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Jaffe-Campanacci syndrome resulted in amputation: A case report

World Journal of Clinical Cases 2024年第10期12卷 1785-1792页

作者： Jun Jiang Min Liu Department of Pediatric Surgery West China Hospital of Sichuan UniversityChengdu 610041Sichuan ProvinceChina

BACKGROUND Jaffe-Campanacci syndrome(JCS)is a very rare syndrome.The treatment of JCS is more conservative,and most authors recommend that no surgery should be done in asymptomatic patients.The conventional concept holds that the natural course of non-ossifying fibromas(NOFs)grows with the development of bones,and the osteolytic region gradually stops expanding and self-healing through bone ossifying around the lesion and ossification within the lesion.But in this case,the bone lesions were potentially biologically aggressive,which led to severe limb deformities and pain.CASE SUMMARY We present the case of a 5-year-old girl with JCS presenting with not only NOF sand café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretching or being touched.Skin examination revealed multiple café-au-lait macules on the neck,arm,axilla,and torso,including the nipples and perineum.Radiographs revealed multiple lytic lesions in the proximal part of the right humerus,distal part of the right clavicle,proximal and distal parts of the right femur,and proximal parts of the right tibia and fibula.Curettage and biopsy were performed on the distal part of the right femur.At the age of 7,the girl was re-admitted to our hospital for a pathological fracture in the middle in the right femur and underwent Intralesional excision,internal fixation,bone grafting,and spica casting.At the age of 10,the girl came to our hospital again for severe pain of the right leg.amputation from the middle level of the right femur was performed.We present the case of a 5-year-old girl with JCS presenting with not only NOFs and café-au-lait macules,but also showed features not mentioned before,severe limb pain,and at last resulted in amputation.She was admitted to our hospital after presenting with claudication and mild pain over her right thigh,which worsened when stretchi

关键词： Jaffe-Campanacci syndrome Multiple non-ossifying fibromas Café-au-lait macule amputation Case report

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Surgical management of the diabetic foot:The current evidence

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World Journal of Orthopedics 2024年第5期15卷 404-417页

作者： Richard Henry Randall Roberts Gareth Rhys Davies-Jones James Brock Vaishnav Satheesh Greg AJ Robertson Department of Trauma and Orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom Department of Trauma and Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens globally.This review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,amputations.The escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality rates.This review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse outcomes.In addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot pathologies.The integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关键词： Diabetes Diabetic foot Charcot Osteomyelitis amputation Diabetic foot attack Conservative surgery

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amputation stump management:A narrative review

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World Journal of Clinical Cases 2022年第13期10卷 3981-3988页

作者： Yoo Jin Choo Du Hwan Kim Min Cheol Chang Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717South Korea Department of Physical Medicine and Rehabilitation College of MedicineChung-Ang UniversitySeoul 06973South Korea Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityTaegu 705-717South Korea

In this review intended for medical staff involved in patient rehabilitation,we provided an overview of the basic methods for managing amputation stumps.After the amputation surgery,it is imperative to optimize the remaining physical abilities of the amputee through rehabilitation processes,including postoperative rehabilitation,desensitization,and continuous application of soft or rigid dressings for pain reduction and shaping of the stump.Depending on the situation,a prosthesis may be worn in the early stage of recovery or an immediate postoperative prosthesis may be applied to promote stump maturation.Subsequently,to maintain the range of motion of the stump and to prevent deformation,the remaining portion of the limb should be positioned to prevent contracture.Continuous exercises should also be performed to improve muscle strength to ensure that the amputee is able to perform activities of daily living,independently.Additionally,clean wound or edema management of the stump is necessary to prevent problems associated with wearing the prosthesis.Our review is expected to contribute to the establishment of basic protocols that will be useful for stump management from the time of completion of amputation surgery to the fitting of a prosthesis to optimize patient recovery.

