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Register a new userUse of the soleus muscle flap to cover exposed tibia
استعمال سديلة العضلة النعلية في تغطية عظم الظنبوب المكشوف
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فراس ملحم( باحث )
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خلال العقدين الأخيرين تمّ إحراز تقدّم كبير في مجال تدبير رضوح الطرفين السفليين إلى الحدّ الذي سمح بإنقاذ الكثير من الأطراف من البتر. يعتبر نقل العضلات الطريقة المثالية في علاج الضياعات المادية الواسعة الشاملة للنسج الرخوة في رضوح الأطراف في حال انكشاف العظم. الهدف من دراستنا هذه هو تحرّي الفعالية العلاجية لإصلاح الضياعات المادية في كسور القسم المتوسط من الظنبوب مع انكشاف العظم باستعمال السديلة العضلية المعنقة للنصف الأنسي للعضلة النعلية. قمنا بدراسة استرجاعية لعشر حالات عانت من كسور مفتوحة خضعت لترميم النسج الرخوة باستخدام التكنيك المذكور بين عاميّ 2013 و 2016 في مشفى الأسد الجامعي باللاذقية. كانت النتائج الترميمية لهذا التكنيك الجراحي ممتازة. تمثّل سديلة العضلة النعلية بنصفها الأنسي خياراً هامّاً لترميم الضياعات الماديّة في الثلث المتوسط من الساق مع انكشاف عظم الظنبوب . يتمّ المحافظة على وظيفة العضلة النعلية. إنّ قوس دوران السديلة الطويل نسبيّاً يجعلها قادرةً على ترميم الضياعات المادية ذات القياسات و الأشكال المختلفة في الثلث المتوسط من الساق مع انكشاف عظم الظنبوب. العملية سهلة نسبيّاً. يمكن للعضلة أن تملأ الجوف الضيّق و أن ترمّم العيب المادي في الوقت ذاته. تعتبر الأذية في الموقع المعطي قليلة الأهميّة.
The management of lower extremity trauma has evolved over the last two decades to the point that many extremities that would have required amputation are routinely salvaged. The use of transposition muscle is regarded as the optimal method for the treatment of extensive defects of soft tissues in limb traumatology. The aim of the study is to investigate the therapeutic effect of repairing soft tissue defects of mid-tibia open fractures with muscle flap pedicled with medial half of soleus. A retrospective study of our outcome of 10 performed soft-tissue reconstruction of an open tibial wound cases. All these patients were operated using the proposed surgical technique between 2013 and 2015 in AL-ASSAD University Hospital in Lattakia, Syria. The results of this technique of reconstruction are excellent. Medial hemisoleus flap is a valuable option for soft tissue coverage of middle third of lower leg. It does not sacrifice the whole function of the Soleus muscle. Due to its longer arc of rotation, this flap can cover the defects of different size and shape in middle third of leg. The operation is relatively easy. The muscle can fill the narrow cavity and repair the soft tissue defect simultaneously. The donor-site injury is minor.
References used
SADASIVAN, K.K., OGDEN, J.T., ALBRIGHT, J.A. Anatomic variations of the soleus muscle. Orthopedics, 1991;14:679–683
THORNTON, B.P., ROSENBLUM W.J., PU, L.L. Reconstruction of limited soft tissue defect with open tibial frature in the distal third of the leg: a cost and outcome study. Ann Plast Surg, 2005, 54(3):276-80
GUYURON, B., DINNER, M.I., DOWDEN, R.V., LABANDTER, H.P. Muscle flaps and vascular detour principle: The soleus. Annals of Plastic Surgery, 1982, 132:8
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Background: The defects in the leg is one of the most important challenges facing
reconstructive surgeons because of the lack of soft tissue covering the front surface of the
leg and the lack of blood perfusion in the lower third of the leg. The mu
scle and
fasciocutaneous flaps are one of the most important reconstruction options as there have
been no local studies about this method so far.
Objective: Evaluation of methods of reconstruction the defects of the soft tissues of
the leg using the muscle flaps and fasciocutaneous flaps and comparing them with the
international studies.
Methods: The study included 25 patients undergoing transposition of the
gastrocnemius and / or soleus flaps, sural flaps for treating soft tissues in the leg, from
2015 to 2017 in both Al-Asaad and Tishreen University hospitals in Lattakia , gathering
information on the etiology the lesion, the time of reconstruction, the flap used to cover the
lesion, and the function of the gastrocnemius-soleus unit, and the following Sensory
disorders.
The benign vascular tumors are the most common of benign soft tissue neoplasms,
majority of them appears in the skin and mucosa, but they are rare in the skeletal muscles,
the difficulties during the management of these tumors are pre-operative dia
gnosis and
completely remove the lesion, especially those neoplasms arising in the face and neck.
These difficulties not allow wide range to prevent the recurrence.
It has done clinical surgical histopathological studying for girl 25 years old, she has
intramuscular hemangioma of the mylohyoid muscle, it should done accurate clinical
examination and (MRI) before the operation, and used frozen section technique during the
operation, for the best result of the ideal surgical procedure.
Abstract In this paper, three different muscle models have been investigated. The first model (Ferrarin’s
muscle model) is a transfer function between electrical stimulation and the resultant knee torque. The
other two muscle models are physiologic
al based (Riener’s muscle model and Virtual Muscle). Riener’s
muscle is modelled in this paper by using Matlab/Simulink, while Virtual Muscle model has been built
using Virtual Muscle software (Virtual Muscle 4.0.1). A quadriceps is modelled using each of the three
models. The three models are tested in terms of their responses to activation and then they are
implemented in a fuzzy logic control (FLC) strategy which aims to control the cycling cadence. The
performance of the three models during control has been discussed and evaluated. It appears that the
type of the muscle model has an influence on the control performance.
An experiment was conducted for two seasons 2015 -2016, to study the effect
of treated waste water (TWW) on some fodder crops productivity at Salamieh
Research Center (GCSAR), on triticale and sesbania crops within crop rotation. This
experiment w
as conducted with collaboration between (ACSAD) and (GCSAR).
The experimental design was split plot design with three replicates, using drip
irrigation (DI) and surface irrigation (SI) systems with two treatments namely fresh
water (FW) and (TWW). Soil and water were analyzed before cultivation.
The Internet is an increasingly popular medium for delivering
educational material.
The aim of this study was to determine the attitudes of
students to the use of the Internet within a dental school in Damascus
University.
Questionnaires were di
stributed to undergraduate dental students
in the third and fourth clinical years. All students have access to computers
and Internet at the university.
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