The loss of a limb results in major disability and psychological trauma to the affected individual. Amputees of dysvascular origin usually have multiple co-morbidities and their complicated post-operative course frequently leads to a prolonged hospitalisation or a subsequent amputation in a higher level of the limb. The integrated comprehensive approach by a interdisciplinary team in post-operative management starts immediately after a limb amputation to assure successful surgical and functional outcomes. The programme comprises a variety of medical and rehabilitation aspects: to control acute medical co-morbidities, evaluate and alleviate different types of pain, optimal wound care, condition the residual limb to be well-fitted with a prosthesis, address patient’s functional goals and achieve maximal independence in mobility and self care, coach ideal coping skills and provide psychosocial support, and educate patient and family about risk factor modulation and residual limb care. Aggressive oedema control and early mobilisation became standardised practice in post-amputation care in view of a number of advantages.
Lower extremity - Surgery

Retrospective study on 56 patients (24 males, 32 females) with chronic venous insufficiency of the lower limbs that CEAP classification from 2 to 5 degree. Most of them got a job needed long standing as textile employee, teacher. 58.9% had been dissected by ligation the venous tranks with stripping them, 25% had been Muller operation alone for other branches. Good result was 92%, complications was not serious, the rate of damage of tranks neuvous was 7,2% in internal ankle area - To reduce the treatment of internal medicine
Venous Insufficiency ; Lower Extremity ; Disease ; Therapeutics ; surgery

138 patients (102 males, 36 females) aged 3-71 years old with 139 deficiencies of various causes in inferior limbs underwent a surgery of free flap transfer with 144 free flaps. Survived rate reached 134/144 flaps (93.05%), full necrosis in 10/144 flaps (6.95%). All cases were sucessfully operated exculding 5/10 cases of second time transfer. Near possible complications such as obstruction of the arterial connection of 4 flap-connect sites, obstruction of the venous connection of 6 flap sites, obstruction of venous-arterial connection of 2 sites, necrotic infection in 1 flap.
Surgical Flaps ; Lower Extremity/abnormalities ; Surgery ; Necrosis

Arteriosclerosis Obliterans ; surgery ; Humans ; Lower Extremity

Despite the overall satisfactory results of total hip arthroplasty, post-operative complications continue to occur. To minimize these problems, computer-assisted total hip arthroplasty using navigation or robot-assisted systems is being developed. A navigation system is defined as a system that locates a position in three-dimensional space and traces the target spot, and a robot-assisted system is defined as a system that performs operations automatically with mechanical robot arms based on prior preoperative planning. Computer-assisted surgeries have shown superior results to conventional methods in implant positioning, fixation, and accurate lower extremity alignment in the limited reports available. However, computer-assisted surgeries take longer compared to conventional methods. Due to the extra time needed, the risk of postoperative infection and blood loss is considered to be higher. Nevertheless, robot-assisted system is being developed for the field of hip arthroplasty, and thus its efficacy and accuracy needs to be further investigated. Since these methods have other advantages compared to conventional methods, they are the focus of much interest.
Arm ; Arthroplasty ; Hip ; Lower Extremity ; Surgery, Computer-Assisted

The paper summarizes the academic thought and clinical experience of professor LI De-hua in treatment of facial nerve injury after total parotidectomy with blade needle based on jingjin (muscle region of meridian, sinew/fascia) theory. This disease is located at muscle regions of hand-/foot-three yang meridians; and the sinew/fascia adhesion is its basic pathogenesis, manifested by "transversely-distributed collaterals" and "knotted tendons". In treatment, the knotted tendons are taken as the points. Using the relaxation technique of blade needle, the lesions of sinews/fascia are dissected and removed to release the stimulation or compression to the nerves and vessels so that the normal function of sinews/fascia can be restored.
Humans ; Facial Nerve Injuries/surgery* ; Fascia ; Foot ; Hand ; Lower Extremity

Posterior tibial slope angle (PTSA) is a risk factor for anterior cruciate ligament (ACL) injury and has attracted a lot of attention, but its mechanism of action and diagnosis are still not systematically studied in the field of sports medicine. In this paper, we believe that PTSA should be measured by full-length lower extremity films and combined with multiple imaging data for comprehensive assessment to reduce errors. A large PTSA may increases risk of anterior cruciate ligament injury, so patients with more than 12 degrees of PTSA should be treated by preserving meniscus as much as possible during ACL reconstruction and combining with tibial osteotomy if necessary, which could effectively prevent risk of ligament re-injury. At the same time, gait analysis has an important reference value for preoperative pathogenic pattern and postoperative rehabilitation function, so the author believes that it will have a guiding significance for the development of individualized rehabilitation strategy based on PTSA, in order to achieve the best treatment effect.
Humans ; Anterior Cruciate Ligament/surgery* ; Tibia/surgery* ; Anterior Cruciate Ligament Injuries/surgery* ; Lower Extremity

Deep vein thrombosis is a common complication after orthopedic, gynecological, and obstetric operations. However, instances of this complication after oral and maxillofacial surgeries have been rarely reported. We report a case with odontogenic keratocyst in the jaw that gained left lower extremity venous thrombosis after operation, and discuss the risk factors and prevention of lower extremity venous thrombosis through literature review.
Cysts ; surgery ; Humans ; Lower Extremity ; Mandibular Diseases ; surgery ; Risk Factors ; Venous Thrombosis

Child ; Female ; Humans ; Ilizarov Technique ; Lower Extremity Deformities, Congenital ; surgery ; Tibia ; abnormalities ; surgery

OBJECTIVEEctopic tissue transplantation is not a new idea. Godina and his colleagues pioneered this method in the 1980s. This method is a last resort method of preserving an amputated body part, which consists of banking the amputated segment in an ectopic area and returning it to its native place at a later date. In this article we present our experience with this demanding procedure.

METHODSDebridement was the mainstay of this procedure. The stump and amputated part are carefully debrided and the stump was either closed primarily or covered by a flap. The amputated part was transplanted to one of several banking sites in the body and at a later date it will be transferred to its native site in an elective setting.

RESULTSSeven patients meeting the set criteria for ectopic transplantation were enrolled in this study. The overall success rate was about 70%, lower than expected but these are cases of severe crush injury. Although the functional recovery of these patients are very low, all of the successful cases except one could find a job as a janitor or light manual worker. No patient could return to his previous job.

CONCLUSIONEctopic transplantation of body parts is an accepted method of treatment of severely crushed extremity or finger injuries. In our country an amputee has very little chance of finding a job instead a disabled person can. In addition in Iran cultures amputation is seen as punishment of either the God or the society, so it is not well accepted and many patients persist on saving the limb even with no functional recovery. None of our successful cases could return to his previous occupation but almost all of them could find a job as janitors or light manual workers.