The anterolateral thigh (ALT) free flap has proven to be a reliable option for the coverage of soft tissue defects in adults and more recently in the pediatric population. When considering the use of the ALT flap in the pediatric patient, there are few studies that detail techniques specific to pediatric free flap management. We present a unique case of a 14- × 8-cm ALT flap used for traumatic ...

Cerebral MRI with thin brainstem slices (thickness 2 mm) detected a small ischemic lesion in the right dorsolateral and ventral medulla ( fig. 1 ). MR angiography showed occlusion of the right vertebral artery ( fig. 2 ), as did duplex sonography. Sensory evoked potentials from the median and tibial nerves were not delayed, providing evidence of normal lemniscal sensation. The patient was disch...

Although it has been well established that fracture healing is influenced by the mechanical environment, the optimal parameters have not yet been established. In two groups of sheep an experimental tibial diaphysial fracture was created, and stabilised using external skeletal fixation. In one group rigid fixation was maintained throughout fracture healing; in the other group controlled axial mi...

The authors present a rare technique of tension band plating of the anterior tibia in the setting of a nonunion stress fracture. Surgical management with an intramedullary nail is a viable and proven option for treating such injuries. However, in treating elite athletes, legitimate concerns exist regarding the surgical disruption of the extensor mechanism and the risk of anterior knee pain asso...

The differential diagnosis includes musculo-tendinous injury, tibial compartment syndrome, tenosynovitis, intermittent claudication of the athlete and stress fracture. A presumptive diagnosis of stress fracture is based on the history and physical findings. In the past, confirmation of stress fractures has been delayed until x-rays showed an abnormality, often from three weeks to three months a...

We performed a prospective, randomised trial in 39 patients with open tibial fractures treated initially by external fixation to compare cast immobilisation (group A) and intramedullary nailing (group B) as a sequential protocol planned from the onset of treatment. The results showed that group B achieved faster union (p < 0.05) than group A with less malunion or shortening and a greater range ...

Background:  Fractures of the distal third of the tibia are mostly associated with a fibular fracture that often requires fixation. The preferred treatment of distal tibial fracture is the minimally invasive percutaneous plate osteosynthesis  (MIPPO) procedure. However, there are no clear cut guidelines on fixation of the fibular fracture and currently most orthopedic surgeons use a plate osteo...

Objective(s) The objective of this study was to document and explain bilateral differences in the Q angle. Materials and Methods Two hundred limbs of healthy adult Indian volunteers were studied. The Q angle was measured using a goniometric method with the subjects supine, quadriceps relaxed and lower limbs in neutral rotation. The relative lateral placement of the tibial tuberosity with res...

Cortical, cervical and lumbar somatosensory evoked potentials were recorded following median and tibial nerve stimulation in patients with traumatic paraplegia and quadriplegia. The isolated cord was able to produce normal potentials even during spinal shock if the vertical extent of the lesion did not involve the generator mechanisms. The cervical potentials showed subtle changes in paraplegia...