scholarly journals Large Autologous Ilium with Periosteum for Tibiotalar Joint Reconstruction in Rüedi-Allgöwer III Pilon Fractures

2020 ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Donor Site ◽  
Soft Tissue Injury ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background: Management of Rüedi-Allgöwer III or AO type C3 pilon fracture present numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients with soft tissue injury of Tscherne-Gotzen I-II after Rüedi-Allgöwer III pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36).Conclusions: Large autologous ilium with periosteum in combination with ORIF can be safely performed for tibiotalar joint reconstruction. This method greatly reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III pilon fractures.Level of Evidence: Level III, retrospective cohort study

scholarly journals Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures: a pilot study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Donor Site ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Implant Fixation ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Non Union ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3–36). Conclusions Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up. Level of evidence Level III, retrospective cohort study.

scholarly journals Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures. A pilot study

2020 ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Donor Site ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Implant Fixation ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Non Union ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background: Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36). Conclusions: Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.Level of Evidence: Level III, retrospective cohort study

scholarly journals Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures. A pilot study

2020 ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Donor Site ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Implant Fixation ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Non Union ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background: Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36). Conclusions: Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This experimental procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.Level of Evidence: Level III, retrospective cohort study

scholarly journals Large autologous ilium with periosteum for tibiotalar joint reconstruction in Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures

2020 ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Donor Site ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Implant Fixation ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Non Union ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background: Management of Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture presents numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients according to Tscherne/Oestern FxCO-I closed fracture and FxOI open fractures classification after Rüedi-Allgöwer III or AO/OTA type C3 pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis. Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36). Conclusions: Large autologous ilium with periosteum in combination with ORIF can be performed for tibiotalar joint reconstruction. This procedure reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III or AO/OTA type C3 pilon fractures in short follow-up.Level of Evidence: Level III, retrospective cohort study

Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures

2017 ◽  
Vol 22 (04) ◽  
pp. 411-415
Author(s):  
Taku Suzuki ◽  
Eiko Yamabe ◽  
Takuji Iwamoto ◽  
Katsuji Suzuki ◽  
Harumoto Yamada ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Compartment Syndrome ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Skin Grafting ◽  
High Energy ◽  
Acute Compartment Syndrome ◽  
Mechanism Of Injury ◽  
Sensory Disturbances

Background: It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb. Methods: We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications. Results: Mechanism of injury of “caught in a machine” was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting. Conclusions: In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.

scholarly journals A cross-sectional study of long-term satisfaction after surgery for congenital syndactyly: does skin grafting influence satisfaction?

2018 ◽  
Vol 44 (3) ◽  
pp. 296-303 ◽  
Author(s):  
Bien R. Ferrari ◽  
Paul M.N. Werker
Keyword(s):  
Donor Site ◽  
Skin Grafting ◽  
Cross Sectional Study ◽  
Complication Rates ◽  
Skin Grafts ◽  
Sectional Study ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Scar Assessment

Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV

scholarly journals Most British Surgeons Would Consider Using a Tissue-Engineered Anterior Cruciate Ligament: A Questionnaire Study

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Sarah Rathbone ◽  
Nicola Maffulli ◽  
Sarah H. Cartmell
Keyword(s):  
Anterior Cruciate Ligament ◽  
Mechanical Performance ◽  
Tissue Injury ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Soft Tissue Injury ◽  
Donor Site Morbidity ◽  
Online Questionnaire ◽  
Common Problems ◽  
Anterior Cruciate

Donor site morbidity, poor graft site integration, and incorrect mechanical performance are all common problems associated with autografts for anterior cruciate ligament (ACL) reconstructions. A tissue-engineered (TE) ligament has the potential to overcome these problems. We produced an online questionnaire relating to tissue engineering of the ACL to obtain input from practising clinicians who currently manage these injuries. 300 British orthopaedic surgeons specialising in knee surgery and soft tissue injury were invited to participate. 86% of surgeons would consider using a TE ACL if it were an option, provided that it showed biological and mechanical success, if it significantly improved the patient satisfaction (63%) or shortened surgical time (62%). 76% felt that using a TE ACL would be more appropriate than a patellar tendon, hamstring, or quadriceps autograft. Overall, most surgeons would be prepared to use a TE ACL if it were an improvement over the current techniques.

