• Amputation is the treatment of choice for diseased limbs and devastating lower-extremity injuries for which attempts at salvage and reconstruction may be lengthy, have high emotional and financial costs, and yield a less-than-satisfactory result. (medscape.com)
  • Whatever the indication for amputation, the goal remains length preservation and surgical reconstruction that maintains the most functional limb possible. (medscape.com)
  • Penn Orthopaedics also offers an Orthoplastics and Limb Salvage (OLS) Fellowship - a microvascular surgery program uniquely focused on traumatic reconstruction. (pennmedicine.org)
  • Directed by Drs. L. Scott Levin , Stephen J. Kovach and Samir Mehta , the program allows fellows to design a more advanced clinical and research experience in managing extremity reconstruction and salvage. (pennmedicine.org)
  • And in 2016, I took part in a bilateral hand transplantation at Penn - and from that moment on, I knew that hand microsurgery and limb reconstruction were what I wanted to do. (pennmedicine.org)
  • Fellows receive additional advanced training in hand transplantation, microsurgical reconstruction of upper and lower extremities in adults and children, and brachial plexus surgery. (pennmedicine.org)
  • The Fellowship focuses on both upper and lower limb extremity, allowing the fellow and the institution to design a more advanced clinical and research experience in managing extremity reconstruction and salvage. (pennmedicine.org)
  • Of the 202 feet that received surgery, 22 (10.9%) were not felt to be suitable for reconstruction and underwent a definitive transtibial amputation without an attempt at reconstruction. (unboundmedicine.com)
  • Other risk factors that were associated with major amputation in patients included active infection at presentation, nonunion/instability after reconstruction, and a postoperative wound problem. (unboundmedicine.com)
  • Although, Dr. McCabe is specially trained in limb salvage, reconstruction, and orthoplastics and is, in fact, the only doctor in the area that's fellowship trained in limb salvage and reconstruction, he believes in exhausting every viable conservative treatment before considering surgery. (livingmagazine.net)
  • Our doctors specialise in the reconstruction of the functional limb using metal implants, bone-grafts or a combination of both. (jupiterhospital.com)
  • He has pioneered a novel foot and ankle reconstruction surgery, using PMMA (Poly Methyl Methacrylate), also called Bone Cement, as foot bone replacement prosthesis for severely destroyed foot and ankle bones. (theseoultimes.com)
  • BACKGROUND/AIM: Free flap reconstruction with damaged or diseased vessels is a challenging problem. (bvsalud.org)
  • The advent of infrainguinal reconstruction for lower-limb salvage introduced the complication of lymphatic fistula after this procedure. (medscape.com)
  • Through a multidisciplinary care team comprising orthopaedic surgery, intervention radiology, plastic surgery, podiatry, physiotherapy and dietetics, the SKH DLS programme has demonstrated high positive patient outcomes, such as higher healing rates and reduced limb amputations and wound recurrences among patients with diabetic foot complications. (healthxchange.sg)
  • The goal of Trident Health System's limb-saving program is to provide patients with every option available to prevent unnecessary amputations. (tridenthealthsystem.com)
  • Amputations of the toes and/or part of the foot and limb not only place limitations on the physical activity of the patient, but are also not cosmetically appealing. (theseoultimes.com)
  • An estimated 50,000 amputations occur every year in India due to diabetes related foot problems. (theseoultimes.com)
  • As a result of our integrated approach combining Podiatric and Vascular surgery, the Advanced Diabetic Foot Clinic has seen significantly reduced rates of amputations for diabetic patients. (jioforme.com)
  • 02). Of 16 amputations in the ESRD group, nine were performed in limbs with patent grafts. (mssm.edu)
  • Surgery may be recommended if your condition is causing you physical and/or emotional health problems, or putting you at risk for early onset osteoarthritis or other complications. (hss.edu)
  • With endovascular surgery comes numerous benefits including a decrease in complications, quicker recovery, smaller incisions and more. (azhd.ae)
  • Attendees will understand principles of managing complications and limb-salvage. (ahn.org)
  • In addition to advanced training at the PGY-6 level or higher, the Penn Orthoplastics and Limb Salvage Surgery Fellowship provides training in extremity reconstructive surgery, including trauma. (pennmedicine.org)
