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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.

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Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
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Sternoclavicular joint infection: classification of resection defects and reconstructive algorithm.

Janna Joethy1, Chong Hee Lim, Heng Nung Koong

  • 1Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.

Archives of Plastic Surgery
|December 13, 2012
PubMed
Summary

This study classifies sternoclavicular joint (SCJ) defects after infection and presents a reconstructive algorithm. Surgical reconstruction using various flaps achieved good wound healing and shoulder function in most patients.

Keywords:
Infectious arthritisSternoclavicular jointSurgical flap

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Management
  • Reconstructive Surgery

Background:

  • Sternoclavicular joint (SCJ) infection requires aggressive treatment including antibiotics and surgical resection.
  • Post-resection SCJ defects necessitate a structured approach for effective reconstruction.
  • A classification system for SCJ defects is crucial for guiding reconstructive strategies.

Purpose of the Study:

  • To classify post-resectional sternoclavicular joint defects.
  • To present a reconstructive algorithm for managing SCJ defects.
  • To evaluate the outcomes of surgical reconstruction for SCJ defects.

Main Methods:

  • A classification system (Types A, B, C) was developed for SCJ defects.
  • Twelve patients underwent reconstruction for SCJ infection defects.
  • Reconstruction utilized pectoralis major flaps, latissimus dorsi flaps, or secondary closure.

Main Results:

  • All reconstructed wounds healed successfully without flap failure.
  • Nine patients achieved good shoulder motion post-reconstruction.
  • Extensive clavicular resection resulted in restricted shoulder abduction in three patients.

Conclusions:

  • A reconstructive algorithm is proposed based on defect type (B or C).
  • Pectoralis major flap is recommended for Type B defects; latissimus dorsi for Type C.
  • Flap selection considers vessel patency in extensive infections, favoring latissimus dorsi if others are compromised.