scholarly journals Knee Sepsis after Suprapatellar Nailing of an Open Tibia Fracture: Treatment with Acute Deformity and External Fixation

2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Chelsea E. Minoughan ◽  
Adam P. Schumaier ◽  
Frank R. Avilucea
Keyword(s):  
Soft Tissue ◽  
Wound Closure ◽  
Distal Tibia ◽  
Soft Tissue Defect ◽  
Fracture Site ◽  
Tibia Fracture ◽  
Primary Wound Closure ◽  
Tissue Healing ◽  
Intramedullary Canal ◽  
Open Tibia Fracture

Case. A 31-year-old male was involved in a dirt bike accident and sustained an isolated type II open mid-distal tibia fracture. The patient underwent suprapatellar intramedullary nailing and subsequently developed knee sepsis. Conclusion. This patient was managed with irrigation and debridements of the knee, fracture site, and intramedullary canal. A resultant soft-tissue defect over the fracture site obviated primary closure. Creation of an acute deformity stabilized by a Taylor spatial frame allowed primary wound closure. After soft tissue healing occurred, the frame was used to correct the intentional deformity and maintain reduction until full healing occurred.

scholarly journals Escherichia hermannii as the sole cause of osteomyelitis in a patient with an open tibial shaft fracture

2019 ◽  
Vol 12 (11) ◽  
pp. e231206
Author(s):  
Jocelyn Compton ◽  
Malynda Wynn ◽  
Michael C Willey ◽  
Poorani Sekar
Keyword(s):  
Shaft Fracture ◽  
Open Reduction Internal Fixation ◽  
Fracture Site ◽  
Tibia Fracture ◽  
Tibial Shaft Fracture ◽  
Primary Wound Closure ◽  
Irrigation And Debridement ◽  
Open Tibia Fracture ◽  
Monomicrobial Infection

Escherichia hermannii is a rare monomicrobial cause of infection in humans. E. hermannii has never before been reported as the sole isolate from an infected open tibia fracture. We present a case of E. hermannii infection after a type III open tibia fracture. The patient was initially treated with irrigation and debridement, open reduction internal fixation and primary wound closure. However, after 8 weeks, he developed a draining wound and infection at the fracture site. He required a repeat debridement, hardware removal, external fixation and 6 weeks of intravenous ceftriaxone for treatment. At 2-year follow-up, he remains infection free, asymptomatic and continues to work with excellent functional outcomes. This case adds to the growing literature that evidences E. hermannii as an organism that can be pathogenic, virulent and cause monomicrobial infection.

Reconstruction of Tibia Fracture With Soft Tissue Defect

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Po-Lun Tsai ◽  
Otto R. Ziegler ◽  
Rowena Sudario-Lumague ◽  
Tsan-Shiun Lin
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Defect ◽  
Tibia Fracture ◽  
Tissue Defect

Increasing the Width of Keratinized Mucosa in Maxillary Implant Areas Using a Split Palatal Bridge Flap: Surgical Technique and 1-Year Follow-Up

2015 ◽  
Vol 41 (5) ◽  
pp. e195-e201 ◽  
Author(s):  
Eberhard Frisch ◽  
Petra Ratka-Krüger ◽  
Dirk Ziebolz
Keyword(s):  
Wound Healing ◽  
Soft Tissue ◽  
Wound Closure ◽  
Soft Tissue Defect ◽  
Soft Tissue Coverage ◽  
Probing Depth ◽  
Secondary Wound Healing ◽  
Keratinized Mucosa ◽  
Tissue Defects

Sufficient soft-tissue coverage of maxillary implant sites may be difficult to achieve, especially after bone augmentation. The use of vestibular flaps moves keratinized mucosa (KM) toward the palate and may be disadvantageous for future peri-implant tissue stability. This study describes a new split palatal bridge flap (SPBF) that achieves tension-free wound closure and increases the KM width in maxillary implant areas. We began SPBF surgery with a horizontal incision in the palatal soft tissue to create a split-thickness flap. The second incision was performed perpendicular to the first, using a bridge design, at a distance of 10 to 15 mm. The superior layer can be moved crestally and sutured to cover the soft-tissue defect. The defect width was measured using a periodontal probe. The inferior layer was left exposed, and secondary wound healing created new KM in this region. This SPBF technique was performed on 37 patients. Of these, 16 patients were included in the assessment of clinical peri-implant outcomes. All of the SPBF procedures successfully resulted in a palatal regeneration of KM through secondary wound healing (mean regeneration width, 4.51 ± 1.17 mm; range, 3–6 mm). The 1-year follow-up of 16 patients revealed a mean pocket probing depth of 3.22 ± 0.6 mm with zero cases of peri-implantitis. The vestibular KM width at the involved implants was 2.82 ± 1.07 mm (range, 1.5–6 mm). Surgery for SPBF may be a promising technique for covering soft-tissue defects and increasing KM width in maxillary implant surgery.