  • In cases where a higher level of wound care is necessary, your podiatrist may be able to use skin or bone grafts, or perform reconstructive surgery to replace or rebuild infected or necrotic bones, tendons and tissue. (toetalfamilyfootcare.com)
  • He then moved to Madison, Wisconsin, where he completed his residency training in Plastic and Reconstructive Surgery, met his wife, Patti, and developed a love for the Midwest. (iu.edu)
  • Dr. Christie enjoys reconstructive surgery because of the ability to help restore patients' sense of wholeness after trauma, cancer removal, or arthritis. (iu.edu)
  • If the issues in your foot are severe enough that conservative treatment can't help, reconstructive surgery can fix the problems for good. (podiatryhotline.com)
  • Learn more about how modern reconstructive surgery can treat your foot and ankle problems. (podiatryhotline.com)
  • From cut to close, VOI specializes in implants for TPLO, CBLO, TTA, Arthrodesis and limb salvage from toy to large breed including canine, feline and equine patients. (insighthack.com)
  • Limb-sparing techniques are used to preserve limbs affected by trauma, arthritis, cancers such as high-grade bone sarcomas, and vascular conditions such as diabetic foot ulcers. (wikipedia.org)
  • Dr. Hanel's research interests include outcome studies related to Hand Surgery and Hand Trauma as well as biomechanical studies related to methods for treating hand injuries. (washington.edu)
  • Limb salvage treatment helps cancer patients, diabetics, victims of trauma, and many others by removing severe injuries and infections without compromising the patients overall quality of life. (diabetesprohelp.com)
  • Traumatic causes include surgery, blunt trauma, penetrating trauma, and diagnostic procedures (eg, lumbar arteriography and subclavian vein catheterization). (medscape.com)
  • Since its December 2009 opening, the Amputation Prevention Center's specialized multidisciplinary team of highly skilled professionals has treated patients from all over the country and around the world with leading-edge technology, achieving a limb salvage rate of 96 percent. (sciencedaily.com)
  • Sengkang General Hospital's Diabetic Limb Salvage service maximises number of shoe-able patients with diabetic foot ulcers to restore their mobility and livelihood. (healthxchange.sg)
  • SINGAPORE, 13 OCTOBER 2023 - More patients with diabetic foot conditions have been able to resume their independence and mobility with the Diabetic Limb Salvage (DLS) service offered by Sengkang General Hospital (SKH). (healthxchange.sg)
  • Since 2019, DLS care team at SKH cared for more than 250 patients with complex diabetic foot ulcers, most of whom were on the verge of losing their limbs. (healthxchange.sg)
  • Assistant Professor Francis Wong, Consultant, Orthopaedic Surgery, SKH shared, "In SKH, we see many younger patients with diabetic foot problems who are sole breadwinners for their families. (healthxchange.sg)
  • Patients are admitted into the hospital for about two nights after the surgery. (hss.edu)
  • As with the DFO, patients undergoing femur and tibia surgery are admitted into the hospital for about two nights after the surgery. (hss.edu)
  • We hypothesized that those patients with CN who presented with a Charcot-related foot wound would have lower rates of successful limb salvage than patients who presented without a wound. (unboundmedicine.com)
  • An additional 18 patients underwent soft tissue surgery, which included drainage of infection, posterior muscle group lengthening, or soft tissue reconstructive flap surgery. (unboundmedicine.com)
  • Dr. McCabe is pioneering ankle replacement surgery that's paving the way for others in his field and returning quality of life to his patients with chronic ankle problems. (livingmagazine.net)
  • Described as "deliberately challenging", the new time-to-treatment targets published by the Vascular Society of Great Britain and Ireland ( VSGBI ), as part of the Peripheral Arterial Disease Quality Improvement Framework, have prompted a number of different measures in the UK for the treatment of patients with chronic limb-threatening ischaemia (CLTI). (vascularnews.com)
  • Focusing on the work done in Leicester for patients with CLTI, Nickinson discussed how "a nurse-led, open access, outpatient limb salvage clinic" has attempted to provide a one-stop assessment for patients. (vascularnews.com)
  • To do this, we interrogated our prospectively maintained clinic database and included all patients who were managed with chronic limb threatening ischaemia or diabetic foot ulceration over a one-year period from the inception of the clinic (February 2018 to February 2019)," commented the speaker. (vascularnews.com)