关键词： amputation Amputee Management Rehabilitation Stump Review

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amputation in diabetic foot ulcer:A treatment dilemma

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World Journal of Orthopedics 2023年第5期14卷 312-318页

作者： Raden Andri Primadhi Rani Septrina Putie Hapsari Maya Kusumawati Department of Orthopaedics and Traumatology Universitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia Division of Plastic Reconstructive and Aesthetic Surgery Department of SurgeryUniversitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia Division of Vascular and Endovascular Surgery Department of SurgeryUniversitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia Internal Medicine Universitas Padjadjaran/Hasan Sadikin HospitalBandung 40161Indonesia

Diabetic foot is a clinical manifestation of diabetes with a wide range of symptoms,including ulceration,osteomyelitis,osteoarticular destruction,and gangrene,as a consequence of advanced disease.Some diabetic foot cases present general indications for amputation,including dead limb,threat to the patient’s life,pain,loss of function,or nuisance.Various tools have been introduced to help decision-making in amputation for diabetic foot.However,it remains a conundrum because diabetic foot involves multiple pathomechanisms and factors that hinder its outcomes.Sociocultural issues often impede treatment from the patient’s side.We reviewed different perspectives in diabetic foot management,particularly related to amputation.In addition to deciding whether to amputate,physicians should address amputation level,timing,and ways to avoid patient deconditioning.Surgeons should not be autocratic in these circumstances and should be aware of beneficence and maleficence when considering whether to amputate.The main goal should be improving the patients’quality of life rather than preserving the limb as much as possible.

关键词： Diabetic foot Ulcer amputation Decision-making Perspective

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Lower limb amputation rehabilitation status in India: A review

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World Journal of Clinical Cases 2023年第30期11卷 7261-7267页

作者： Raktim Swarnakar Shiv Lal Yadav Darshana Surendran Department of Physical Medicine and Rehabilitation All India Institute of Medical SciencesNew Delhi 110029DelhiIndia

Rehabilitation of lower limb amputation in developing countries is quite challenging.Though there are basic to highly advanced prostheses available in India,the set-up is still facing difficulties in developing countries.Prosthetic management is difficult due to lack of availability of prostheses and reduced affordability among low income populations.In this review we highlighted the lower limb amputation and prosthetic rehabilitation status in India.Currently,India is advancing well in the rehabilitation field,but further studies are required to provide more evidence and recommendation.

关键词： amputation Lower limb amputation Prosthesis Rehabilitation Lower limb prosthesis Prosthetic rehabilitation

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Association between tourniquet use and intraoperative blood loss during below-knee amputation

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World Journal of Orthopedics 2022年第7期13卷 644-651页

作者： Alden E Wyland Erik Woelber Liam H Wong Jordan Arakawa Zachary M Working James Meeker School of Medicine Oregon Health and Sciences UniversityPortlandOR 97239United States Department of Orthopaedics and Rehabilitation Oregon Health and Sciences UniversityPortlandOR 97239United States

BACKGROUND Despite over 150000 amputations of lower limbs annually,there remains a wide variation in tourniquet practice patterns and no consensus on their necessity,especially among orthopedic patient populations.The purpose of this study was to determine whether tourniquet use in orthopedic patients undergoing below knee amputation(BKA) was associated with a difference in calculated blood loss relative to no tourniquet use.AIM To determine if tourniquet use in orthopedic patients undergoing BKA was associated with a difference in calculated blood loss relative to no tourniquet use.METHODS We performed a retrospective review of consecutive patients undergoing BKA by orthopedic surgeons at a tertiary care hospital from 2008 through 2018.Blood loss was calculated using a combination of the Nadler equation for preoperative blood volume and a novel formula utilizing preoperative and postoperative hemoglobin levels and transfusions.Univariate and forwards step-wise multivariate linear regressions were performed to determine the association between tourniquet use and blood loss.A Wilcoxon was used to determine the univariate relationship between tourniquet use and blood loss for in the restricted subgroups of patients who underwent BKA for trauma,tumor,and infection.RESULTS Of 97 eligible patients identified,67 underwent surgery with a tourniquet and 30 did not.In multivariate regression,tourniquet use was associated with a 488 mL decrease in calculated blood loss(CI 119-857,P = 0.01).In subgroup analysis,no individual group showed a statistically significant decrease in blood loss with tourniquet use.There was no significant association between tourniquet use and either postoperative transfusions or reoperation at one year.CONCLUSION We found that tourniquet use during BKA is associated with decreased calculated intraoperative blood loss.We recommend that surgeons performing this procedure use a tourniquet to minimize blood loss.

