis was used to determine the accuracy of the prognosis of LEFT. A total of twenty-five lower limb injuries were recorded. The model explained 53% of the variance in lower limb injury, showing that predictions by LEFT score is reliable, and correctly predicted 89.3% of cases, which is a large improvement. ROC analysis showed significant accuracy of the LEFT score (AUC 0.908, 95% CI 1.126-1.336, p = 0.001, OR = 1.227) in discriminating between injured and uninjured players. The optimum cut-off level of the LEFT score was 90.21 s; Our findings showed that the LEFT score was able to predict lower limb injuries in professional male footballers. The slower an athlete's LEFT scores, the more susceptible they are to future injury risk. Sports medicine specialists, football coaches and managers are suggested to use LEFT as a pre-season screening test to identify and prevent the weakness and functional imbalance of the athletes before the injury occurs by conducting this test.

Double microvascular free flap reconstruction for bilateral lower extremity injury in a paediatric patient.

Many challenges have been described by microsurgeons in paediatric free flaps. With the advancement in microsurgical expertise, it is now possible to achieve excellent results. We present a case of a female child with car-tyre friction injury of bilateral feet with associated extradural haemorrhage who underwent emergency bilateral anterolateral thigh flap. A secondary tendon reconstruction of the left foot was performed at 6 months. No complications were observed in the postoperative period after both procedures and good functional recovery was achieved at 1 year follow-up. The problems unique to this case were the presence of head injury and bilateral extremity injury in the paediatric patient. The technical details of planning, execution, difficulties and recommendations to minimise the risk in such cases are discussed. To the best of our knowledge, this is the only case report of bilateral lower limb paediatric emergency free flap with associated head injury.

Technical Variables in Lower Extremity Free Flap Reconstruction.

BACKGROUND: Lower extremity free flap failure rates are higher than in other areas of the body. While prior studies assessed the effect of intraoperative technical variables, these generally investigated individual variables and did not examine relationships between the many individual technical decisions made during free tissue reconstruction. Our purpose was to investigate the effect of variation in intraoperative microsurgical techniques on flap outcomes in a diverse cohort of patients requiring lower extremity free flap coverage. METHODS: Consecutive patients undergoing free flap reconstruction of the lower extremity at two level 1 trauma centers from January 2002 to January 2020 were identified using Current Procedural Terminology codes, followed by a review of medical records. Information regarding demographics and comorbidities, indications, intraoperative technical details, and complications was collected. Outcomes of interest included an unplanned return to the operating room, arterial thrombosis, venous thrombosis, partial flap failure, and total flap failure. Bivariate analysis was performed. RESULTS: In total, 410 patients underwent 420 free tissue transfers. The median follow-up time was 17 months (interquartile ranges: 8.0-37). Total flap failure occurred in 4.9% (n = 20), partial flap failure in 5.9% (n = 24), and unplanned reoperation in 9.0% (n = 37), with arterial thrombosis in 3.2% (n = 13) and venous thrombosis in 5.4% (n = 22). Overall complications were significantly associated with recipient artery choice, with arteries other than PT and AT/DP having a higher rate (p = 0.033), and with arterial revisions (p = 0.010). Total flap failure was also associated with revision of the arterial anastomosis (p = 0.035), and partial flap failure was associated with recipient artery choice (p = 0.032). CONCLUSION: Many interoperative options and techniques are available when performing microvascular lower extremity reconstruction that leads to equally high success rates. However, the use of arterial inflow outside of the posterior tibial and anterior tibial arteries leads to a higher overall complication rate and partial flap failure rate. Intraoperative revision of the arterial anastomosis portends poorly for ultimate flap survival.

The association of pre-existing mental health conditions and patient outcomes after lower extremity orthopaedic trauma: a scoping review.

