LP19: CLINICAL OUTCOME COMPARISON BETWEEN FREE MYOCUTANEOUS LATISSIMUS DORSI AND FREE FASCIOCUTANEOUS ANTERO-LATERAL THIGH FLAPS FOR SOFT TISSUE RECONSTRUCTION OF LOWER EXTREMITY TRAUMATIC OPEN FRACTURES

2010 ◽  
Vol 126 (2) ◽  
pp. 720-721
Author(s):  
S. Al-Benna ◽  
H.-U. Steinau ◽  
L. Steinstraesser
Keyword(s):  
Soft Tissue ◽  
Clinical Outcome ◽  
Lower Extremity ◽  
Latissimus Dorsi ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Outcome Comparison ◽  
Tissue Reconstruction ◽  
Lateral Thigh

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Infection Rate ◽  
Clinical Data ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Satisfactory Outcome ◽  
Tissue Damages ◽  
Tissue Reconstruction ◽  
Severe Soft Tissue

Abstract Objective This study aimed to retrospectively analyze clinical data of a series of patients with severe open fractures of extremities (Gustilo IIIb or IIIc), who achieved a satisfactory outcome through radical orthoplastic surgery, so as to provide a reference for determining the treatment of severe open fractures of extremities. Methods The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and January 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. Results The mean (±SD) age of the patients was 38 ± 16 years. A total of 90 open fractures and severe soft tissue damages were analyzed. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. Conclusion The overall rate of infection exhibited a lower tendency in this study compared with previous studies on high-grade open fractures following a two-stage orthopedic approach. The consequence of infection rate and union time was similar to that in previous studies. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Open Tibial Fractures in Children

2020 ◽  
pp. 135-140
Keyword(s):  
Soft Tissue ◽  
Open Fractures ◽  
Antibiotic Administration ◽  
Soft Tissue Reconstruction ◽  
Fractures In Children ◽  
Adolescents And Adults ◽  
Tissue Reconstruction ◽  
Similarities And Differences ◽  
Periosteal Callus ◽  
Simultaneous Delivery

Since the last edition of this book the total number of published articles on the management of open fractures of the tibia in children has trebled. This allows for a further evaluation of similarities and differences in the management of open fractures in children, adolescents and adults. The principles evolving from the evidence published thus far indicate there are greater similarities than there are differences. Early antibiotic administration is important as is the simultaneous delivery of combined orthoplastic care. The techniques of soft tissue reconstruction are similar to those used in adults. Fracture stabilisation will need to factor in the presence of a physis. Bone loss after injury or excision (debridement) is replaced using the same techniques as in adults; an exception is the young (under 6 years of age) child with a small (less than 3 cm) defect that may restitute spontaneously from periosteal callus.

Soft tissue reconstruction and salvage of infected fixation hardware in lower extremity trauma

Microsurgery ◽  
2017 ◽  
Vol 38 (3) ◽  
pp. 259-263 ◽  
Author(s):  
Hyuma A. Leland ◽  
Alexis D. Rounds ◽  
Karen E. Burtt ◽  
Daniel J. Gould ◽  
Geoffrey S. Marecek ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Lower Extremity Trauma ◽  
Extremity Trauma ◽  
Tissue Reconstruction

A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high?

Microsurgery ◽  
2013 ◽  
Vol 33 (7) ◽  
pp. 578-586 ◽  
Author(s):  
Jonas A. Nelson ◽  
John P. Fischer ◽  
Philip S. Brazio ◽  
Stephen J. Kovach ◽  
Gedge D. Rosson ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Soft Tissue Reconstruction ◽  
Flap Loss ◽  
Tissue Reconstruction

Outcomes of Soft Tissue Reconstruction for Traumatic Lower Extremity Fractures with Compromised Vascularity

2017 ◽  
Vol 83 (10) ◽  
pp. 1161-1165 ◽  
Author(s):  
Ido Badash ◽  
Karen E. Burtt ◽  
Hyuma A. Leland ◽  
Daniel J. Gould ◽  
Alexis D. Rounds ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Limb Salvage ◽  
Arterial Injury ◽  
Soft Tissue Reconstruction ◽  
Complication Rates ◽  
Arterial Injuries ◽  
Flap Failure ◽  
Vascular Compromise ◽  
Tissue Reconstruction