关键词： amputation Tourniquet Blood loss Hemostasis

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Self-strangulation induced penile partial amputation:A case report

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World Journal of Clinical Cases 2023年第22期11卷 5373-5381页

作者： A-Bu-Lai-Ti Maimaitiming Ye-Li-Su-Dan Mulati Ai-Re-Ti Apizi Xiao-Dong Li Department of Urology The First Affiliated Hospital of Xinjiang Medical UniversityXinjiang Clinical Research Center for Genitourinary SystemUrumqi 830011Xinjiang Uygur Autonomous RegionChina

BACKGROUND Traumatic amputation of the penis is a rare surgical emergency,usually caused by self-mutilation,accidents,circumcision,assault and animal attacks.This study aimed to summarize our treatment experience involving penile reconstruction in a rare case of a self-strangulation induced chronical penile partial amputation.CASE SUMMARY A 22-year-old man presented with self-strangulation induced chronical penile partial amputation for 3 mo where the penile proximal part was 1 cm far from the pubis.Reconstruction methods included end-to-end anastomosis of the urethral mucosa,proximal anastomosis of the corpus cavernosum and tunica albuginea of the penis,anastomosis of the deep dorsal vein,dorsal artery,and superficial dorsal vein.Patient urinated smoothly after the catheter was removed on day 21.3 mo after the surgery,the patient's penile preliminary cosmetic appearance was satisfactory,with occasional morning erections.Distal penile sensation was preserved,yet erection hardness of the distal penis was not satisfactory.CONCLUSION Complete preoperative assessment and prompt surgical intervention decreases loss of residual penile functions.

关键词： amputation Reconstruction Body dysmorphic disorders Psychological treatment Case report

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Altered intra- and inter-network brain functional connectivity in upper-limb amputees revealed through independent component analysis

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Neural Regeneration Research 2022年第12期17卷 2725-2729页

作者： Bing-Bo Bao Hong-Yi Zhu Hai-Feng Wei Jing Li Zhi-Bin Wang Yue-Hua Li Xu-Yun Hua Mou-Xiong Zheng Xian-You Zheng Department of Orthopedic Surgery Shanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina Institute of Diagnostic and Interventional Radiology Shanghai Jiao Tong University Affiliated Sixth People’s HospitalShanghaiChina Department of Traumatology and Orthopedics Yueyang HospitalShanghai University of Traditional Chinese MedicineShanghaiChina

Although cerebral neuroplasticity following amputation has been observed, little is understood about how network-level functional reorganization occurs in the brain following upper-limb amputation. The objective of this study was to analyze alterations in brain network functional connectivity(FC) in upper-limb amputees(ULAs). This observational study included 40 ULAs and 40 healthy control subjects;all participants underwent resting-state functional magnetic resonance imaging. Changes in intra-and inter-network FC in ULAs were quantified using independent component analysis and brain network FC analysis. We also analyzed the correlation between FC and clinical manifestations, such as pain. We identified 11 independent components using independent component analysis from all subjects. In ULAs, intra-network FC was decreased in the left precuneus(precuneus gyrus) within the dorsal attention network and left precentral(precentral gyrus) within the auditory network;but increased in the left Parietal_Inf(inferior parietal, but supramarginal and angular gyri) within the ventral sensorimotor network, right Cerebelum_Crus2(crus Ⅱ of cerebellum) and left Temporal_Mid(middle temporal gyrus) within the ventral attention network, and left Rolandic_Oper(rolandic operculum) within the auditory network. ULAs also showed decreased inter-network FCs between the dorsal sensorimotor network and ventral sensorimotor network, the dorsal sensorimotor network and right frontoparietal network, and the dorsal sensorimotor network and dorsal attention network. Correlation analyses revealed negative correlations between inter-network FC changes and residual limb pain and phantom limb pain scores, but positive correlations between inter-network FC changes and daily activity hours of stump limb. These results show that post-amputation plasticity in ULAs is not restricted to local remapping;rather, it also occurs at a network level across several cortical regions. This observation provides additional insights into the plasticity of brain netw

