Free myocutaneous rectus abdominis flap for tissue augmentation of the face in an adult patient with bilateral facial microsomia

Summary A 27-year-old male patient known to suffer from bilateral facial microsomia was operated, and a free musculocutaneous flap was transferred to his face. The soft tissue augmentation of his lower half of the face was good. The advantages of this method are shown and the relevant literature is reviewed.     

股骨头坏死的临床与影像诊断

目的　探讨股骨头缺血坏死的临床表现 ,X线平片、CT、MRI和DSA表现 ,以提高该病的确诊率。方法　对 116例共计 184髋股骨头坏死 ,采用X线平片及CT联合检查 ,并通过MRI或 /和DSA检查证实 ,总结各期的临床表现与影像学改变。结果　按Ficat分期标准 ,Ⅰ期 18髋 ,Ⅱ期 10 1髋 ,Ⅲ期 44髋 ,Ⅳ期 2 1髋。其中X线平片阳性 94髋 ,全部为Ⅱ期以上 ,CT阳性 115髋 ,Ⅰ期仅占 3髋 ,MRI阳性 161髋 ,Ⅰ期 12例。行DSA检查 68例 ,主要表现为股骨头供养动脉的变细、缺失。结论　因股骨头坏死缺乏特征性临床表现 ,其诊断一直为临床上的一个难题 ,MRI和DSA对股骨头坏死的诊断具有高度敏感性 ,因此X线平片和CT结果阴性者 ,必须做MRI或 /和DSA检查 ,以免漏诊     

True profunda femoris aneurysms: Are they more dangerous than other atherosclerotic aneurysms of the femoropopliteal segment?

Three cases of true aneurysms of the profunda femoris artery are reported along with a review of 17 other cases in the literature. These aneurysms are rare and commonly present with rapid enlargement or rupture (9/20), the risk of rupture being higher than those affecting the femoral or popliteal arteries. All patients underwent successful surgical treatment except for one who required amputation. The diagnosis of an aneurysm of the profunda femoris artery must be considered in all patients with a pulsatile swelling in the groin. Surgical treatment is mandatory, and it carries a low mortality as well as a low risk of amputation.     

Neuromuscular adaptations in older males and females with knee osteoarthritis during weight-bearing force control

Background

Females exhibit significantly greater incidence, prevalence, and severity of osteoarthritis (OA) compared to males. Despite known biological, morphological, and functional differences between males and females, there has been little sex-related investigation into sex-specific biomechanical and neuromuscular responses to OA.

Enabling Task-Specific Volitional Motor Functions via Spinal Cord Neuromodulation in a Human With Paraplegia

We report a case of chronic traumatic paraplegia in which epidural electrical stimulation (EES) of the lumbosacral spinal cord enabled (1) volitional control of task-specific muscle activity, (2) volitional control of rhythmic muscle activity to produce steplike movements while side-lying, (3) independent standing, and (4) while in a vertical position with body weight partially supported, voluntary control of steplike movements and rhythmic muscle activity. This is the first time that the application of EES enabled all of these tasks in the same patient within the first 2 weeks (8 stimulation sessions total) of EES therapy.     

EMG spectral differences among the quadriceps femoris during the stretch reflex

Introduction: The purpose of this study was to examine the electromyographic (EMG) spectral characteristics of the quadriceps femoris muscles during tendon tap stretch reflexes. Methods: Sixteen healthy subjects (mean ± SD age = 21.2 ± 2.8 years) performed tendon tap reflexes of the leg extensors as surface EMG signals were detected from the vastus lateralis (VL), rectus femoris (RF), and vastus medialis (VM) muscles of the dominant thigh. All EMG signals were processed with a wavelet analysis, and the resulting spectra were decomposed with nonparametric spectral decomposition. Results: The results showed that the spectra for the VL had significantly more high‐frequency power than those for the RF and VM, with similar spectral shapes for the RF and VM. Conclusions: These findings could be due to differences in the width of the innervation zone, or the fiber type composition of the muscles, although the latter seems to be more likely. Muscle Nerve 52 : 826–831, 2015     

Current concepts in MRI of rectus femoris musculotendinous (myotendinous) and myofascial injuries in elite athletes

Rectus femoris injuries are extremely common in athletes, particularly in soccer players, rugby player, and sprinters. Magnetic resonance imaging (MRI) plays a key role in diagnosis, prognosis, and rehabilitation of these injuries. The current article discusses current concepts in the diagnosis and treatment of rectus femoris injuries in elite athletes, including a discussion of the less well known myofascial injuries and key prognostic factors as seen at MR imaging.     

陈旧性膝关节运动损伤者股四头肌随意动员能力下降

目的:观察陈旧性膝关节运动损伤股四头肌随意动员能力的变化。方法:60名天津体育学院学生,自愿参加测试,根据其是否有陈旧性膝关节运动损伤分为2组,损伤组(有训练史)30人,对照组(无训练史)30人。应用股四头肌随意动员能力评定系统测定分析股四头肌最大随意等长肌力(MVC)、随意动员能力(MA)和力量上升速率(RFD)。结果:对照组两侧股四头肌MVC、MA和RFD无显著差异(P>0.05),损伤组两侧股四头肌MVC无显著性差异(P>0.05)。对照组右侧股四头肌MVC、RFD值显著低于损伤组未损伤侧(P<0.05,P<0.01),损伤组膝关节损伤侧MA、RFD值显著低于未损伤侧(P<0.05,P<0.01)。结论:即使陈旧性膝关节运动损伤者股四头肌肌肉力量已恢复到未损伤侧水平,其随意动员能力和力量上升速率依然较低,膝关节神经肌肉控制仍较差,这可能是影响陈旧性膝关节运动损伤功能状态的主要因素之一。股四头肌随意动员能力评价系统可检测这一变化。     

股二头肌长头肌皮瓣高压氧喷气式气垫综合治疗复杂性坐骨结节压疮

目的观察股二头肌长头肌皮瓣、高压氧及术后应用喷气式气垫综合治疗复杂性坐骨结节压疮的临床疗效。方法对16例坐骨结节压疮患者应用股二头肌长头肌皮瓣修复,联合高压氧治疗及术后长期应用喷气式气垫。结果 16例患者中14例一期愈合,1例肌皮瓣近臀侧边缘少量透明状液体渗出,经换药14 d愈合并拆线,1例肌皮瓣近臀侧皮肤拆线后裂开,经换药28 d后瘢痕愈合。所有患者坚持应用喷气式气垫床,2～7年随访无一例复发。结论股二头肌长头肌皮瓣修复坐骨结节压疮联合高压氧及术后坚持气垫床根治复杂性坐骨结节压疮疗效确切。