BackgroundComputer-assisted surgery (CAS) has been introduced to mandible reconstruction with bular free ap in cutting guide placement. When CAS is cooperated with different plate xations, the results show various degrees of errors by which this study aimed to evaluate.
MethodsMock surgeries were conducted in 3D-printed mandibles with either 2 types of defects; limited or extensive, reconstructed from 2 ameloblastoma patients. Three types of xations; miniplate, manually bending reconstruction plate and patient-speci c plates are tested, each of which was performed 3 times in each type of defects, adding up to 18 surgeries. One with the least errors was selected and applied with patients whose 3D-printed mandibles derived. Finally, in vivo errors were compared with the mock.
ResultsIn limited defect, average errors show no statistical signi cance among all types. In extensive defect, patient-speci c plate had a signi cantly lower average condylar error than manually bending reconstruction plate and miniplate (8.09±2.52 mm vs. 25.49±2.72 and 23.13±13.54 mm, respectively).When patient-speci c plate was applied in vivo, the errors were not signi cantly different from the mock.
ConclusionPatient-speci c plates cooperated with CAS shows the least errors. Nevertheless, manually bent reconstruction plates and miniplates could be applied in limited defects with caution.
Background:
The atherosclerotic cardiovascular disease (ASCVD) risk score is used to estimate coronary artery disease and stroke risk. Atherosclerosis affects arteries throughout the body, including the legs, causing peripheral arterial disease. Atherosclerosis causes luminal stenosis in popliteal artery branches, which affects operative decisions such as intravascular surgery, and lower limb reconstruction. The objective was to investigate the relationship between the ASCVD risk score and degree of stenosis among the popliteal artery and its branches.
Methods:
The data regarding all patients who underwent computed tomography angiography (CTA) of the legs during 2016–2021 with complete data for ASCVD risk score assessment were recruited. The association between luminal stenosis from CTA and calculated ASCVD risk score was analyzed.
Results:
A total of 383 limbs of 117 men and 81 women, averaged 66.5 years old, were studied. Common comorbidities included hypertension (84.3%), diabetes mellitus (61.1%), and chronic kidney disease (34.3%). Average 10-year ASCVD risks in the greater than or equal to 50% stenosis group of popliteal, anterior tibial, and posterior tibial arteries were significantly higher than the less than 50% stenosis group (P < 0.01). The peroneal artery had no significant difference between stenosis groups. The popliteal artery had significantly higher lifetime ASCVD risks than in the greater than or equal to 50% stenosis group (P < 0.01), but the other arteries showed no statistically significant difference.
Conclusions:
The 10-year ASCVD risks showed significant higher values in the greater than or equal to 50% stenosis group of popliteal, anterior tibial, and posterior tibial arteries. These findings can establish the further study on how ASCVD risks can be applied to predict the stenosis of these arteries and guide the rationale of preoperative leg CTA for FFF harvest.
Summary:
We report a case of extremity lymphedema after a Mycobacterium abscessus infection in a 43-year-old man with anti-interferon-γ autoantibody syndrome. Lymphaticovenular anastomosis was performed using the contralateral healthy or less severe limb as a mirror image to map the lymph vessels in the edematous limb. A satisfying outcome was provided after the surgery. No report of lymphedema caused by this condition has been previously reported in the literature.
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