BACKGROUND: Cerebrotendinous xanthomatosis is a rare autosomal recessive metabolic disease. Surgical treatment is only indicated when the xanthoma becomes large, painful, and irritable with shoe wear. Reconstruction of the large defect following resection challenging, especially with resection of the entire Achilles tendon.
METHODS: We report a case of bilateral Achilles tendon defects of 16 cm following resection of bilateral Achilles tendon xanthomata, with reconstruction using vascularized iliotibial tract. The patient had a good functional outcome with well-preserved strength and cosmesis.
RESULTS: Reconstruction of a total Achilles tendon defect using Vascularized iliotibial tract is safe and effective.

Frontalis suspension surgery is commonly used for the repair of congenital ptosis and involutional blepharoptosis with poor levator function. Grafts for this procedure have been developed using a variety of different materials, each with advantages and disadvantages. The retroauricular fascia graft might be beneficial in this surgery. This article reports the surgical results of blepharoptosis, who were treated with the retroauricular fascia, which is a new autologous graft for the frontalis suspension technique. This case series study targeted patients with ptosis who underwent frontalis suspension surgery with the retroauricular fascia graft at Wakayama Medical University in Japan between May 2016 and May 2023. Patients with insufficient follow-up (<6 months) were excluded from the study. Eligible patients were categorized into one of the following three assessment groups: \"good\" (improvement of palpebral fissure height without laterality, Margin reflex distance-1 gap between right and left side <0.5 mm), \"fair\" (improvement of palpebral fissure height with laterality), or \"poor\" (poor improvement of palpebral fissure height). Thirty-five eyes in 25 patients were treated with the retroauricular fascia graft. The mean postoperative follow-up was 27 months. Eight patients were classified as good (32%), 15 as fair (60%), and two as poor (8%). Two patients (8%) had postoperative lagophthalmos. No patients had eyelash inversion, tarsal deformity, or recurrence of ptosis. Scars along the edge of the hairline were inconspicuous and there were no hypertrophic scars. Functional reconstruction of the eyelids using the retroauricular fascia graft technique is described here for the first time. This grafting technique may be a useful alternative for frontalis suspension surgery because it can be harvested with easy access and without leaving conspicuous scars.

UNASSIGNED: Apical prolapse involves the upper vagina or vaginal vault after hysterectomy. Treatment is indicated for symptomatic women, and surgical approach is considered for women who failed or refused conservative therapy. We performed 10 pickups of autologous fascia, used for robotic sacrocolpopexy (RSCP).
UNASSIGNED: We included patients between 60 and 80 years old who showed a Pelvic Organ Prolapse Quantification (POP-q) over the second stage and with symptoms related to prolapse.
UNASSIGNED: All of them underwent autologous fascia lata (AFL) pickup from the right leg and after to RSCP. One patient underwent also posterior colporrhaphy. The mean intraoperative time was 199.2 min (183-230 min). No intra-operatory complications were reported. POP-q assessment during follow-up showed improvements: C point gained on average 7.6 points (5-8) and mean values went from -0.6 to - 8.2 cm (-7 to -9 cm). The three women who had anterior compartment defects shows good anatomical reconstitution with a mean Aa and Ba value of - 2.83 cm (-2.5 to -3 cm) and gained 4 points (average gain: 3.5-4.5 cm). Total vaginal lenght (TVL).
UNASSIGNED: According to these data, in our experience, AFL employment showed a good anatomical result from the first to last follow-up.

