External Fixation: Indications in Lower Extremity Reconstruction and Limb Salvage

2009 ◽  
Vol 123 (4) ◽  
pp. 160e-161e ◽  
Author(s):  
Pranay M. Parikh ◽  
Melanie M. Hall ◽  
Christopher E. Attinger ◽  
Derek L. Masden ◽  
John S. Steinberg
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Limb Salvage ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Lower Extremity Reconstruction Following Tumor, Burns and Infections

2020 ◽  
Author(s):  
Dennis P Orgill
Keyword(s):  
Lower Extremity ◽  
Limb Salvage ◽  
New Technologies ◽  
Severe Infection ◽  
Case Examples ◽  
Reconstructive Ladder ◽  
Extremity Trauma ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction ◽  
Complex Wounds

Advances in plastic surgery have allowed for limb salvage in most cases of severe infection or tumor.  This often involves moving adjacent or distant vascularized soft tissue into the area.  Traditionally, surgeons have used the "Reconstructive Ladder" as a paradigm to consider various options to treat complex wounds.  Common flaps in the lower extremity will be reviewed as well as case examples to illustrate the principles of reconstruction.  New technologies such as dermal scaffolds, Negative Pressure Wound Therapy and Advanced biologics have all changed how we manage these conditions.  Advances in the microanatomy of skin has allowed surgeons to design a wide array of new flaps simplifying the extent of surgical innovation.  This review contains 6 figures, 2 tables, and 27 references. Keywords:lower extremity, wound, infection, tumor, osteomyelitis, sarcoma, lower extremity trauma, amputation, limb salvage

scholarly journals Antibiotic Cement-Coated interlocking Intramedullary Nails in the Treatment of Septic Complex Lower Extremity Reconstruction; A Retrospective Analysis with Two year Minimum Follow up

2020 ◽  
Vol 5 (4) ◽  
pp. 176-183
Author(s):  
Asim M. Makhdom ◽  
Joshua Buksbaum ◽  
S. Robert Rozbruch ◽  
Rachael Da Cunha ◽  
Austin T. Fragomen
Keyword(s):  
Lower Extremity ◽  
Limb Salvage ◽  
Complication Rate ◽  
Bone Union ◽  
Salvage Procedure ◽  
Intramedullary Nails ◽  
Antibiotic Cement ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction

Abstract. Background: To report on our experience with antibiotic cement coated interlocking intramedullary nails (ACC-IMNs) for limb salvage in septic complex lower extremity reconstruction with a minimum of 2-year follow up.Methods: We retrospectively reviewed the records of all consecutive patients who underwent a limb salvage procedure with ACC-IMNs. We reviewed patients' demographics, the preoperative infecting organism, and host type, time to bone union, complications, limb salvage rates, and infection control rates.Results: There were 28 patients with a mean age of 62 years (range 22-88). The mean follow up period was 40 months (range 28-84). The ACC-IMNs were used in 14 patients (50 %) to achieve knee fusion after failed revisions of infected total knee arthroplasty, in 8 patients (28%) for septic tibial nonunion, and in 6 patients (21%) with ankle fusion nonunions. Bony union/fusion was achieved in 87 % (21/24) of patients. The infection was controlled in 80% (21/26) of patients. Four out the five patients who had recurrent infection were type B hosts (p=0.63). The limb salvage rate was 89% (25/28). The overall complication rate was 32%.Conclusions: The use of ACC-IMNs was an effective treatment strategy and associated with high limb salvage and bone union rates. Furthermore, the infection recurrence rate was low. Knee fusion patients after failed TKA should be counseled preoperatively for a potential high complication rate.

Principles of Orthoplastic Surgery for Lower Extremity Reconstruction: Why Is This Important?

2019 ◽  
Author(s):  
Saïd C. Azoury ◽  
John T. Stranix ◽  
Stephen J. Kovach ◽  
L. Scott Levin
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
Limb Salvage ◽  
Soft Tissue Coverage ◽  
Soft Tissue Reconstruction ◽  
Treatment Team ◽  
Management Protocol ◽  
Lower Extremity Reconstruction ◽  
Tissue Reconstruction ◽  
Extremity Reconstruction

Abstract Background Regardless of the antecedent etiology, lower extremity salvage and reconstruction attempts to avoid amputation, restore limb function, and improve quality of life outcomes. This goal requires a treatment team well versed in neurovascular pathology, skeletal and soft tissue reconstruction, and physical rehabilitation. Methods A review was performed of historical milestones that lead to the development of orthoplastic extremity reconstruction, principles of current management and the evidence that supports an orthoplastic approach. Based on available evidence and expert opinion, the authors further sought to provide insight into the future of the field centered around the importance of a multidisciplinary management protocol. Results Historically, orthopaedic and plastic surgeons worked separately when faced with challenging reconstructive cases involving lower extremity skeletal and soft tissue reconstruction. With time, many embraced that their seemingly separate skill-sets and knowledge could be unified in a collaborative orthoplastic approach in order to offer patients the best possible chance for success. First coined by the senior author (LSL) in the early 1990s, the collaborative orthoplastic approach between orthopaedic and plastic surgeons in limb salvage for the past several decades has resulted in a unique field of reconstructive surgery. Benefits of the orthoplastic approach include decreased time to definitive skeletal stabilization/soft tissue coverage, length of hospital stay, post-operative complications, need for revision procedures and improved functional outcomes. Conclusion The orthoplastic approach to lower extremity reconstruction is a collaborative model of orthopaedic and plastic surgeons working together to expedite and optimize care of patients in need of lower extremity reconstruction. The implementation of protocols, systems, and centers that foster this approach leads to improve outcomes for these patients. We encourage centers to embrace the orthoplastic approach when considering limb salvage, as the decision to amputate is irreversible.

Dangle protocols in lower extremity reconstruction

2021 ◽  
Vol 266 ◽  
pp. 77-87
Author(s):  
Z-Hye Lee ◽  
Elie P. Ramly ◽  
Allyson R. Alfonso ◽  
David A. Daar ◽  
Christodoulos Kaoutzanis ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Lower Extremity Reconstruction ◽  
Extremity Reconstruction
Sign in / Sign up

Export Citation Format

Share Document