关键词： amputation functional connectivity functional magnetic resonance imaging independent component analysis neuroimaging phantom pain phantom sensation resting-state networks

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Assistive technologies for pain management in people with amputation: a literature review

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Military Medical Research 2018年第2期5卷 159-164页

作者： Kamiar Ghoseiri Mostafa Allami Mohammad Reza Soroush Mohammad Yusuf Rastkhadiv Department of Orthotics and Prosthetics School of Rehabilitation SciencesHamadan University of Medical SciencesHamadanIran Janbazan Medical and Engineering Research Center(JMERC) Farrokh AveVelenjakTehranIran Department of Occupational Therapy School of Rehabilitation SciencesHamadan University of Medical SciencesHamadanIran

The prevalence of limb amputation is increasing globally as a devastating experience that can physically and psychologically affect the lifestyle of a person. The residual limb pain and phantom limb pain are common disabling sequelae after amputation surgery. Assistive devices/technologies can be used to relieve pain in people with amputation. The existing assistive devices/technologies for pain management in people with amputation include electrical nerve block devices/technologies, TENS units, elastomeric pumps and catheters, residual limb covers, laser systems, myoelectric prostheses and virtual reality systems, etc. There is a great potential to design, fabricate, and manufacture some portable, wireless, smart, and thin devices/technologies to stimulate the spinal cord or peripheral nerves by electrical, thermal, mechanical, and pharmaceutical stimulus. Although some preliminary efforts have been done, more attention must be paid by researchers, clinicians, designers, engineers, and manufacturers to the post amputation pain and its treatment methods.

关键词： Amputees amputation stumps Self-help devices Pain Acute pain Chronic pain Pain management

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Diabetic wounds and artificial intelligence:A mini-review

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World Journal of Clinical Cases 2023年第1期11卷 84-91页

作者： Samabia Tehsin Sumaira Kausar Amina Jameel Computer Science Bahria UniversityKarachi 75260SindhPakistan Computer Science Bahria UniversityIslamabad 46000Pakistan Department of Computer Engineering Bahria UniversityIslamabad 46000Pakistan

Diabetic wound takes longer time to heal due to micro and macro-vascular ailment.This longer healing time can lead to infections and other health complications.Foot ulcers are one of the most common diabetic wounds.These are one of the leading cause of amputations.Medical science is continuously striving for improving quality of human life.A recent trend of amalgamation of knowledge,efforts and technological advancement of medical science experts and artificial intelligence researchers,has made tremendous success in diagnosis,prognosis and treatment of a variety of diseases.Diabetic wounds are no exception,as artificial intelligence experts are putting their research efforts to apply latest technological advancements in the field to help medical care personnel to deal with diabetic wounds in more effective manner.The presented study reviews the diagnostic and treatment research under the umbrella of Artificial Intelligence and computational science,for diabetic wound healing.Framework for diabetic wound assessment using artificial intelligence is presented.Moreover,this review is focused on existing and potential contribution of artificial intelligence to improve medical services for diabetic wound patients.The article also discusses the future directions for the betterment of the field that can lead to facilitate both,clinician and patients.

关键词： Diabetic wounds Artificial intelligence Foot ulcer amputation Diagnosis Machine learning

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