Multiligamentary knee injuries associated with transtibial amputation is a pathologie with a low incidence, so their diagnosis and treatment represent a great challenge for the medical team, mainly due to the low rate of scientific publications on the matter. This article intends to present the treatment of a really infrequent pathology, presenting the clinical case of a polytraumatized patient who suffered a left transtibial amputation associated with a multiligament knee injury with dislocation of the proximal tibiofibular joint. After analyzing the multiple therapeutic options, a specific surgical planning is carried out for the specific case of a multiligament knee injury associated with an ipsilateral transtibial amputation, proceeding to the execution of the reconstruction of the injury with good results. For this, several specific surgical gestures are carried out, adapted to the patient\'s condition, which will facilitate the surgery and are explained in the surgical technique. In conclusion, we must know that in order to obtain satisfactory results in these patients, it is important to carry out an early diagnosis and treatment of the injury, analyzing the proximal tibiofibular stability and providing adequate stability through the execution of a precise surgical technique.

The distal radius is rarely affected by either primary or metastatic bone cancers. The most frequent tumors of the distal radius are giant cell tumors, which are benign tumors with the propensity to invade. En bloc excision of giant cell tumors of the distal radius achieves a low recurrence rate but compromises the wrist joint, necessitates a significant reconstruction, and has functional consequences. Reconstruction after en bloc resection of a distal radius bone tumor is challenging. Furthermore, orthopedic oncologists disagree on treating such long bone anomalies most effectively. The present article summarizes the various biological and non-biological reconstruction techniques performed after en bloc resection of a distal radius tumor, discusses the advantages and disadvantages of each reconstruction strategy, and summarizes several case studies and case reports.

Pure laparoscopic donor right hepatectomy (PLDRH) is a technical demanding procedure, and many centers have strict selection criteria especially an anatomical variation. Portal vein variation is considered as a contra-indication for this procedure in most centers. We presented a case of PLDRH in donor who had rare non-bifurcation portal vain variation. The donor was 45-year-old female. Pre-operative imaging showed a rare non-bifurcation portal vain variation. The procedure was following the routine step of laparoscopic donor right hepatectomy except the hilar dissection phase. All portal branches should not be dissected before division of bile duct to prevent vascular injury. Regarding bench surgery, all portal branches were reconstructed together. Finally, the explanted portal vein bifurcation was used to reconstruct all portal vein branches as a single orifice. The liver graft was successfully transplanted. The graft was well functioned, and all portal branches were patented.
This technique facilitated identification and safely divided all portal branches. PLDRH in donor with this rare portal vein variation can be performed safely by a highly experienced team and good reconstruction technique. Pure laparoscopic donor right hepatectomy (PLDRH) is a technical demanding procedure, and many centers have strict selection criteria especially an anatomical variation. Portal vein variation is considered as a contra-indication for this procedure in most centers. Lapisatepun and colleagues report PLDRH in rare non-bifurcation portal vein variation, and reconstruction technique was scanty reported.

UNASSIGNED: In this radioanatomical study with clinical correlate, we study a variation of the \'extended nasal floor mucosa\' (ENFM) free-graft, the purely nasal floor mucosa (PuNFM) free-graft. The objectives of this study are to evaluate the coverage surface area provided by the PuNFM, study the adequacy of the PuNFM in the reconstruction of endoscopic endonasal approach (EEA) transsellar postoperative defects and compare and evaluate this reconstructive technique with current sellar region reconstruction practices.
UNASSIGNED: Dissections were performed on five cadaveric specimens. PuNFM were harvested bilaterally and the area provided for reconstruction was calculated. Twenty-five consecutive cases of pituitary adenomas resected through an EEA were analyzed to estimate the sellar defect surface area (SDSA) after a transsellar EEA and calculate the area of PuNFM bilaterally.
UNASSIGNED: The median cadaveric SDSA was 4.77 cm2, with a median left and right side PuNFM area of 5.09 and 5.19 cm2, respectively. Clinically, the median SDSA was 5.36 cm2, and the total radiological PuNFM surface area was 5.46 cm2, with modified Knosp grade >2 tumors having larger SDSA than that of Knosp grade <2 tumors. The PuNFM graft proved to be most effective for covering modified Knosp <2 tumor defects.
UNASSIGNED: The PuNFM represents a variation of the ENFM free-graft sellar defect reconstruction technique that provides sufficient surface area to reconstruct the majority of the sellar defects related to transsellar EAA for pituitary adenomas. This technique may positively impact sinonasal function and quality of life. Future prospective clinical studies are needed to verify these findings.

We have developed an observation and measurement method for spatial electromagnetic fields by using scanning electron/ion microscopes, combined with electron holography reconstruction technique. A cross-grating was installed below the specimen, and the specimens were observed under the infocus condition, and the grating was simultaneously observed under the defocus condition. Electromagnetic fields around the specimen were estimated from grating-image distortions. This method is effective for low and middle magnification and resolution ranges; furthermore, this method can in principle be realizable in any electron/ion beam instruments because it is based on the Lorentz force model for charged particle beams. Mini Abstract We have developed a visualization technique for spatial electromagnetic fields by using scanning electron/ion microscopes, combined with electron holography reconstruction technique. A specimen and a cross-grating installed below the specimen were observed simultaneously. The distorted grating image caused by electromagnetic fields around the specimen were quantitatively measured and visualized.

The outcomes of pancreatectomy with resection and reconstruction of the involved arteries for locally advanced pancreatic cancer following chemotherapy have improved in recent years. In pancreatic head cancers in which there is contact with the common and proper hepatic arteries, margin-negative resection requires pancreati-coduodenectomy, with the resection of these arteries and the restoration of hepatic arterial flow. Here, we describe a middle colic artery transposition technique in hepatic arterial reconstruction during pancreatoduo-denectomy for an initially unresectable locally advanced pancreatic cancer. This technique was effective and may provide a new option for hepatic artery reconstruction in such cases.

