Manual Kirschner-Wire Insertion through the Soft Tissue for Finger Immobilization after Scar Contracture Release

2015 ◽  
Vol 20 (1) ◽  
pp. 8
Author(s):  
Jun Hee Lee ◽  
Kang Woo Lee ◽  
Jin Sik Burm ◽  
Won Yong Yang ◽  
Sang Yoon Kang
Keyword(s):  
Soft Tissue ◽  
Kirschner Wire ◽  
Scar Contracture ◽  
Contracture Release

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

2021 ◽  
pp. 107110072110130
Author(s):  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Hee-June Kim ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Kirschner Wire ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Simple Method ◽  
Wire Fixation ◽  
The Mean ◽  
Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

Skin Grafting

2019 ◽  
pp. 65-72
Author(s):  
Stephen M. Milner
Keyword(s):  
Skin Grafting ◽  
Skin Grafts ◽  
Full Thickness ◽  
Preoperative Preparation ◽  
Scar Contracture ◽  
Skin Defects ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Contracture Release

Skin grafting is an indispensable technique used in a variety of clinical situations, including acute burns, traumatic wounds, scar contracture release, and oncological and congenital deficiencies. The author’s preferred techniques for harvesting and resurfacing various skin defects using split- and full-thickness skin grafts are described in this chapter, together with the assessment of donor and recipient sites, preoperative preparation and postoperative considerations.

“Pilot Hole” Technique for Interphalangeal Joint Fusion of Toes

2016 ◽  
Vol 106 (4) ◽  
pp. 305-307
Author(s):  
Nikhil Sharma ◽  
David Morley ◽  
Dev Damany
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Kirschner Wire ◽  
Interphalangeal Joint ◽  
Claw Toe ◽  
Pilot Hole ◽  
Reproducible Technique ◽  
Joint Fusion ◽  
Intramedullary Canal

Fusion of an interphalangeal joint of a lesser toe is a commonly used procedure for addressing interphalangeal joint deformities such as a hammer or a claw toe. Fusion can be achieved by insertion of an intramedullary Kirschner wire in a retrograde manner. Deviation of the Kirschner wire from the intramedullary canal into the surrounding soft tissues is common. This can render the fusion unstable and can cause painful soft-tissue irritation and early Kirschner wire loosening, resulting in an unstable nonunion with recurrence of deformity. We describe a simple and reproducible technique to assist with optimal intramedullary placement of the Kirschner wire, thereby reducing the risk of complications after interphalangeal joint fusion of a toe.

Double combined Z-plasty for wide-scar contracture release

2013 ◽  
Vol 66 (5) ◽  
pp. 629-633 ◽  
Author(s):  
Takatoshi Yotsuyanagi ◽  
Ken Yamashita ◽  
Ayako Gonda ◽  
Shinji Kato ◽  
Asuka Sugai ◽  
...  
Keyword(s):  
Scar Contracture ◽  
Contracture Release

Development of International Outcomes Instrument for Hand and Upper Extremity Burn Scar Contracture Release

2017 ◽  
Vol 38 (1) ◽  
pp. e395-e401 ◽  
Author(s):  
Lawrence Cai ◽  
Joseph Lippi ◽  
Jay Dumanian ◽  
Matthew Klein ◽  
Mohan Krishna Dangol ◽  
...  
Keyword(s):  
Upper Extremity ◽  
Burn Scar ◽  
Scar Contracture ◽  
Contracture Release

Analysis of Upper Extremity Motion in Children After Axillary Burn Scar Contracture Release

2009 ◽  
Vol PAP ◽  
Author(s):  
Mitell Sison-Williamson ◽  
Anita Bagley ◽  
Kyria Petuskey ◽  
Sally Takashiba ◽  
Tina Palmieri
Keyword(s):  
Upper Extremity ◽  
Burn Scar ◽  
Scar Contracture ◽  
Contracture Release ◽  
Extremity Motion

Use of Skin Z-Plasty for Management of Extension Contracture in Recurrent Claw- and Hammertoe Deformity

1994 ◽  
Vol 15 (4) ◽  
pp. 209-212 ◽  
Author(s):  
Mark S. Myerson ◽  
Paul Fortin ◽  
Pierre Girard
Keyword(s):  
Soft Tissue ◽  
Revision Surgery ◽  
Surgical Procedure ◽  
Metatarsophalangeal Joint ◽  
Soft Tissue Release ◽  
Dorsal Skin ◽  
Scar Contracture

Nine patients with recurrent metatarsophalangeal joint extension contracture after clawtoe or hammertoe procedures were treated with Z-plasty skin closures as part of the revision surgical procedure. The indication for performing the Z-plasty was the presence of scar contracture in the skin that prevented satisfactory correction of the toe. Soft tissue release of the metatarsophalangeal joint was followed by a simple dorsal skin Z-plasty transposition. Patients were evaluated 1 1/2 to 6 years after revision surgery. No recurrence of the extension contracture had occurred.

scholarly journals Distally based peroneal artery perforator-plus fasciocutaneous flap in the reconstruction of soft tissue defects over the distal forefoot: a retrospectively analyzed clinical trial

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Ping Peng ◽  
Zhaobiao Luo ◽  
Guohua Lv ◽  
Jiangdong Ni ◽  
Jianwei Wei ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Kirschner Wire ◽  
Peroneal Artery ◽  
Soft Tissue Defects ◽  
Partial Necrosis ◽  
Total Length ◽  
Distally Based ◽  
Artery Perforator ◽  
Pedicle Width ◽  
Tissue Defects

Abstract Background Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps are widely used for reconstructing soft-tissue defects of the lower extremity. However, reports on the reconstruction of the defects over the distal forefoot using the DPAPF flaps are scarce. Herein, we describe our experience on the reconstruction of these defects using DPAPF flaps in a considerable sample size. Methods Between February 2005 and August 2019, a total of 56 DPAPF flaps in 56 patients were used to reconstruct soft-tissue defects in the forefoot. In order to reduce the length of fascial pedicle and the total length of the DPAPF flaps, the ankles were fixed in dorsiflexion using a Kirschner wire before designing the flaps. The flaps were elevated by the anterograde–retrograde approach. Patient factors and flap factors were compared between the “survival” and “partial necrosis” groups. Results Overall, 47 flaps had survived completely in one stage. Partial necrosis developed in nine flaps, with only one remnant defect covered using a local flap. By fixing the ankles in dorsiflexion, the length of the fascial pedicle was reduced approximately 2.35 ± 0.58 cm, the total length of the flap was simultaneously shortened by the same amount as the length of the fascial pedicle. The width of the fascia pedicle varied from 3.0 cm to 6.0 cm. The fascial pedicle width > 4 cm was found in 21 flaps. The partial necrosis rate of the DPAPF flaps with the top edge located in the 8th zone was significantly lower than that in the 9th zone (p < 0.05). Conclusions The DPAPF flaps can be effectively used to reconstruct the defects over the distal forefoot because of convenient harvest and reliability. By fixing the ankle in dorsiflexion with Kirschner wire and widening the fascial pedicle appropriately, the top edge and LWR of the flaps will be decreased, and thus the procedures are helpful for the flaps survival.

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