Traumatic lower extremity fractures with compromised arterial flow are limb-threatening injuries. A retrospective review of 158 lower extremities with traumatic fractures, including 26 extremities with arterial injuries, was performed to determine the effects of vascular compromise on flap survival, successful limb salvage and complication rates. Patients with arterial injuries had a larger average flap surface area (255.1 vs 144.6 cm2, P = 0.02) and a greater number of operations (4.7 vs 3.8, P = 0.01) than patients without vascular compromise. Patients presenting with vascular injury were also more likely to require fasciotomy [odds ratio (OR): 6.5, confidence interval (CI): 2.3–18.2] and to have a nerve deficit (OR: 16.6, CI: 3.9–70.0), fracture of the distal third of the leg (OR: 2.9, CI: 1.15–7.1) and intracranial hemorrhage (OR: 3.84, CI: 1.1–12.9). After soft tissue reconstruction, patients with arterial injuries had a higher rate of amputation (OR: 8.5, CI: 1.3–53.6) and flap failure requiring a return to the operating room (OR: 4.5, CI: 1.5–13.2). Arterial injury did not correlate with infection or overall complication rate. In conclusion, arterial injuries resulted in significant complications for patients with lower extremity fractures requiring flap coverage, although limb salvage was still effective in most cases.

scholarly journals Pedicled Latissimus Dorsi Flap for Shoulder Soft-Tissue Reconstruction After Excision of a Musculoskeletal Neoplasm

2016 ◽  
Vol 6 (2) ◽  
pp. e16 ◽  
Author(s):  
Ryan Engdahl ◽  
Joseph Disa ◽  
Edward A. Athanasian ◽  
John H. Healey ◽  
Peter G. Cordeiro ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Latissimus Dorsi ◽  
Latissimus Dorsi Flap ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction

scholarly journals Radical treatment of severe open fractures of extremities by orthoplastic surgery: a 10-year retrospective study

2020 ◽  
Author(s):  
Zhao Yang ◽  
Chao Xu ◽  
Yong-Gang Zhu ◽  
Jun Li ◽  
Zi-Xiang Wu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Open Fracture ◽  
Aesthetic Surgery ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Central Unit ◽  
Chinese Characteristics ◽  
Tissue Reconstruction ◽  
The Mean

Abstract Orthoplastic treatment based on the collaboration of orthopedic and plastic surgeons in an “orthoplastic” central unit has been recommended by the British Association of Plastic Reconstructive and Aesthetic Surgery. However, this approach is not used worldwide especially in most developing countries. Based on the aggressive orthoplastic management, orthoplastic experience with Chinese characteristics has been carried out in last 10 years. The clinical data of 41 consecutive patients with severe open fracture (Gustilo IIIb or IIIc) of the limb, who underwent successful surgical debridement, fixation, and soft tissue reconstruction in one stage between January 2008 and April 2019, were retrospectively reviewed. Postoperative indicators, including infection rate and union time, were acquired by a regular follow-up and analyzed. The mean (±SD) age of the patients was 38±16 years. The soft tissue cover was achieved within 72 h. The overall rate of infection was 14.6% (6/41). Sex and the Mangled Extremity Severity Score were associated with infection. The median union time of 40 patients (one amputation) was 32 weeks. The overall rate of infection exhibited a lower tendency in this study. These results indicated that the single-stage radical orthoplastic treatment was an effective and reliable option for reconstructing severe open fractures.

Soft Tissue Reconstruction

2020 ◽  
pp. 63-74
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Donor Site ◽  
Free Flaps ◽  
Donor Site Morbidity ◽  
Open Fractures ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction ◽  
Wound Excision

Soft tissue coverage of open fractures with well-vascularised tissues should be performed within 72 hours of injury or at the same time as internal fixation. It may be in the form of local or free flaps, and may comprise muscle, fasciocutaneous tissues, or both. Flap selection depends on multiple factors, including the size and location of the defect following wound excision, availability of flaps, and donor site morbidity. Local flaps are usually used to cover defects with a limited zone of injury. Anastomoses for free flaps should be performed outside the zone of injury. Experimental data suggest that coverage with muscle leads to improved healing of fractures. However, there is currently little clinical evidence to support the use of one form of soft tissue cover over another for open fractures of the lower limb. The plastic surgeon must always consider the donor site morbidity of the flap(s) chosen.

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