scholarly journals Gastrocnemius Muscle Flap for Coverage Of Knee & Proximal Third of Tibial Defects

2013 ◽  
Vol 23 (2) ◽  
pp. 58-61
Author(s):  
Alak Kanti Biswas ◽  
Tafhim Ehsan Kabir ◽  
M Nazrul Islam Chowdhury ◽  
Md Abdul Hye ◽  
Quasarul Matin ◽  
...  
Keyword(s):  
Gastrocnemius Muscle ◽  
Operative Procedure ◽  
Age Groups ◽  
Muscle Flap ◽  
Functional Restoration ◽  
Tissue Loss ◽  
Soft Tissue Loss ◽  
Upper Third ◽  
Delayed Reconstruction ◽  
Results Of Surgery

Gastrocnemius is the muscle of choice for reconstruction of defects involving soft tissue loss over the upper third tibia as well as knee joint. We present a series of 12 patients who underwent gastrocnemius muscle flap(Medial head, proximally based) coverage for this type of defects. Patients age-18 years or above. There were 9 males and 3 females. In all cases, delayed reconstruction was performed ranging from 1 week to 3 months after the creation of defects. Maximum number of pts were within 18-35 years age groups (66.66%), 75% were victims of RTA, 75% had associated fractures. Results of surgery were graded as excellent(83.33%) to good(16.67%) depending upon the outcome and functional restoration of patients. There was no case of complete muscle flap failure. Minor complications were ( 1 pt. developed partial flap necrosis & 1 pt. developed infection) noted but none required a separate operative procedure. We have found this procedure to be reliable, technically easy, biologically sound and esthetically acceptable. JCMCTA 2012 ; 23 (2): 58-61

A STUDY ON DIFFERENT SURGICAL OPTIONS OF LOWER THIRD LEG DEFECTS AND ITS OUTCOME

2021 ◽  
pp. 32-34
Author(s):  
Ajay Kumar Pathak ◽  
Md Ghulam Jeelani Naiyer ◽  
Pragati Awasthi
Keyword(s):  
Reconstructive Surgery ◽  
Soft Tissues ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Tissue Loss ◽  
Conventional Teaching ◽  
Surgical Options ◽  
Soft Tissue Loss ◽  
Flap Cover ◽  
Upper Third

Background: The bones of the lower third are vulnerable to injury. Due to the paucity of soft tissues around them, the fractures that occur are often open. Most muscles become tendons at that level and in the case of soft tissue loss, skin graft may not sufce and flap cover becomes mandatory. Conventional teaching recommends gastrocnemius muscle and myocutaneous aps and fasciocutaneous aps for the upper third leg defects, soleus aps for the middle third defects and free aps for the lower third defects. Aim: Different surgical options in management of lower third leg defects. Material And Method: The study was conducted from JANUARY 2018 to December 2019, in the Department of Plastic & Reconstructive Surgery Institute of Post Graduate Medical Education and Research (IPGME&R) and SSKM Hospital, KOLKATA. Result: 70 patients admitted to the Department of Plastic & Reconstructive Surgery and referred patients from Department of General Surgery & Orthopaedic Surgery, IPGME&R and SSKM Hospital, KOLKATA. Association of FLAP LOSS with Pedicled ap was statistically signicant (p=0.0259). We found that association of DONOR SITE MORBIDITYwith Pedicled ap was not statistically signicant (p=0.7679). Conclusion: We consider that perforator propeller aps are ideal in reconstructing small-medium defects of the middle and distal third of the leg, being safe, easy to perform, providing similar tissue in texture and thickness of damaged tissues, with low donor-site morbidity.

scholarly journals Gastrocnemius muscle flap with vancomycin/gentamicin-calcium sulfate and autogenous iliac bone graft for the phase I treatment of localized osteomyelitis after tibial plateau fracture surgery

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weiwei Ruan ◽  
Menglu Li ◽  
Qiaofeng Guo ◽  
Bingyuan Lin
Keyword(s):  
Phase I ◽  
Calcium Sulfate ◽  
Tibial Plateau ◽  
Gastrocnemius Muscle ◽  
Tibial Plateau Fracture ◽  
Muscle Flap ◽  
Iliac Bone ◽  
Type Iii ◽  
Plateau Fracture ◽  
Fracture Surgery