scholarly journals Management of Fractures of Distal third Tibia by Interlock Nailing

2016 ◽  
Vol 3 (1) ◽  
pp. 15-22
Keyword(s):  
Tissue Injury ◽  
Distal Tibia ◽  
Soft Tissue Injury ◽  
Skin Condition ◽  
Delayed Union ◽  
Fracture Site ◽  
Tibia Fracture ◽  
Asia Pacific ◽  
Fracture Geometry ◽  
Fibula Fracture

ABSTRACT Introduction Most of the distal third tibia is subcutaneous and has precarious blood supply. Fractures of the distal third tibia have comminution at the fracture site, as it is metaphyseal cancellous bone with a thin shell of cortex, and have associated significant soft tissue injury. Generally, skin condition is not satisfactory due to ecchymosis, blebs, swellings, wounds, etc. All these factors contribute to delayed union, nonunion, and malunion. The present study is about the ability to maintain a mechanically stable reduction in the distal third tibia with intramedullary nail, when lower 4 cm of tibia not fractured. If associated with fibula fracture (in lower 10 cm), it is always fixed as a rule to give stability to syndesmosis and stability to same-level tibia fracture. Materials and methods From January 2013 to March 2015, 60 patients of distal tibia fracture admitted to Government Medical College and Hospital, Latur, were operated and followed up prospectively. Results Mean age of patients was 35 years (25–50). Fracture union was seen radiologically within 3 to 4 months, depending on fracture geometry. Conclusion We conclude that results of fractures of distal third tibia not extending into lower 4 cm of tibia treated with interlock nailing were found satisfactory. Meticulous planning and placement of nail at the center of a wide metaphysis in the anteroposterior and lateral is mandatory to avoid varus, valgus, and posterior tilt. Polar screw or temporary K-wire during surgery is very helpful. Same-level fibula fracture fixation with a plate or square nail is very effective for stability of reduction. How to cite this article Gawali SR, Kukale SB, Nirvane PV, Toshniwal RO. Management of Fractures of Distal third Tibia by Interlock Nailing. J Foot Ankle Surg (Asia-Pacific) 2016;3(1):15-22.

Delayed Primary Wound Closure in Upper Extremity Soft Tissue Infections

1997 ◽  
Vol 335 ◽  
pp. 286-291 ◽  
Author(s):  
Stephen B. Schnall ◽  
Virginia D. Thommen ◽  
Tim Allan ◽  
Paul D. Holtom
Keyword(s):  
Soft Tissue ◽  
Upper Extremity ◽  
Wound Closure ◽  
Soft Tissue Infections ◽  
Primary Wound Closure

scholarly journals Distally based hemisoleus flap for soft tissue defect closure following chronic osteomyelitis of the distal tibia: A case report

2021 ◽  
Vol 87 ◽  
pp. 106437
Author(s):  
Muhammad Phetrus Johan ◽  
Ira Nong ◽  
Ruksal Saleh ◽  
Erich Svante Subagio ◽  
Ahmad Perdana Asy'arie ◽  
...  
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Chronic Osteomyelitis ◽  
Distal Tibia ◽  
Soft Tissue Defect ◽  
Defect Closure ◽  
Tissue Defect ◽  
Distally Based

scholarly journals The Role of Plastic Reconstructive Surgery in Surgical Therapy of Soft Tissue Sarcomas

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3534
Author(s):  
Rebekka Götzl ◽  
Sebastian Sterzinger ◽  
Andreas Arkudas ◽  
Anja M. Boos ◽  
Sabine Semrau ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Reconstructive Surgery ◽  
Wound Closure ◽  
Soft Tissue Sarcomas ◽  
Comprehensive Cancer Center ◽  
Complication Rates ◽  
Primary Wound Closure ◽  
The Impact

Background: Soft tissue sarcoma (STS) treatment is an interdisciplinary challenge. Along with radio(chemo)therapy, surgery plays the central role in STS treatment. Little is known about the impact of reconstructive surgery on STS, particularly whether reconstructive surgery enhances STS resection success with the usage of flaps. Here, we analyzed the 10-year experience at a university hospital’s Comprehensive Cancer Center, focusing on the role of reconstructive surgery. Methods: We performed a retrospective analysis of STS-patients over 10 years. We investigated patient demographics, diagnosis, surgical management, tissue/function reconstruction, complication rates, resection status, local recurrence and survival. Results: Analysis of 290 patients showed an association between clear surgical margin (R0) resections and higher-grade sarcoma in patients with free flaps. Major complications were lower with primary wound closure than with flaps. Comparison of reconstruction techniques showed no significant differences in complication rates. Wound healing was impaired in STS recurrence. The local recurrence risk was over two times higher with primary wound closure than with flaps. Conclusion: Defect reconstructions in STS are reliable and safe. Plastic surgeons should have a permanent place in interdisciplinary surgical STS treatment, with the full armamentarium of reconstruction methods.

Sign in / Sign up

Export Citation Format

Share Document