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.

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.

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.

scholarly journals Reverse sural artery fasciocutaneous flap in soft tissue reconstruction in lower extremity

2020 ◽  
Vol 10 (3) ◽  
pp. 84-87
Author(s):  
Suresh Pandey ◽  
Suraj Bidary
Keyword(s):  
Soft Tissue ◽  
Demographic Data ◽  
Soft Tissue Defect ◽  
Soft Tissue Reconstruction ◽  
Superficial Infection ◽  
Pedicle Flap ◽  
Satisfactory Outcome ◽  
Flap Procedure ◽  
Tissue Reconstruction ◽  
Sural Artery

Background: Soft tissue defect around distal leg, ankle and heel region is a challenging task for an orthopaedic surgeon. Sural artery reverse fasciocutaenous flap has been widely used and is a successful method for soft tissue reconstruction in such situation. This study aimed to find out the result of sural artery distal based pedicle flap in managing soft tissue recon­struction around the ankle and distal leg. Methods: This was a retrospective study of 12 cases of sural artery based fasciocutaenous flap done between January 2015 to December 2019. Medical records were used to find the details of demographic data, operative details and post-operative status of the patients. Patients were contacted for the final follow up at minimum of 6 months after operation for assessment of the outcome. Demographic and clinical data were entered in excel chart and the clinical result was analyzed using SPSS software version 20.0. Results: There were total of 12 patients who underwent sural artery flap procedure. Among them, 10 were male and 2 females with mean age of 39 (range, 25-52) years. Eleven flaps survived with satisfactory functional outcome. One had complete flap necrosis, two had patchy margin necrosis and two had superficial infection which healed well with minor debridement and antibiotics. Conclusions: Sural artery based reverse fasciocutaenous flap is good and technically easier option for an orthopaedic surgeons for the soft tissue reconstruction around ankle, heel and distal leg in traumatic, infective or other etiology with satisfactory outcome in most of the patients.

scholarly journals Myelomeningocele defect reconstruction with keystone flaps: vascular rationale for the design and operative technique

2021 ◽  
Vol 48 (3) ◽  
pp. 254-260
Author(s):  
Beatriz Hatsue Kushida-Contreras ◽  
Miguel Angel Gaxiola-García
Keyword(s):  
Soft Tissue ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Cerebrospinal Fluid Leakage ◽  
Soft Tissue Reconstruction ◽  
Dorsal Midline ◽  
Tissue Reconstruction ◽  
Clinical Records ◽  
Tertiary Care Hospitals

Background Myelomeningocele is a frequently seen condition at tertiary care hospitals. Its treatment involves a variety of plastic reconstructive techniques. Herein, we present a series of myelomeningocele patients treated using keystone flaps.Methods We gathered information regarding soft tissue reconstruction and the use of bilateral keystone flaps to treat myelomeningocele patients. We obtained data from clinical records and recorded the demographic characteristics of mothers and children with the condition. The size, level of defect, and complications detected during the follow-up were analyzed.Results A series of seven patients who underwent bilateral keystone flaps for myelomeningocele closure was analyzed. There were no cases of midline or major dehiscence, flap loss, necrosis, surgical site infections, or cerebrospinal fluid leakage. No revision procedures were performed. Minor complications included one case with minimal seroma and three cases with areas of peripheral dehiscence that healed easily using conventional measures.Conclusions The use of keystone flaps is an adequate option for closure of dorsal midline soft tissue defects related to myelomeningocele. This technique offers predictable results with an acceptable spectrum of complications. Robust blood flow can be predicted based upon anatomical knowledge.

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.

On the timing of soft-tissue reconstruction for open fractures of the lower leg

1999 ◽  
Vol 119 (1-2) ◽  
pp. 7-12 ◽  
Author(s):  
R. Hertel ◽  
S. M. Lambert ◽  
S. Müller ◽  
F. T. Ballmer ◽  
R. Ganz
Keyword(s):  
Soft Tissue ◽  
Lower Leg ◽  
Open Fractures ◽  
Soft Tissue Reconstruction ◽  
Tissue Reconstruction
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