  • In total, we assessed 294 patients in the first year of the clinic, of which 222 had chronic limb threatening ischaemia or neuropathic diabetic foot ulceration. (vascularnews.com)
  • Following his presentation on the success of a specialist limb salvage clinic, Nickinson turned his attention to what may be happening before patients reach the clinic and, specifically, whether or not a timely diagnosis of CLTI is being made in primary care. (vascularnews.com)
  • The dramatic change of events from amputation to limb salvage surgeries has heralded a new hope to these patients who have this form of cancer. (txhospitals.in)
  • We specialize in amputation prevention and limb salvage for patients who suffer from peripheral arterial disease (PAD). (insighthack.com)
  • Vascular Institute is dedicated to providing the most comprehensive limb salvage program to our patients, physicians, and the community. (insighthack.com)
  • The infection and progression of these ulcers very often lead to loss of the limb in the immune compromised patients of diabetes. (theseoultimes.com)
  • The Department of Endocrinology and Podiatric Surgery at the Amrita Institute of Medical Sciences (AIMS), Kochi, Kerala, is the only centre in India where a new type of reconstructive and corrective foot and ankle surgery is being performed in large numbers in high-risk diabetic foot patients under the able guidance of diabetic lower limb and foot and ankle reconstructive surgeon Professor Dr Ajit Kumar Varma. (theseoultimes.com)
  • Between 2009 and 2011 Paul underwent a period of formal research training at St George's, University of London, and was awarded an MD for his thesis examining the outcomes of patients undergoing limb saving bypass surgery or angioplasty in England. (bset.co.uk)
  • Given the morbidity of infected ankle arthroplasty, careful consideration should be made about performing arthroplasty in patients with multiple prior surgeries and comorbidities that predispose to wound-healing difficulties. (qxmd.com)
  • There is actually one last shot at limb salvage for these patients, and that is the ArtAssist® device. (acimedical.com)
  • At the State of the Art Advanced Diabetic Foot Clinics as part of SUGAR - Apollo's initiatives to address the growing epidemic of Diabetes & Diabetic Foot, we partner with physicians and diabetic patients to save limbs, heal wounds, and optimally preserve limb function. (jioforme.com)
  • Here, your patients receive intervention and treatment from an interdisciplinary team that includes Board-certified Podiatric surgeons, Vascular specialists and Endocrinologists who specialize in limb salvage. (jioforme.com)
  • Major limb amputation despite a patent graft remains a problem of unique frequency in patients with ESRD. (mssm.edu)
  • Endovascular surgery is the use of minimally invasive techniques to treat patients with vascular diseases. (azhd.ae)
  • Limb preservation specializes in the management of complex extremity problems and treatment of conditions and diseases that place people at risk of losing an extremity. (tridenthealthsystem.com)
  • Dr. McHugh specializes in a wide array of hip and knee surgeries including total joint replacement, minimally invasive hip and knee surgery, robotic hip and knee surgery, the treatment of hip dysplasia in adolescents and adults, complex revision surgeries, as well as hip preservation. (oint.org)
  • One of the nation's few facilities of its kind, the Advanced Diabetic Foot Clinic at Apollo hospitals brings a uniquely integrated and highly effective approach to limb preservation. (jioforme.com)
  • Dr. Kane specializes in foot and ankle problems ranging from bunions and hammertoes to complex reconstructive procedures and limb salvage surgeries. (oint.org)
  • When bunions get too large and painful to deal with, it's time to get surgery to make them smaller. (podiatryhotline.com)
  • The Fellowship Programs at the Department of Orthopaedic Surgery at Penn Medicine were developed to encompass the breadth of technical knowledge required of subspecialists in orthopaedic surgery. (pennmedicine.org)
  • After completing my residency in orthopaedic surgery and a hand fellowship in Israel, I knew I wanted experience in research, and particularly in microsurgical research. (pennmedicine.org)
  • In Israel, I finished my residency in orthopaedic surgery and a hand fellowship. (pennmedicine.org)
  • His podiatrist referred him to Dr. Rogers at Valley Presbyterian Hospital's Amputation Prevention Center, an integrated limb salvage center that is one of only a handful in the nation. (sciencedaily.com)
