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Surgery of the Hip
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Daud TS Chou, Jonathan Miles, John Skinner
The incision is continued through subcutaneous fat and down to fascia lata. The fascia lata is incised distally in line with the skin incision overlying the lateral femur and proximally in line with the fibres of gluteus maximus (Figure 10.7). At this point a self-retaining retractor is inserted.
Blocks of Nerves of the Lumbar Plexus Supplying the Lower Extremities
Published in Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand, Pediatric Regional Anesthesia, 2019
Bernard J. Dalens, Jean-Pierre Monnet, Yves Harmand
Below the inguinal ligament, the femoral nerve lies in the femoral triangle, limited by: (1) laterally, the medial border of the sartorius muscle; (2) medially, the lateral border of the adductor longus muscle; and (3) rostrally, the inguinal ligament. The femoral triangle is covered by the fascia lata. Its floor is formed by the pectineus muscle (medially) and the iliopsoas muscle (laterally). The femoral vessels are bundled by the femoral sheath and lie immediately below the fascia lata. The femoral nerve is adjacent and lateral to the artery, but is deep to the fascia iliaca, not bundled with the vessels within the femoral sheath.16
Conditions around the hip and thigh
Published in David Silver, Silver's Joint and Soft Tissue Injection, 2018
The iliotibial band is a thickening of the fascia lata in the lateral side of the thigh. It is superficial and extends from the anterior superior iliac spine to the Gerdy’s tubercle on the anterolateral side of the upper tibia. Flexion and extension of the knee joint causes the band to move in an anterior and posterior fashion, thus causing friction of the band over the lateral femoral condyle. Pain may be quite acute, which is an indication to inject steroid. Otherwise, physiotherapy in the form of deep massage, heat and anti-inflammatories are useful.
Cerebellar slump following removal of haematoma: a manifestation of hydrocephalus?
Published in British Journal of Neurosurgery, 2021
Debarshi Chatterjee, Dipendra Kumar Pradhan
It was therefore decided to reconstruct the posterior cranial defect. At second surgery a fascia lata graft was harvested from the left thigh and the previous wound was explored. The cerebellar hemispheres were seen herniating through the craniectomy defect. On depressing the left hemisphere at the margin of the craniectomy defect, CSF which had collected as infratentorial subdural hygromas was seen to gush out, as if it had been under pressure. After this release of CSF, the cerebellar hemispheres sank comfortably within the craniectomy defect. The fascia lata was then stitched to repair the dural defect and a titanium mesh was used to reconstruct the bony anatomy of the posterior fossa. The wound was closed in layers. Following the procedure, the patient’s hiccoughs subsided, his respiration became regular and his sensorium improved.
Direct superior approach versus posterolateral approach in total hip arthroplasty: a randomized controlled trial on early outcomes on gait, risk of fall, clinical and self-reported measurements
Published in Acta Orthopaedica, 2021
Michele Ulivi, Luca Orlandini, Jacopo A Vitale, Valentina Meroni, Lorenzo Prandoni, Laura Mangiavini, Nicolò Rossi, Giuseppe M Peretti
In a previous study, the consequences of dissection and suturing the fascia lata were studied using MRI and ultrasonography and it was reported that the fascia has strong relationships with the underlying musculature. It appears that an intact fascia represents a vital component for the normal function of thigh muscles and knee control in bipedal locomotion (Huijing 2012). As a consequence, our primary aim was to evaluate 3D movement differences during walking (i.e., gait analysis) between the 2 study groups. The risk of fall, evaluated by the OAK device, did not show any statistically significant inter-group difference but a significant improvement for both DSA and PL was detected at T3 compared with earlier assessments. TUG was significantly different from preoperative values to T1 (p = 0.009) and T3 (p = 0.009) only for DSA but not for PL (Figure 2). However, the inter-group difference was not statistically significant. All spatiotemporal parameters significantly improved in both groups. Gait cadence and speed had a highly significant improvement from T1 to T3, which was more pronounced in the DSA group. The analysis of the kinematic parameters deserves particular attention and accurate interpretation. While ROM improvement for hip flexion/extension was significant in PL from PRE to T3 and from T1 to T3, results on hip abduction/adduction ROM showed a different pattern with a significant difference from PRE to T3 only in the DSA group. However, the inter-group differences for these 2 kinematic parameters were not significant.
Treatment of CSF leakage and infections of dural substitute in decompressive craniectomy using fascia lata implants and related anatomopathological findings
Published in British Journal of Neurosurgery, 2021
Giorgio M. Callovini, Andrea Bolognini, Tommaso Callovini, Marco Giordano, Roberto Gazzeri
The successful repair of infected alien dura mater materials and CSF leakage control depends on the ability to achieve sufficient debridement and a watertight seal using well-vascularized tissue14. Fascia lata is a validated autograft and the most commonly-used graft adopted across different surgical fields in reconstructive procedures; ophthalmology, digestive-tract surgery, ENT surgery, and skull-base surgery, especially the repair of CSF leakage15. The fascia lata is the material whose biological characteristics are most similar to those of the dura, especially in terms of its negligible host response, eliciting a minimal inflammatory response16, and its non-immunogenicity, not to mention its lack of cost17. Further characteristics that contribute to making this material excellent in terms of dealing with infection issues at the surgery site are good manipulability, resistance to scarring and inflammation, and its ability to provide a scaffold for integration between the dura and the implant. In addition, fascia lata is a flexible material, which allows it to be sutured to the entire circumference of the dural defect in a watertight fashion. The successful control of infection and of CSF leak lie principally in the use of autologous material, in obtaining a watertight seal and in using well-vascularized tissue.