The Use of a Freestanding A Frame External Fixator for Significant Bone and Soft Tissue Loss Upper Limb Trauma

2016 ◽  
Vol 31 (1) ◽  
pp. 51-52
Author(s):  
Stephen M. McDonnell ◽  
John Cashman ◽  
David Burges
Author(s):  
Hashem Bark Awadh Abood ◽  
Abdulaziz Munahi Alanazi ◽  
Falah Bader Alhajraf ◽  
Wejdan Nawaf Mesfer Alotaibi ◽  
Bushra Saad Alghamdi ◽  
...  

Vascular injuries to the upper or lower limb in the context of significant soft tissue loss, fractures, or other life-threatening injuries are associated with a high amputation rate. Complex extremity vascular injuries in which acute arterial insufficiency combined with severe or prolonged shocks are unacceptable because warm, warm, skeletal muscle time is often exceeded before adequate revascularization, and are associated with extended ischemia periods or fractures or soft tissue wounds. Revascularizing the limb is essential for the success of the limb rescue. Selective intravascular temporary shunting hence allows better overall care of the patient and can therefore be predicted to increase both limb rescue and patient survival rates. The aim of this article was to review and summarize results of previous literature regarding effectiveness on intravascular shunting as management of limb trauma as well as reviewing its potential complications.


2018 ◽  
Vol 14 (15) ◽  
pp. 12
Author(s):  
Omer Ali Rafiq Barawi ◽  
Zmnako J. Amen

This is a comparative study to evaluate the outcome of forty patients with bone loss in tibia using conventional external fixation device for group A while for group B using Ilizarov external fixator device each group consists of 20 patients, based on principles of distractive osteogenesis. Patients and methods: Forty patients with bone loss of 4 to 14 centimeters in tibia between April 2011 and April 2016 were treated, ages (15-65 years); female to male ratio was 6:34. The cause of defects in tibia was fracture due to road traffic accident (20 cases), bullet injury to leg (8 cases), gap nonunion (8 cases) and infected non unions(4 cases). They were divided into two groups each consists of 20 patients, conventional external fixator used for group A while for group B Ilizarov external fixator device was used with performing transverse corticotomy proximal or distal to the gap for both groups. Results: Evaluation of results was done according to Association for Study and Application of Methods of Ilizarov (A.S.A.M.I.) scoring system and it revealed that both functional and bony results were better in group B than group A. Conclusions: Fixation of the bone by Ilizarov frame gives more rapid union of the bone, less chance of pin tract infection and cosmetically more preferable because of smaller scar tissue of entry of K wires than Schanz pins. Prevention and treatment of equinus deformity and clawing of the toes can be done by extending the Ilizarov frame to correct them. In cases of severe soft tissue loss it is better to apply conventional external fixator as a provisional fixator till the soft tissue loss and swelling will be diminished.


2017 ◽  
Vol 164 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Darren C Roberts ◽  
D M Power ◽  
S A Stapley

BackgroundScapula fractures are relatively uncommon injuries, mostly occurring due to the effects of high-energy trauma. Rates of scapula fractures are unknown in the military setting. The aim of this study is to analyse the incidence, aetiology, associated injuries, treatment and complications of these fractures occurring in deployed military personnel.MethodsAll UK military personnel returning with upper limb injuries from Afghanistan and Iraq were retrospectively reviewed using the Royal Centre for Defence Medicine database and case notes (2004–2014).ResultsForty-four scapula fractures out of 572 upper limb fractures (7.7%) were sustained over 10 years. Blast and gunshot wounds (GSW) were leading causative factors in 85%. Over half were open fractures (54%), with open blast fractures often having significant bone and soft tissue loss requiring extensive reconstruction. Multiple injuries were noted including lung, head, vascular and nerve injuries. Injury Severity Scores (ISS) were significantly higher than the average upper limb injury without a scapula fracture (p<0.0001). Brachial plexus injuries occurred in 17%. While military personnel with GSW have a favourable chance of nerve recovery, 75% of brachial plexus injuries that are associated with blast have poorer outcomes. Fixation occurred with either glenoid fractures or floating shoulders (10%); these were as a result of high velocity GSW or mounted blast ejections. There were no cases of deep soft tissue infection or osteomyelitis and all scapula fractures united.ConclusionScapula fractures have a 20 times higher incidence in military personnel compared with the civilian population, occurring predominantly as a result of blast and GSW, and a higher than average ISS. These fractures are often associated with multiple injuries, including brachial plexus injuries, where those sustained from blast have less favourable outcome. High rates of union following fixation and low rates of infection are expected despite significant contamination and soft tissue loss.


2021 ◽  
Vol 17 (1) ◽  
pp. 1-17
Author(s):  
Yue Pan ◽  
Ying Hao ◽  
Yao Xiao ◽  
Kun Shi ◽  
Ying Qu ◽  
...  

Soft Tissue augmentation is a way to restore lost tissue and also a way to reshape confidence for patients who suffer from soft tissue loss. Materials that can realize such a function are called soft tissue fillers. Among the large number of fillers, injectable fillers have attracted widespread attention in facial cosmetic fields due to their convenience and competitive performance. Meanwhile, there is a huge demand for better injectable soft tissue fillers in medical cosmetology market. This review introduces several fillers which were once used in clinical or are now still in use. Furthermore, we update recent improvements and progress on injectable filling materials hoping to contribute to its further developments.


2013 ◽  
Vol 40 (3) ◽  
pp. 276-280 ◽  
Author(s):  
M. M. Al-Qattan

Over a 20-year period, six patients (19 tendons) underwent two-staged extensor tendon reconstruction using silicone rods followed by palmaris longus tendon grafts sutured proximally to the divided flexor carpi radialis tendon. All patients were young men (mean age, 22 years) who sustained the injury in car accidents. The soft tissue loss from the dorsum of the hand was associated with extensor tendon loss over the entire zone 6 with or without loss in zone 7. Primary soft tissue coverage was done elsewhere, and patients presented for secondary tendon reconstruction. All patients had supple metacarpophalangeal joints before reconstruction. After the two-staged tendon reconstruction, full or near-full active flexion at the metacarpophalangeal joints was obtained in all patients. However, minor extension lags (10°–15°) at the metacarpophalangeal joints were seen in 15 out of 19 reconstructed fingers.


1997 ◽  
Vol 18 (11) ◽  
pp. 735-738 ◽  
Author(s):  
Ranjan Maitra ◽  
Lisa Tiffany DeGnore

Isolated dislocations of the middle cuneiform are uncommon. There have been four reported previously. Significant force is required to produce these injuries, and they can have serious neurovascular consequences. In this case report and review of the literature, we present an isolated middle cuneiform dislocation in a 69-year-old farmer with impending skin and soft tissue loss over the dislocated bone.


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