BACKGROUND Severe lower extremity trauma as a devastating combat related injury is on the rise and this presents reconstructive surgeons with significant challenges to reach optimal cosmetic and functional outcomes. This study assessed early reconstructions of complex lower extremity battlefield soft tissue wounds. METHODS  This was a prospective case series study of battled field injur...

Learning Objectives: After studying this article, the participant should be able to: 1. Understand the indications for the use of free-tissue transfer in lower extremity reconstruction. 2. Understand modalities to enhance the healing and care of soft tissue and bone before free-tissue transfer. 3. Understand the lower extremity reconstructive ladder and the place of free-tissue transfer on the ...

The popularity of skiing and snowboarding has increased tremendously over the past few decades. Whereas skiing has been an established winter sport for some time, snowboarding was created only in the 1960s. The great surge in popularity of snowboarding was sparked by its inclusion in the 1998 Winter Olympics. With increased participation in these winter activities has come a tremendous rise in ...

Since the onset of combat activity in Iraq and Afghanistan, there have been over 1100 major limb amputations among United States service members. With a sustained military presence in the Middle East, continued severe lower extremity trauma is inevitable. For this reason, combat surgeons must understand the various amputation levels as well as the anatomic and technical details that enable an o...

Evidence-Based Answer Complete decongestive physiotherapy (i.e., a noninvasive protocol consisting of skin care, lymph drainage massage, exercises, and compression bandaging1) effectively improves edema, rates of infection, and quality of life in patients with lower-extremity lymphedema. (Strength of Recommendation [SOR]: B, based on prospective cohort studies.) Microsurgery may be effective fo...

Obesity and osteoarthritis are complex diseases to which multiple interacting factors contribute. The moderate association between obesity and knee joint osteoarthritis reflects the amplification by obesity of role of joint loading in the development and progression of osteoarthritis. However, joint loading is insufficient to explain the disparities between the incidence of knee OA in obese peo...

Diagnostic ultrasound techniques used in the evaluation of the musculoskeletal system are rapidly evolving. Conventional B-mode and Doppler ultrasound imaging methods are workhorses in the diagnosis and treatment decision making for traumatic and pathologic conditions of joints, tendons, muscles, ligaments, and peripheral nerves. Recently developed sonoelastography techniques enable the qualita...

statistically and found to be of little value in reliably determining the presence or absence of DVT. The differential diagnosis for leg pain and swelling includes lymphedema, chronic venous insufficiency, infection (cellulitis), aneurysm, pseudoaneurysm, Baker cyst, and other musculoskeletal causes. Diagnosis of DVT depends on the clinician’s pretest probability assessment and a combination of...