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Bone Segments (bone + segment)
Selected AbstractsVascularized Cadaveric Fibula Flap for Treatment of Erectile Dysfunction Following Failure of Penile ImplantsTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2010Christopher J. Salgado MD ABSTRACT Introduction., Postpriapism erectile dysfunction in patients with sickle cell disease is a particularly devastating condition. Where penile implants have failed, there is no good surgical alternative at present. Free tissue transfer is fraught with risks in patients with sickle cell disease and are not the best option for treatment. Aim., To describe a new surgical technique involving prefabrication of a bone flap for treatment of erectile dysfunction in a patient with sickle cell disease. Methods., The descending branch of the lateral circumflex femoral artery was isolated and implanted within a cadaveric bone segment. The prefabricated flap was then transferred 2 months later as a neophallus for penile autoaugmentation. Results., Bone scan showed viability of the bone flap after transfer. The patient was able to have vaginal intercourse and successfully achieve orgasm 2 months after the second stage surgery. Conclusions., Prefabrication of a cadaveric bone flap and subsequent transfer is a novel and effective technique for treatment of erectile dysfunction refractory to medical management. This technique may be particularly useful for "implant cripples," who have no other surgical option. Salgado CJ, Chim H, Rowe D, and Bodner DR. Vascularized cadaveric fibula flap for treatment of erectile dysfunction following failure of penile implants. J Sex Med 2010;7:3504,3509. [source] Osteomyocutaneous peroneal artery perforator flap for reconstruction of composite maxillary defects,HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 4 2006Sukru Yazar MD Abstract Background. Composite maxillary defects often involve the maxilla, nasal mucosa, palate, and maxillary sinus. We presented the surgical techniques and outcome of the osteomyocutaneous peroneal artery perforator (PAP) flap for reconstruction of composite maxillary defects. Methods. Six patients underwent an osteomyocutaneous PAP flap reconstruction of composite maxillary defects. The average age was 52 years. The defects were Cordeiro type II in three patients and type IV midfacial defects in another three patients. Results. No total or partial flap failures occurred. At a mean 12-month follow-up, five patients had a normal speech and were able to eat a regular diet. One patient tolerated a soft diet and had intelligible speech. One patient had ectropion develop. Excellent cosmesis was found in five patients. Conclusions. The osteomyocutaneous PAP flap represents a further refinement of the fibula flap and increases its versatility, with multiple skin paddles, bone segments, and soleus muscle independently isolated. It is a comparable reconstruction option for composite maxillary defects. © 2005 Wiley Periodicals, Inc. Head Neck28: 297,304, 2006 [source] Interfragmentary surface area as an index of comminution severity in cortical bone impactJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2005Christina L. Beardsley Abstract A monotonic relationship is expected between energy absorption and fracture surface area generation for brittle solids, based on fracture mechanics principles. It was hypothesized that this relationship is demonstrable in bone, to the point that on a continuous scale, comminuted fractures created with specific levels of energy delivery could be discriminated from one another. Using bovine cortical bone segments in conjunction with digital image analysis of CT fracture data, the surface area freed by controlled impact fracture events was measured. The results demonstrated a statistically significant (p < 0.0001) difference in measured de novo surface area between three specimen groups, over a range of input energies from 0.423 to 0.702 J/g. Local material properties were also incorporated into these measurements via CT Hounsfield intensities. This study confirms that comminution severity of bone fractures can indeed be measured on a continuous scale, based on energy absorption. This lays a foundation for similar assessments in human injuries. © 2004 Orthopaedic Research Society. Published by Elsevier Ltd. All rights reserved. [source] Induction of a neoarthrosis by precisely controlled motion in an experimental mid-femoral defectJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2002Dennis M. Cullinane Bone regeneration during fracture healing has been demonstrated repeatedly, yet the regeneration of articular cartilage and joints has not yet been achieved. It has been recognized however that the mechanical environment during fracture healing can be correlated to the contributions of either the endochondral or intramembranous processes of bone formation, and to resultant tissue architecture. Using this information, the goal of this study was to test the hypothesis that induced motion can directly regulate osteogenic and chondrogenic tissue formation in a rat mid-femoral bone defect and thereby influence the anatomical result. Sixteen male Sprague Dawley rats (400 ± 20 g) underwent production of a mid-diaphyseal, non-critical sized 3.0 mm segmental femoral defect with rigid external fixation using a custom designed four pin fixator. One group of eight animals represented the controls and underwent surgery and constant rigid fixation. In the treatment group the custom external fixator was used to introduce daily interfragmentary bending strain in the eight treatment animals (12°s angular excursion), with a hypothetical symmetrical bending load centered within the gap. The eight animals in the treatment group received motion at 1.0 Hz, for 10 min a day, with a 3 days on, one day off loading protocol for the first two weeks, and 2 days on, one day off for the remaining three weeks. Data collection included histological and immunohistological identification of tissue types, and mean collagen fiber angles and angular conformity between individual fibers in superficial, intermediate, and deep zones within the cartilage. These parameters were compared between the treatment group, rat knee articular cartilage, and the control group as a structural outcome assessment. After 35 days the control animals demonstrated varying degrees of osseous union of the defect with some animals showing partial union. In every individual within the mechanical treatment group the defect completely failed to unite. Bony arcades developed in the experimental group, capping the termini of the bone segments on both sides of the defect in four out of six animals completing the study. These new structures were typically covered with cartilage, as identified by specific histological staining for Type II collagen and proteoglycans. The distribution of collagen within analogous superficial, intermediate, and deep zones of the newly formed cartilage tissue demonstrated preferred fiber angles consistent with those seen in articular cartilage. Although not resulting in complete joint development, these neoarthroses show that the induced motion selectively controlled the formation of cartilage and bone during fracture repair, and that it can be specifically directed. They further demonstrate that the spatial organization of molecular components within the newly formed tissue, at both microanatomical and gross levels, are influenced by their local mechanical environment, confirming previous theoretical models. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Development of an anatomically based whole-body musculoskeletal model of the Japanese macaque (Macaca fuscata)AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2009Naomichi Ogihara Abstract We constructed a three-dimensional whole-body musculoskeletal model of the Japanese macaque (Macaca fuscata) based on computed tomography and dissection of a cadaver. The skeleton was modeled as a chain of 20 bone segments connected by joints. Joint centers and rotational axes were estimated by joint morphology based on joint surface approximation using a quadric function. The path of each muscle was defined by a line segment connecting origin to insertion through an intermediary point if necessary. Mass and fascicle length of each were systematically recorded to calculate physiological cross-sectional area to estimate the capacity of each muscle to generate force. Using this anatomically accurate model, muscle moment arms and force vectors generated by individual limb muscles at the foot and hand were calculated to computationally predict muscle functions. Furthermore, three-dimensional whole-body musculoskeletal kinematics of the Japanese macaque was reconstructed from ordinary video sequences based on this model and a model-based matching technique. The results showed that the proposed model can successfully reconstruct and visualize anatomically reasonable, natural musculoskeletal motion of the Japanese macaque during quadrupedal/bipedal locomotion, demonstrating the validity and efficacy of the constructed musculoskeletal model. The present biologically relevant model may serve as a useful tool for comprehensive understanding of the design principles of the musculoskeletal system and the control mechanisms for locomotion in the Japanese macaque and other primates. Am J Phys Anthropol, 2009. © 2008 Wiley-Liss, Inc. [source] | |||||||||||||