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The flattening of philtral ridge resulted from failure to reconstruct natural orientation of orbicularis oris muscle during surgery.
Clinically, the quadriceps-sparing and subvastus approaches are very similar techniques, as both avoid the incision into the quadriceps tendon and the vastus medialis muscle during surgery.
Subjects were less than 65 years old, had recently undergone primary unilateral THA using a direct lateral (Hardinge) approach, which involves splitting the gluteus medius muscle during surgery.
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Neuromuscular blockade was established with rocuronium (1 mg/kg) to facilitate endotracheal intubation and provide muscle relaxation during surgery.
Exclusion criteria included wound dehiscence, use of skin or muscle flap during surgery and first stage revision (i.e. removal of prosthesis and/or insertion of spacer).
Neostigmine, which is an agent frequently used to reverse the effects of muscle relaxants during surgery, also exerts profound cholinomimetic effects due to its inhibition of the peripheral anticholinesterase enzyme [ 10, 11].
Our aim was to investigate the in vivo metabolic changes in the skeletal muscle during TKA surgery using microdialysis (MD).
Individual kinesiologic adaptations were present due to the very limited hip kinematics resulting from the muscles injuries incurred during surgery and the lower limb length discrepancy.
In the first nine children (treated between September 1994 and May 1995), the procedure was limited to neurolysis because a conducting neuroma (based on direct stimulation of C5 and C6 and needle recording in the related muscles) was found during surgery.
This clear effect could be explained by assuming that the afferents supplying the neck muscles had been sensitized during surgery (exposure and separation of muscles, dissection of the atlanto-occipital ligament) causing ongoing afferent activity that contributed to maintain the activity of second order neurons.
Malignant hyperthermia is a metabolic muscle disease characterized by high fever and extreme rigidity of muscles, usually caused by certain anesthetics or muscle-relaxant medications given during surgery.
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