OBJECTIVE: To evaluate the image quality and ability to delineate the small visceral arteries of high-resolution (HR) abdominal CT angiography (CTA) using an ultra-high-resolution computed tomography (UHR CT) scanner.
METHODS: Thirty-seven patients were enrolled who underwent abdominal CTA using a UHR CT scanner. The images were reconstructed with a matrix of 1024 × 1024 and 0.25 mm thickness for HR CTA and with a matrix of 512 × 512 and 0.5 mm thickness for normal resolution (NR) CTA. Maximum CT value, image quality, and delineation of the small arteries were compared between HR CTA and NR CTA.
RESULTS: HR CTA showed significantly higher maximum CT value, higher image quality, and better delineation of the small arteries than did NR CTA (P < .005).
CONCLUSIONS: HR CTA using a UHR CT scanner showed higher image quality than NR CTA and enhanced the delineation of visceral arteries.

Breast conserving surgery (BCS) followed by radiotherapy is used for the management of early-stage breast cancers. There are different techniques to reconstruct the breast after BCS, each has its own advantages and disadvantages. In this study, we aim to present a novel local transposition flap and report the follow-up results of patients who underwent breast reconstruction using this method in the short and long term.
We enrolled 100 patients who underwent BCS in the form of upper or lower outer quadrant lumpectomy with or without axillary lymph node dissection. After lumpectomy, the patients underwent breast reconstruction using the local transposition flap technique. We followed the patients for 1 year, and the satisfaction results are assessed and reported postoperation, after radiochemotherapy, and after 1 year.
The patients\' mean age is 47.6 (±11.7) years, and the mean BMI is 32.4 (±2.5). The duration of hospitalization was 1 day in 96 patients and 2 days in 2 patients. There were 2 patients hospitalized for 3 days. Three patients developed seroma and there were no cases of any other complication. The surgeon and patients satisfaction surveys conducted postop, after the radiochemotherapy course, and 1 year after BCS shows that the excellent and good satisfaction rate is 85%, 85%, and 92% respectively.
We believe that the local transposition flap can be an excellent substitution for the existing methods in the reconstruction of the lateral side breast defects.

BACKGROUND: Inferior tendon quality, wide retraction, and tendon stumps that cannot be mobilized define the limits of what is technically feasible for open and arthroscopic rotator cuff reconstruction. The aim of this study was to develop a procedure that enables the open reconstruction of otherwise non-reconstructable rotator cuff tears.
METHODS: From 2014 to 2018, 23 operations were performed on 21 patients (mean age 63) using open procedure involving separating the infraspinatus tendon from the point of insertion on the greater tubercle and mobilizing it proximally and ventrally into the defective area. Any remaining defects were augmented using an autologous biceps tendon interposition graft. This augmentation was performed to achieve complete closure of the defect. Furthermore, the augmentation of the rupture zone was intended to strengthen the tendon stumps of the SSP and ISP to better neutralize the initial tensile forces. After a postoperative period of 12 months-4 years, clinical examination and functional tests were carried out, the Constant score was determined, and radiological and magnetic resonance imaging check-up examinations were performed.
RESULTS: The technique resulted in a low-tension closure of an otherwise \"non-repairable\" superior rotator cuff defect. All patients experienced a significant functional improvement, a reduction in pain, and an increase in muscle strength. An improvement in the Constant score from 48 points preoperatively to 87 points postoperatively (p < 0.05) was observed. In 19 patients (90%), the magnetic resonance image showed an intact reconstruction. Re-rupture was seen in three patients (14%).
CONCLUSIONS: The surgical procedure using infraspinatus tendon shift and autologous biceps tendon interposition grafts resulted in the successful reconstruction of otherwise non-reconstructable massive rotator cuff lesions. The complete closure of the defect was observed.

Particularly for patients with heart arrhythmias, conventional BestSystole (BS) and BestDiastole (BD) reconstruction techniques in computed tomography (CT) frequently show artifacts that hinder the readability of the coronary tree. To address this problem, this paper presents an alternative reconstruction method that combines the technique \"reconstructions with identical filling\" (RIF) with motion mapping: This new technique is called \"RIF in motion mapping\" (RIMM). This study compares the diagnostic quality of images generated with RIMM to that of the other reconstruction techniques.
Having shown major artifacts in standard reconstructions, the CT datasets of 23 patients with suspected coronary artery disease or prior to transcatheter aortic valve replacement were selected manually. Each dataset was evaluated with four reconstruction techniques: BS, BD, RIF, and RIMM. Two radiologists, blinded to the applied reconstruction type, then evaluated the entire coronary tree of each sample using the 15-segment American Heart Association model and the six-grade Likert scale.
Of the 345 analyzed coronary segments, the RIMM technique showed a significant number of images with reliable diagnostic quality (n = 228, 66%) as compared to RIF (P = 0.002) and BS/BD reconstructions (P < 0.001). Per coronary segment, vessel, and patient, the RIMM technique scored significantly better than the conventional BS/BD reconstructions (P = 0.003) and better than the RIF reconstructions with regard to the right coronary artery (P = 0.041).
This new technique works: Using RIMM on the worst CT images substantially erased many of these artifacts, thereby enabling the radiologists to clearly visualize these segments. As RIMM considerably eliminates artifacts, this new CT reconstruction technique can help make a fast reliable evaluation of a patient\'s coronary tree. Thus, this enhanced visualization of cardiac images by RIMM avoids the need for further invasive diagnostic procedures.