An ulnar parametacarpal perforator flap for volar digital soft tissue reconstruction

2020 ◽  
Vol 45 (8) ◽  
pp. 842-848
Author(s):  
Satoshi Usami ◽  
Kohei Inami ◽  
Yuichi Hirase ◽  
Hiroki Mori
Keyword(s):  
Donor Site ◽  
Perforator Flap ◽  
Soft Tissue Reconstruction ◽  
Level Of Evidence ◽  
Tissue Reconstruction ◽  
The Mean ◽  
Lost To Follow Up ◽  
Pulp Repair ◽  
Sensory Reinnervation

We present outcomes of using a perforator-based ulnar parametacarpal flap in 25 patients for digital pulp defects. These included 17 free transfers to the thumb, index, middle and ring fingers and eight reverse pedicled transfers to the little fingers. This flap includes a dorsal sensory branch of the ulnar nerve, which was sutured to the digital nerve in all transfers. Each flap had one to three reliable perforators (mean 0.44 mm diameter) to the ulnar parametacarpal region and contained at least one perforator within 2 cm proximal to the palmar digital crease. All the 25 flaps survived completely. Twenty-two patients were followed for 15 months (range 12 to 24), and three were lost to follow-up. The mean static and moving two-point discrimination of the flap was 7 mm and 5 mm, respectively. At the donor site, sensory reinnervation was acceptable. We conclude that ulnar parametacarpal perforator flaps offer sensate, thick and glabrous skin for finger pulp repair, all in a single operative field. Level of evidence: IV

scholarly journals Intra-articular Calcaneus Fractures: Current Concepts Review

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142092733
Author(s):  
Paul R. Allegra ◽  
Sebastian Rivera ◽  
Sohil S. Desai ◽  
Amiethab Aiyer ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Late Complications ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Tarsal Bones ◽  
Calcaneus Fractures

Calcaneal fractures are the most common fracture of the tarsal bones and represent 1% to 2% of all fractures. Roughly 75% of these fractures include intra-articular involvement of the posterior facet of the calcaneus. Intra-articular calcaneal fractures are challenging injuries to manage for both patients and surgeons given their association with both early and late complications. This article aims to review the management, classification systems, surgical approaches, and care regarding intra-articular calcaneal fractures. A review of the current literature yielded treatment strategies that aim to reduce complications such as soft tissue injury or loss of articular reduction while maintaining satisfactory clinical outcomes. The purpose of this article is to review these current concepts in the management of intra-articular calcaneal fractures. Level of Evidence: Level V, expert opinion.

Modified Littler flap for sensory reconstruction of large thumb pulp defects

2018 ◽  
Vol 43 (5) ◽  
pp. 546-553 ◽  
Author(s):  
Hui Wang ◽  
Xiaoxi Yang ◽  
Chao Chen ◽  
Bin Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Donor Site ◽  
Ring Finger ◽  
Middle Finger ◽  
Donor Site Morbidity ◽  
Digital Nerve ◽  
Level Of Evidence ◽  
Dorsal Branch ◽  
Ulnar Aspect ◽  
Monofilament Test

The Littler flap has been widely used to repair large pulp defects of the thumb; however, several complications have occurred frequently. In order to reduce these issues, the modified Littler flap innervated by the dorsal branch of the proper digital nerve and the proper digital nerve from the ulnar aspect of the middle finger or the radial aspect of the ring finger were devised in 16 consecutive cases. At the donor site, the defect of the proper digital nerve was repaired with a nerve graft from the proximal portion of the ipsilateral dorsal branch of the proper digital nerve. At the final follow-up, the scores for the static two-point discrimination test, Semmes–Weinstein monofilament test and total active motions in both recipient and donor fingers were nearly normal. This modified Littler flap provides a simple and reliable alternative for treatment of large defects of the thumb pulp with low donor-site morbidity. Level of Evidence: IV

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