BACKGROUND Glomus tumors are rare, benign, soft-tissue lesions, usually occurring in the hand, but they can occur in other regions of the body, such as the thigh. Most of the time, extradigital glomus tumors are difficult to diagnose, and symptoms can persist for a long time. The usual clinical presentations consist of pain, tenderness at the site of the tumor, and hypersensitivity to cold. CASE REPORT We report a case of a GT of the proximal thigh in a 39-year-old man with left thigh pain without palpable mass for several years, without clear diagnosis. He had pain and hyperesthesia exacerbated by running. The patient was diagnosed initially by ultrasound imaging, which revealed a round, solid, hypoechoic, homogeneous mass in the left upper thigh. Magnetic resonance imaging (MRI) with contrast showed a well-defined intramuscular lesion in the tensor fascia lata. A percutaneous biopsy was done through ultrasound guidance, followed by excisional biopsy and immediate pain relief. CONCLUSIONS Glomus tumors of the thigh are a rare neoplasm, especially in the proximal thigh; they are difficult to diagnose and are associated with morbidity. Diagnosis can be made through a systematic approach and simple investigation, such as via ultrasonography. A percutaneous biopsy can help in drawing up a management plan, and malignancy must be considered if the lesion is suspicious. Symptoms can persist in case of incomplete resection or unrecognized synchronous satellite lesions; thus, symptomatic neuroma should be considered.

BACKGROUND: Historically, the segmental loss of the Achilles tendon with overlying soft-tissue defects had been frequently reconstructed with the composite anterolateral thigh (ALTP) flap, including the iliotibial tract or fasciae latae. This study aimed to present our modified combination using the bi-pedicled conjoined flap with vascularized fasciae latae, for the approximately total reconstruction of the Achilles tendon and extensive soft tissue.
METHODS: From May 2015 to March 2018, 15 patients (9 male and 6 female) with a mean age of 36 years (ranged, 18-52 years) underwent microvascular Achilles tendon reconstruction. Harvested on the abdomen and groin, the conjoined flap was chimeric with the vascularized fasciae latae. Primary donor-site closure was accomplished in all patients. A standard assessment of the functional and esthetical outcomes was completed.
RESULTS: Mean follow-up time was 42 months (ranged, 32-48 months). The average dimension of the conjoined flap was 25 × 14 cm (ranged, 18 × 10-35 × 18 cm), and the average size of the folded fasciae latae was 15 × 6 cm (ranged, 12 × 5-25 × 8 cm). At the last follow-up, the Thompson test was negative in all patients. The mean American Orthopedic Foot and Ankle Society (AOFAS) score was 91.0. The mean Achilles tendon total rupture score (ATRS) was 18.5. The mean Vancouver Scar Scale (VSS) score was 3.0.
CONCLUSIONS: The composite bi-pedicled flap including vascularized fasciae latae provides an alternative approach with great functional and esthetic outcomes, in selected patients who suffered severe Achilles tendon and skin defects. The one-stage procedure facilitates better rehabilitation postoperatively.

UNASSIGNED: Shoulder has multidirectional mobility with capsule and rotator cuff as stabilizers. Irreparable subscapularis tears are relatively uncommon. Anterior capsule reconstruction (ACR) is one of the different modalities of treatment for irreparable subscapularis tears. Anterior capsular reconstruction can be performed using hamstring autograft, tibialis anterior allograft, and human dermal allograft. Procedures using hamstring autograft and tibialis anterior allograft reported severe capsular deficiency, recurrent dislocation, and subluxations. Dermal allograft is routinely used for ACR anterior capsule reconstruction. But However, there are no reports of Fascia lata autograft being used for ACR anterior capsule reconstruction. As fascia lata is an autograft, it may have a better chance of healing than dermal allograft.
UNASSIGNED: A 60-year year-old male patient came with history of slip and fall at home 3 months ago and injured his left shoulder. Magnetic resonance imaging MRI is showing subscapularis tear retracted medial to glenoid and anterior supraspinatus tear with minimal retraction. The aim of this case report is to describe in detail the arthroscopic technique of ACR anterior capsule reconstruction using fascia lata autograft using the new knotless all suture anchors (fibereTak) on glenoid.
UNASSIGNED: Fascia lata being an autograft may have better healing potential, but its superiority over dermal allografts in the setting of ACR anterior capsule reconstruction needs further studies.

