Cranial bone grafting in orbital reconstruction - Review of technique

to assess the versatility of calvarial bone grafting in the reconstruction of the facial and orbital skeleton following traumatic injuries of the face. Materials and ninety-eight patients underwent 135 bone graftings for periorbital deformities. Eighty-five [86.7%] males and 13 [13.3%] females were included and age ranged from 2-54 years [mean 27.6 years]. Craniomaxillofacial trauma was the main reason for calvarial bone grafting; orbital floor [55.6%], lateral orbital wall [18.4%] and orbital roof [9.6%]. Access for calvarial bone graft harvest was via coronal or temporoparietal incision. Design: retrospective analysis of patients undergoing periorbital reconstruction using calvarial bone graft. ninety-eight percent of patients achieved satisfactory cosmetic and functional results following primary surgery. Four [4.1%] patients needed secondary reconstructive surgery to correct persistent diplopia and 5.1% had correction of residual enophthalmos and ocular dystopia. Postoperative wound complications were minimal and responded to local therapy. There was no intracranial complication but one intraoperative dural tear during calvarial bone harvest, which was sutured primarily. No intra- or postoperative bleeding and no neurological injuries were encountered. calvarial bone is a reliable and safe grafting material in the hands of experienced surgeons. Its reliability stems from the fact that it is thick, can be harvested in large amounts, in different shapes and sizes, proximity to the recipient site, minimal morbidity and low resorption velocity

Medical Quiz acute mesenteric ischaemia

A 62 years old Bahraini man was admitted through the surgical clinic with recurrent attacks os central abdominal pain of several month's duration. He gave a history of ischaemic heart disease but was not on regular treatment. Previous echocardiography had shown impaired systolic left ventricular function with global hypokinesia. On the second day of his admission he developed a cold left lower limb. Clinical examination revealed an absent pulse from dorsalis pedis and posterior tibial arteries that was confirmed by duplex ultrasound. Following a femoral angiography [Fig. 1] he underwent a successful femoral embolectomy. On the first postoperative day he complained of severe central abdominal pain and became hypotensive and tachycardiac