INTRODUCTION: Existing research has established a correlation between post-traumatic mental health conditions, including anxiety and depression, and various aspects of recovery, such as pain exacerbations, reduced functional recovery, and lowered patient satisfaction. However, the influence of pre-existing mental health conditions on orthopaedic trauma outcomes has not been thoroughly investigated. The objective of this study was to systematically review literature addressing the association between pre-existing mental health conditions and patient outcomes following surgical interventions for lower extremity fractures in non-geriatric populations. METHODS: A systematic literature review was conducted using Medline, Embase, and Scopus databases following PRISMA-ScR guidelines to select studies that examined lower extremity orthopaedic trauma outcomes in relation to pre-existing mental health conditions. Studies that evaluated patients with surgically treated lower extremity fractures and a history of mental health conditions such as anxiety, depression, or mood disorders were included. Studies with a mean patient age above 65 years of age were excluded to focus on non-geriatric injury patterns. RESULTS: The systematic review identified 12 studies investigating the relationship between surgical outcomes of orthopaedic lower extremity fractures and pre-existing mental health disorders in non-geriatric populations. Studies included patients with pelvis, femur, tibia, and ankle fractures. A majority (83%) of these studies demonstrated that patients with pre-existing mental health diagnoses had inferior functional outcomes, heightened pain levels, or an increase in postoperative complications. DISCUSSION: The presence of pre-existing mental health conditions, particularly anxiety and depression, may predispose orthopaedic trauma patients to an elevated risk of suboptimal functional outcomes, increased pain, or complications after surgical intervention for lower extremity fractures. Future research should focus on interventions that mitigate the impact of mental health conditions on orthopaedic outcomes and patient wellness in this population.

Enhanced recovery for acute open lower limb fracture 'fix and flap'.

INTRODUCTION: Enhanced recovery (ER) aims to achieve earlier recovery, reduced hospital length of stay (LoS) whilst improving outcomes. Our ER protocol for acute lower-limb open fracture (ALLOFs) includes dangling at day 3 and mobilising fully weight-bearing from day 5. Our aims were to evaluate the outcomes of ALLOFs using our ER protocol for limb salvage, LoS following 'fix & flap', return to theatre, rate of successful flap salvage, flap failure and deep infection rates. METHODS: An observational study of a prospectively maintained lower limb flap database from September 2020 to January 2023 was undertaken. Search criteria encompassed patients with a Gustilo IIIB/C injury and a free flap reconstruction. Exclusions were for local/perforator flaps, soft tissue injury only, fracture related/prosthetic joint infections, or chronic osteomyelitis cases. RESULTS: 161 patients were available for analysis, 126 male (78 %) and 35 female (22 %) with a median age of 40 years (12-79, interquartile range 30.0). 81 % of cases were high-energy injuries. For all patients, the median time to definitive fixation and soft tissue coverage from injury was 4 days (0-30, interquartile range 2). 18 cases (11.2 %) required return to theatre for flap exploration; 11 cases were successfully salvaged (61 %). Nine free flaps failed (5.4 %). The median total LoS from admission was 10 days (6 to 46, interquartile range 5), with a median LoS following definitive fixation and soft tissue coverage of 7 days (4 to 20, interquartile range 3). The median follow-up period was 18 months (12 to 38.2, interquartile range 9), with a deep infection rate of 6.5 %. CONCLUSION: In isolated ALLOFs, our ER protocol is safe and effective in shortening the LoS. Our outcomes sit comfortably within acceptable ranges of contemporary literature for return to theatre, flap salvage/failure and deep infection. Our ER protocol actively involves our allied health professional colleagues early to facilitate discharge.

Evaluation of the Value of the Y-Balance Test to Predict Lower Limb Injuries in Professional Male Footballers.

CONTEXT: The aim of this prospective cohort study was to identify whether Y-Balance Test (YBT) performance and asymmetry are associated with lower limb injury in elite adult football athletes. DESIGN: A prospective cohort study. METHODS: Preseason YBT measures were obtained from 121 male footballers participating in National League One across the 2021-2022 season. Lower limb injuries were tracked across the season to determine the relationship between YBT variables and injury incidence using logistic regression analysis. The statistical significance level was .05. RESULTS: The average YBT score was 111.0 (5.8) cm on the left limb and 112.0 (5.5) cm on the right limb, with an average asymmetry of 2.3 (1.4) cm. Athletes with lower YBT scores on both the left (odds ratio = 2.9; 95% confidence interval, 1.7 to 4.8: P ≤ .001) and right (odds ratio = 2.3; 95% confidence interval, 1.6 to 3.2: P ≤ .001) limbs were at a greater risk of injury. Similarly, athletes with greater amounts of asymmetry were also more likely to get injured (odds ratio = 2.1; 95% confidence interval, 1.3 to 3.3: P = .002). CONCLUSIONS: Results indicate that lower and asymmetrical YBT scores have a significant relationship with future lower limb injuries in professional male footballers. The YBT offers a simple, reliable, and effective screening tool that can be used by practitioners in football to help identify players at a greater risk of injury before the season commences.

Training for shorter ultra-trail races results in a higher injury rate, a more diverse injury profile, and more severe injuries: 2022 Mac ultra races.