UNASSIGNED: The extensor apparatus of the knee can be thought of a chain that transmits the muscular strength developed by the quadriceps muscles to the proximal tibia. This complex is essential to allow the extension of the tibia over the femur, being essential to provide knee mobility and stability. In case of lesions which irreparably damage the patella, such as a locally aggressive bone tumor, it is necessary to restore both the apparatus\' anatomical continuity and its strength.
UNASSIGNED: A 67-years-old Caucasian woman developed atraumatic swelling and soreness in her left knee. X-rays and MRI images evidenced an osteolytic degeneration of the patella. A diagnosis of Gigant cell tumor of bone was made with a needle biopsy. We performed an en bloc resection of the patella and replaced it with a composite augment made with a polypropylene mesh and a fascia lata allograft. No complication was observed. In her latest follow-up, our patient did not have any extension lag and quadriceps strength was completely restored.
UNASSIGNED: The combination of internal layers of polypropylene surgical mesh and a surface allogenic graft can provide good mechanical performances for patients who underwent patellectomy due to a locally aggressive tumor.

暂无摘要。

Reconstruction of the composite defects of the Achilles tendon and the overlying skin is a great challenge. Should the tendon insertion and adjoining calcaneal defects coexist, such reconstruction becomes far more complicated. A chimeric superolateral thigh flap based on the ascending branch of the lateral circumflex femoral artery provides all the components for this complex defect. We aim to illustrate a case underwent one-stage reconstruction of such defects with this chimeric flap. A 55-year-old man presented with composite defects of Achilles tendon (11 cm), adjoining calcaneus (2 × 2 × 3 cm), and the overlying skin (15 × 3.5 cm) due to unsuccessful repair for his right chronic Achilles tendon rupture, which was complicated by infection. This complex defect was reconstructed using a chimeric superolateral thigh flap consisting of the superolateral thigh skin (8.5 × 17.5 cm), full-thickness iliac bone (4 × 3 cm), and the intervening iliotibial tract preserving the fascia-bone junction, which substituted for the lost insertion of the Achilles tendon. Bone union and full weight bearing were achieved by 11 and 24 weeks, respectively, after surgery. Two debulking procedures were performed. Isometric plantar flexion muscle strength was comparable to the healthy side, but isotonic strength was somewhat reduced at 18 months after reconstruction. This chimeric flap provided all the possible components necessary for the complex Achilles tendon defect, and led functional outcomes.

UNASSIGNED: Fascia Lata is one of the oldest materials used in the repair of inguinal hernia. It lost its popularity following the advent of meshes, mainly Tantalum and Marlex. However, the use of synthetic meshes in infected scenario is controversial. Biological meshes though started off as a potential reinforcement in contaminated fields did not show much benefit. In our case, we describe a successful technique where fascia lata was harvested and laparoscopically placed as a free graft in the preperitoneal plane for inguinal hernia repair.
METHODS: A 58-year-old man presented with right inguinal hernia associated with pain of two days duration and vomiting. On ultrasound, he had acute cholecystitis and incarcerated omentum in the right inguinal region. Patient underwent a Trans-Abdominal Pre-Peritoneal (TAPP) laparoscopic repair of the inguinal hernia.
UNASSIGNED: Synthetic meshes have been associated with complications such as mesh erosion, migration and chronic inguinodynia which is often difficult to treat. The deployment of mesh in contaminated fields is even more controversial as infection of the mesh always needs to be explanted or can lead to chronic sinus formation. Fascia lata, on the other hand can withstand infection better compared to synthetic meshes as it is biological and an autologous material.
CONCLUSIONS: To our knowledge, it is the first described use of Fascia Lata in the pre-peritoneal space for Laparoscopic Inguinal Hernia repair. There have been reports of the use of Fascia Lata in Incisional hernias by a Japanese group. We describe the technique with favorable outcomes.