  • As a fellowship-trained surgeon and podiatrist, Dr. McCabe spends his days returning quality of life to men, women, and children offering everything from treatment for ingrown toenails to total ankle replacement surgery. (livingmagazine.net)
  • 3. Downing R, Grimley R et al: Problems in diagnosis of popliteal aneurysms. (ispub.com)
  • World Voice Day is a worldwide annual event on April 16, to create awareness of problems, diagnosis, and treatment of various voice-related diseases. (vpslakeshorehospital.com)
  • In a selected series of 3046 popliteal aneurysms, a rupture rate of 2.5% and limb amputation rate of 27.5% has been reported 1 . (ispub.com)
  • Operative intervention of infected total ankle arthroplasty resulted in limb salvage in 79% of cases (a 21% amputation rate). (qxmd.com)
  • 23 ] Benign intermuscular lipomas are most frequently found in the pelvic limb, particularly between the semitendinosus, semimembranosus and bicep femoris muscles and less frequently in the thoracic limbs. (thieme-connect.com)
  • A 8-year-old neutered female Alaskan Malamute was presented with a 12 months history of progressive left thoracic limb lameness of variable degree. (thieme-connect.com)
  • The Internet Journal of Thoracic and Cardiovascular Surgery. (ispub.com)
  • Dr. Kowalski brings his expertise in cervical, thoracic, and lumbar problems ranging from disc herniations to complex spinal deformity correction surgeries. (oint.org)
  • The Orthoplastics and Limb Salvage Surgery fellow also becomes an integral member of the Hand Transplantation Service and is expected to participate in research, resulting in at least one publication or formal presentation alongside our faculty members, who are heavily involved in clinical and basic research. (pennmedicine.org)
  • Limb-sparing techniques, also known as limb-saving or limb-salvage techniques, are performed in order to preserve the look and function of limbs. (wikipedia.org)
  • Unlike the traditional procedure of amputation, in which the whole limb is removed, limb salvage surgery helps to preserve the affected limb by targeting only the affected area. (jupiterhospital.com)
  • There are two main surgeries to treat knock knees: A distal femoral osteotomy (DFO) and a DFO with tibial osteotomy. (hss.edu)
  • Distal femoral osteotomy, or DFO, surgery involves creating a cut in the femur just above the knee to reshape the bone and realign the entire limb. (hss.edu)
  • Age, runoff score of the International Society for Cardiovascular Surgery/Society for Vascular Surgery, isolated tibial bypass graft, and location of distal anastomosis were not predictive of hemodynamic failure. (mssm.edu)
  • As you rotate with our six fellowship-trained foot and ankle surgeons you will be immersed in a learning environment designed to foster independent and successful activity in the world of foot and ankle surgery. (uth.edu)
  • The Orthopedic surgeons at the TX Hospitals can diagnose and treat many types of bone and joint problems using minimally invasive techniques. (txhospitals.in)
  • As Arizona's leading vascular surgery group since 2005, our team of award-winning, board certified, vascular and endovascular surgeons have a combined 100+ years of vascular devoted surgical experience. (insighthack.com)
  • The problem is that some people exhaust all of those options and vascular surgeons believe they have no other choice but to amputate - but that's not true! (acimedical.com)
  • When his primary care physician finally agreed to Mr. Winkler's request for an x-ray, they discovered the metatarsal bones in Mr. Winkler's left foot were all broken -- a common symptom of this serious and potentially limb-threatening lower-extremity complication. (sciencedaily.com)
  • Initially there a stepping awkwardly off one problem, others such as the palate, joint with no lowest price for paxlovid is quickly followed by partial thyroidectomy offers many months in late complication. (fountainheadapartmentsma.com)
  • Knee-joint salvage enhances rehabilitative efforts and decreases the energy expenditure required for ambulation. (medscape.com)
  • Most minimally invasive orthopedic surgeries are done with the use of an arthroscope, a special thin tool designed for viewing and treating problems inside a joint. (txhospitals.in)
  • We also look for foot deformities or joint problems that may increase the risk of wounds. (jioforme.com)
  • If the damage from ankle arthritis gets severe enough, the only option is to perform surgery on the ankle joint. (podiatryhotline.com)
  • Understand how cutting-edge ankle joint replacement surgery can help your joint work like new again. (podiatryhotline.com)
  • His practice encompasses all aspects of vascular surgery from varicose veins to carotid disease but he has a particular focus on peripheral vascular disease. (bset.co.uk)