OBJECTIVES: Determine and compare the epidemiology, clinical characteristics, and injury severity among race entrants training towards different ultra-trail race distances. DESIGN: Retrospective cross-sectional study. SETTING: The six months training period before the 2022 Mac Ultra races (46 km, 80 km, 161 km and 322 km). PARTICIPANTS: Of the 245 race entrants, 162 (66% of Mac ultra-trail runners) consented to analyse their data. OUTCOME MEASURES: Injury rate (injuries per 1000 h of running), point prevalence (% of currently injured participants), injury severity (time loss), and the frequency (n, %) of injuries reported during pre-race medical screening in the six months before the race. Using inferential statistics, we compared the injury rates between the different race distance categories (46 km, 80 km, 161 km, 322 km). All tests were performed at a 5% level of significance. RESULTS: We reported a statistically significantly higher injury rate among 46 km study participants (3.09 injuries per 1000 h) compared to the injury rates reported among 80 km (0.68 injuries per 1000 h; p = 0.001) and 161 km (1.09 injuries per 1000 h; p = 0.028) participants. The lower limb (89%) was the most injured anatomical region, with only 46 km study participants reporting upper limb, trunk, and head injuries (11%). Muscle/tendon was the most reported injured tissue type (56%), with muscle injuries (31%) the most reported pathology type. Shorter distance ultra-trail runners reported the highest injury severity. CONCLUSION: Ultra-trail runners training towards shorter ultra-trail distance races presented with a higher injury rate, more diverse injury profile, and a higher injury severity.

Associations of musculoskeletal dysfunction, time to brake, and patient reported outcomes following lower extremity trauma.

INTRODUCTION: Inability to drive a motor vehicle due to lower extremity injury is a major inconvenience. Timing of safe return to driving has not been much studied. Objective measurements such as time to brake (TTB) have been proposed; however, utility and concordance of functional outcome measurements have not been previously evaluated. The purpose of this project is to measure these parameters and to assess for associations with ability to safely return to driving, improving the ability of clinicians to assess for measurements of driving readiness without specifically measuring TTB. METHODS: A prospective, cohort study of 232 patients with complex lower extremity injuries to the pelvis, acetabulum, hip, femur, knee, tibia, ankle, and foot was performed. Time to brake (TTB) was measured once weightbearing was allowed. Function was assessed by the Musculoskeletal Function Assessment (MFA) questionnaire, and pain, mobility, and physical functions, via patient reported outcome measurement information system (PROMIS) surveys. RESULTS: Patients with longer TTB had significantly elevated MFA scores indicating increased musculoskeletal dysfunction post-injury. As the MFA score increased by 1 point, TTB increased by 0.013 s (p<0.001). PROMIS metrics were also significantly associated with patients experiencing more pain and worse mobility as TTB increased. DISCUSSION: Many patients continue to exhibit musculoskeletal dysfunction several months post-treatment for complex lower extremity injuries. Patients with better PROMIS metrics and MFA scores, and shorter TTB are more appropriate to return to driving. Surgeons may be better informed about safe driving ability by considering these measurements. LEVEL OF EVIDENCE: II.

Characteristics and mechanism of lower limb injury induced by landmine blast: A research in a rabbit model.

BACKGROUND: Limb injuries caused by landmine explosions are tricky to treat and difficult to protect. It is necessary to establish an animal model for studying lower limb injury and to investigate the characteristics and mechanisms of lower limb injury induced by landmine blasts. METHODS: Twenty-six mature white rabbits were randomly divided into sham group (n=10) and injury group (n=16). Landmine blast was simulated by electric detonators under the right lower limb in upright state by a special modified fixation frame. High-speed photography was used to observe the body movements. Vital signs, vascular injury (determining by digital subtraction angiography), pathological characteristics, and ATP concentration of the tibialis anterior muscle and triceps surae of shank were recorded for com-parison. RESULTS: Generally, middle and lower segment of the injured legs of the rabbits was seriously damaged. The limb stump presents a distribution of three areas, tissue free zone, contusion hematoma, and edema contusion. Sneak wound track, myofascial destruction, and periosteum stripping were typical characteristics of landmine blast injury. ATP concentration and pathological analysis showed that the tibialis anterior muscle was the most seriously injured, followed by the gastrocnemius and soleus. ATP concentration of affected muscle of both the contusion and commotio area declined remarkably over time, but the muscle in the avulsion area stayed at a low activity level with no change over the time. Small vascular injury in the contusion area was evident. The site of the sciatic nerve lesion was higher than the muscle. Injured site of sciatic nerve injury was higher than serious contusion muscle. High-speed photography demonstrated that the joints of the injured limb extremely flexed followed by a rapid stretch under the blast shock wave. CONCLUSION: The established experimental model presents typical effect of lower limbs wounded by the mine blast in war field. Landmine blast can cause typical damage on lower limbs including nerve lesion, knee injury, and microcirculation damage that is pro-gressive over time. The limb stump is divided into three zones based on gross pathology and micropathology, which can provide an important reference for clinical treatments and prognosis.

