Reconstruction technique of multiligamentous knee injury in a patient with traumatic transtibial amputation.

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.

Infrared Spectroscopic Detection of Biosignatures at Lake Tírez, Spain: Implications for Mars.

The detection of potential biosignatures with mineral matrices is part of a multifaceted approach in the search for life on other planetary bodies. The 2020 ExoMars Rosalind Franklin rover includes within its payload three IR spectrometers in the form of ISEM (Infrared Spectrometer for ExoMars), MicrOmega, and Ma-MISS (Mars Multispectral Imager for Subsurface Studies). The use of this technique in the detection and characterization of biosignatures is of great value. Organic materials are often co-deposited in terrestrial evaporites and as such have been proposed as relevant analogs in the search for life on Mars. This study focuses on Ca-sulfates collected from the hypersaline Tírez Lake in Spain. Mid infrared and visible near infrared analysis of soils, salt crusts, and crystals with green and red layering indicative of microbial colonization of the samples was acquired from across the lake and identified the main mineral to be gypsum with inputs of carbonate and silica. Organic functional groups that could be attributed to amides and carboxylic acids were identified as well as chlorophyll; however, due to the strong mineralogical absorptions observed, these were hard to unambiguously discern. Taxonomical assignment demonstrated that the archaeal community within the samples was dominated by the halophilic extremophile Halobacteriaceae while the bacterial community was dominated by the class Nocardiaceae. The results of this research highlight that sulfates on Mars are a mixed blessing, acting as an effective host for organic matter preservation but also a material that masks the presence of organic functional groups when analyzed with spectroscopic tools similar to those due to fly on the 2020 ExoMars rover. A suite of complementary analytical techniques therefore should be used to support the spectral identification of any candidate extraterrestrial biosignatures.

The Bilobed Racquet Flap or Extended Seagull Flap for Thumb Reconstruction: A Case Report.

The treatment of extensive soft tissue defects in the thumb with dorsal metacarpal artery flaps has been previously reported in the literature. Island flaps from the dorsum of the index and long fingers have been the subject of many reports and studies. However, when the defect involves the whole thumb, a 360° circumferential defect, standard first or second dorsal metacarpal artery flaps are usually insufficient. There are fewer reports on the use of bilobed flaps for this application and we have found no reports on the use of bilobed racquet flaps or extended seagull flaps as treatment for this condition. We report the salvage of a thumb degloving injury with use of a bilobed racquet flap.