  • Although a diseased limb can be removed quite readily, resolving the problem of the extremity, the care does not end there. (medscape.com)
  • So, for example, if you have atherosclerosis (hardening of the arteries) of the lower extremity or a diabetic foot ulcer, your problems would not be solved with a lymphedema pump, even if it has been modified to be more powerful. (acimedical.com)
  • He then completed his fellowship in Hand and Upper Extremity Surgery at Stanford University, before returning to the Midwest and joining the faculty at Indiana University. (iu.edu)
  • Attendees will understand new concepts and techniques utilized in the management of complex diabetic lower extremity problems such as Charcot, ankle fractures, osteomyelitis and significant soft tissue deficits. (ahn.org)
  • We describe our case series using an arteriovenous loop or bypass surgery with free flaps for complex defect reconstructions at the lower extremity and the pelvic region. (bvsalud.org)
  • Rotationplasty is also performed on children with congenital femoral deficiencies, such as those that cause unstable hip joints or limb-length discrepancy of the femur. (wikipedia.org)
  • OLS fellows have shared clinical responsibilities with rotating orthopaedic and plastic surgery residents, have access to the McKay Orthopaedic Research Laboratory for anatomy, microsurgery and biomechanics projects, and become integral members of the Hand Transplantation Service. (pennmedicine.org)
  • Limb Salvage Bypass Surgery. (azhd.ae)
  • In order to establish whether or not this limb salvage service can help to meet time-to-treatment targets, Nickinson explained that an investigation evaluating one-year amputation outcomes was conducted. (vascularnews.com)
  • He performs clinical research investigating outcomes in hand and wrist surgery, and in surgeon decision-making, and has multiple book chapters and publications in top reconstructive surgical journals. (iu.edu)
  • Our limb-saving program features a unique approach involving specialists from various disciplines, from diabetes and cardiovascular care to wound care and diagnostics. (tridenthealthsystem.com)
  • It's a major problem in medicine that is not limited to wound care,' says Bowler. (dermatologytimes.com)
  • Whenever we can, we use minimally invasive techniques to treat your foot, ankle, or heel problem. (upmc.com)
  • ArtAssist®…The Arterial Assist Device® (Arterial Pump Technology) should not be confused with lymphedema or DVT prevention treatment because the ArtAssist® device solves an entirely different problem: facilitating arterial blood flow to the places that need it, especially in the legs and feet (there are also cuffs available for arms, though it is somewhat less common). (acimedical.com)
  • We create treatment plans tailored to your specific healthcare needs, which may include adopting lifestyle changes like quitting smoking, taking prescription medications and having surgery. (sutterhealth.org)
  • When a person has cancer of the bone, Surgery forms a part of the treatment. (txhospitals.in)
  • VAC's scope of practice includes complete dialysis access maintenance services, limb salvage, venous and arterial disease treatment, and other related work. (insighthack.com)
  • Free rupture give our brains are not know so treatment but beside a candidate for surgery, minor displaced anteriorly. (fountainheadapartmentsma.com)
  • Limb salvage surgery along with the comprehensive oncology center is pioneering new methods in the treatment of orthopaedic oncology. (vpslakeshorehospital.com)
  • Early recognition/treatment of a problem can greatly reduce your risk of amputation. (toetalfamilyfootcare.com)
  • Through a combination of these methods, limb salvage has been found to be an effective treatment for infected limbs, and as an alternative to amputation. (toetalfamilyfootcare.com)
  • Arthroscopic or keyhole surgeries of the joints are routinely performed. (txhospitals.in)
  • Surgery can be helpful in early stages involving acute fractures of the foot or ankle or in later stages when offloading is ineffective, according to the article. (sciencedaily.com)
  • Alloprosthetic composites are a combination of multiple limb-sparing techniques, namely allografts and prosthesis. (wikipedia.org)
  • After the removal of a diseased limb and the application of an appropriate prosthesis, the patient can resume being an active member of society and maintaining an independent lifestyle. (medscape.com)
  • The surgery must be performed well to ensure that the patient is able to wear a prosthesis comfortably. (medscape.com)
  • This substance can deteriorate bony tissue and cause serious bone problems for the patient. (wikipedia.org)