Prevención y promoción de la salud de heridas mediante el uso ambulatorio de la termografía portátil. Estudio piloto / Prevention and promotion of wound health through the ambulatory use of portable thermography. Pilot study

Introducción y objetivo: Las heridas crónicas requieren seguimiento continuo para evaluación y prevención de complicaciones. Esta evaluación es subjetiva, sujeta a errores y consume mucho tiempo y dinero para pacientes y salud pública. Proponemos utilizar modelos tridimensionales y termográficos que complementan la evaluación de heridas. Material y método: Estudio piloto en 6 casos en donde se propone la creación de modelos tridimensionales termográficos a partir de imágenes obtenidas con dispositivos portátiles de bajo costo. Resultados: Muestran patrones de diferencias de temperaturas que parecen relacionarse con el comportamiento del área de esta herida. Conclusiones: Observamos la utilidad de una herramienta de visualización de bajo costo e indicadores objetivos cuantitativos y cualitativos de la evolución de heridas, así como la posibilidad de realizar la monitorización en zonas remotas en donde hay falta de especialistas, ya que al proveer métricas, ayudaría en su seguimiento y evaluación.(AU)

Background and objective: Chronic wounds require regular monitoring for evaluation and prevention of complications. Such assessment remains subjective, prone to error, and it is often a time-consuming and costly process for patients and public health. We propose to use three-dimensional thermographic models that can complement wound assessment. Methods: A pilot study in 6 participants where three-dimensional thermographic models were created from images obtained with low-cost portable devices. Results: The results show patterns of temperature differences that seem to be related to the behavior of the wound area. Conclusions: We observe its usefulness in providing a low-cost visualization tool and objective quantitative and qualitative indicators of the evolution of wounds, as well as the possibility of monitoring in remote areas where there is a lack of specialists, since by providing metrics, it would help in their monitoring and evaluation.(AU)

Reinervación muscular dirigida diferida en el manejo del dolor neuropático tras amputación de extremidad inferior / Delayed targeted muscle reinnervation in the management of neuropathic pain after lower limb amputation

Introducción y objetivo: El dolor neuropático es una de las complicaciones más comunes en la cirugía de amputación de extremidad inferior. En este contexto surge la Reinervación Muscular Dirigida (TMR) como técnica con resultados prometedores en el tratamiento del dolor neuropático tras amputación. En este artículo presentamos la técnica quirúrgica y nuestra experiencia clínica. Material y método: Entre enero de 2021 y diciembre de 2022 registramos los pacientes intervenidos para TMR diferida de extremidad inferior en el Servicio de Cirugía Plástica del Hospital Universitario Miguel Servet (Zaragoza, España) evaluando su capacidad de portar prótesis a los 6 meses de la intervención. Asimismo, exponemos la técnica quirúrgica empleada. Resultados: Intervenimos 9 pacientes, 7 amputaciones infracondíleas y 2 supracondíleas. A los 6 meses, 7 eran capaces de deambular con prótesis y en 2 persistía dolor de componente mixto que impedía la protetización. Ambos pacientes habían sido amputados por causas vasculares. Conclusiones: En nuestra serie clínica obtuvimos resultados prometedores que permitieron la protetización en una gran proporción de casos, si bien la selección de pacientes es un punto crucial en la aplicación de esta técnica.(AU)

Background and objective: Neuropathic pain is one of the most common complications in lower extremity amputation surgery. In this context, Targeted Muscle Reinnervation (TMR) emerges as a technique with promising results in the treatment of neuropathic pain after amputation and phantom limb.In this article we describe the surgical technique and our clinical experience. Methods: Between January 2021 and December 2022, we registered the patients operated on for delayed TMR of the lower extremity in the Plastic Surgery Service of the Miguel Servet University Hospital (Zaragoza, Spain) evaluating their ability to wear prostheses 6 months after the intervention. Likewise, we expose the surgical technique used. Results: A total of 9 patients were operated, being 7 infracondylar and 2 supracondylar amputations. Six months after surgery, 7 patients could walk with the prosthesis, while the other 2 ones still experienced pain that prevented fitting the prosthesis. Both patients had been amputated for vascular causes. Conclusions: In our clinical series, we obtained promising results which allow ambulation in a large proportion of patients although we consider that patient selection is a crucial point in the application of this technique.(AU)