  • The extra effort to save that small amount of bone around the hip is important for our goal to salvage the limb, get the cancer out and make sure there's nothing left behind. (clevelandclinic.org)
  • The surgeon can attach special tools to the end of the arthroscope to shave, cut, or remove tissue or bone that are causing problems. (txhospitals.in)
  • CT scan is recommended only in the case of diagnostic problems or doubt, to provide clearer visualization of calcification, periosteal bone formation, or cortical destruction. (medscape.com)
  • What kind of heal problems and time? (cancer.org)
  • George Andros, M.D., the Center's Medical Director, performed vascular surgery to restore circulation to Mr. Winkler's left foot so that it would heal. (sciencedaily.com)
  • Domain of Expertise: Diabetic foot and Diabetic lower limb surgeon, Podiatric Surgeon, Foot and ankle reconstructive and corrective surgeon. (healthcaremagic.com)
  • 5. 1st May, 2004 to 31st May 2015: Professor and Chief of Unit-- Diabetic lower limb and Podiatric surgery, Department of Endocrinology, Diabetic lower limb and Podiatric surgery -Amrita Institute of Medical Sciences and Research Center, Kochi, Kerala, India. (healthcaremagic.com)
  • In May 2004 he joined the 'Amrita Institute of Medical Sciences and research centre', Kochi, Kerala, a 1400 bed, tertiary referral hospital, as the chief of the Unit of diabetic lower-limb and Podiatric Surgery. (healthcaremagic.com)
  • Speaking at the VSGBI's annual meeting (27-29 November, Manchester, UK) , Andrew Nickinson (University of Leicester, Leicester, UK) spoke about the potential benefits offered by a specialist, vascular limb salvage (VaLS) clinic, as well as missed opportunities for the timely recognition of CLTI within primary care. (vascularnews.com)
  • Through the entire knee surgery process we have been so please with the results and care given to us. (oint.org)
  • Gaining power and screws may be counselled carefully planned after-care: the main problems are made you find out of the same or around pain, peritonitis, constipation. (fountainheadapartmentsma.com)
  • He is also in charge of the Pediatric Hand Surgery Program at Seattle Children's Hospital, which the affiliated hospital at the University of Washington providing comprehensive subspecialty care for all pediatric medical problems. (washington.edu)
  • Dr. Christie places great importance in patient-centered care, and in shared decision-making when discussing difficult surgeries and challenging conditions. (iu.edu)
  • On 1st June 2015 he joined the Aster Medcity Hospital, a quartinary care institute, Kochi, Kerala, as Senior Consultant of the Department of Podiatric Surgery.This is the largest of its kind in India, and concentrates mainly on limb salvage. (healthcaremagic.com)
  • As the techniques for chemotherapy, radiation, and diagnostic modalities improve, there has been a trend toward limb-sparing procedures to avoid amputation, which has been associated with a lower 5-year survival rate and cost-effectiveness compared to limb salvage in the long-run. (wikipedia.org)
  • As a result, AIMS has been able to maintain a lower-limb salvage rate of 91.5%, in diabetic foot and ankle diseases, which is comparable to the best centres in the world, said Dr. Varma to Citizen News Service - CNS. (theseoultimes.com)
  • Paul has published and presented extensively on the subject of lower limb revascularisation, limb salvage, the management of diabetic foot problems and varicose veins. (bset.co.uk)
  • A retrospective, cohort study that looked at mortality rate after a first lower limb amputation found nearly one quarter of people died within 30 days after a first lower limb amputation and almost half at one year. (dermatologytimes.com)
  • Cases managed include extensive necrotizing fasciitis, plantar-space infections, diabetic gangrene of the lower limb and osteomylites, and severely destroyed foot and ankle Charcot. (healthcaremagic.com)
  • Rotationplasty, more commonly known as Van-Nes or Borggreve Rotation, is a limb-sparing medical procedure performed when a patient's leg is amputated at the knee. (wikipedia.org)
  • Risk factors for infection in our cohort included diabetes, prior ankle surgery, and wound healing problems more than 14 days postoperatively. (qxmd.com)
  • These issues not only impact the knees, hips and back, but are also predicators of bigger problems, like hypertension, cardiovascular disease, diabetes, and other costly chronic health conditions. (healthworldnet.com)
  • The Orthopedic Institute of North Texas (OINT) is a full-service orthopedic surgery practice with offices in Frisco, Flower Mound, Farmers Branch and Lewisville, Texas. (oint.org)