Abstract Purpose To investigate the clinical effect of gastrocnemius muscle flaps combined with vancomycin/gentamicin-calcium sulfate combined and autologous iliac bone graft in the phase I treatment of traumatic focal osteomyelitis (Cierny-Mader type III) after tibial plateau fracture surgery. Methods From July 2009 to January 2018, 35 patients with localized osteomyelitis (Cierny-Mader type III) who met the inclusion criteria were followed up and treated. All patients were infected after undergoing internal fracture fixation surgery. Among them, 18 cases were plate-exposed, 14 cases were due to sinus tracts, two were due to skin necrosis, and one was bone-exposed. We treated patients with several measures. All cases were then followed up. The follow-up indicators included Hospital for Special Surgery knee scores (HSS), the time of laying drainage pipe, bone healing time, infection control rate, and the incidence of nonunion and other complications. Results All patients were followed up for 24–60 months. None of them underwent amputation. For repairing soft tissue defects, 17 cases were covered with a muscle flap using the medial head of gastrocnemius alone, 15 cases were treated with the lateral head of gastrocnemius muscle, and three cases were covered with the combination of the two heads. Compared to the preoperative score, we found that the average HSS improved at the 1-year and 2-year follow-up (54 vs. 86 vs. 87). Conclusion Using a gastrocnemius muscle flap combined with vancomycin/gentamicin-calcium sulfate and autogenous iliac bone was an effective method for the phase I treatment of osteomyelitis (Cierny-Mader type III) after tibial plateau fracture surgery. In the primary treatment of focal traumatic osteomyelitis, it can decrease the treatment time, number of surgeries, pain of patients, time of bone healing, postoperative exudation, and infection recurrence rate and increase the healing bone’s strength.

scholarly journals Treatment of digital ulcers in systemic sclerosis: Case series study of thirteen patients and discussion on outcome

2017 ◽  
Vol 63 (5) ◽  
pp. 422-426 ◽  
Author(s):  
Yahia Abuowda ◽  
Raquel Sousa Almeida ◽  
Ana Alves Oliveira ◽  
Petra Pego ◽  
Cristina Santos ◽  
...  
Keyword(s):  
Systemic Sclerosis ◽  
Treatment Protocol ◽  
Treatment Strategies ◽  
Case Series ◽  
Tissue Loss ◽  
Repeated Treatment ◽  
Digital Ulcers ◽  
Case Series Study ◽  
Clinical Description ◽  
Soft Tissue Loss

Summary Introduction: In systemic sclerosis (SSc), digital ulcers (DU) are debilitating and recurrent. They are markers of prognosis and are associated with disability and mortality. Treatment strategies have been developed to block the proposed mechanisms of this complication. Objective: Clinical description of a population of SSc patients with DU, treatment, complications and outcome. Method: Analysis of 48 SSc patients meeting 2013 ACR-EULAR criteria, followed between 1999-2015; 13 patients had DU. Treatment protocol applied included cycles of 21 days of alprostadil, which can be repeated in the absence of DU healing. After DU healing, bosentan was initiated. Results: DU healing was achieved with intravenous prostanoid in 12 patients; seven patients required repeated treatment for DU healing. Twelve patients were later treated with bosentan; three of them experienced recurrence of DU, while one was anti-B2-GPI positive. Four patients had soft tissue loss and three other suffered digital amputation, these being late diagnosis. Conclusion: Younger patients and early referrals had better outcomes. Endothelin receptor antagonist toxicity should be monitored, particularly in patients previously exposed to hepatotoxic drugs.

Injectable Soft Tissue Nano/Micro Fillers for Facial Reconstruction

2021 ◽  
Vol 17 (1) ◽  
pp. 1-17
Author(s):  
Yue Pan ◽  
Ying Hao ◽  
Yao Xiao ◽  
Kun Shi ◽  
Ying Qu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Facial Reconstruction ◽  
Soft Tissue Augmentation ◽  
Tissue Loss ◽  
Competitive Performance ◽  
Filling Materials ◽  
Tissue Augmentation ◽  
Soft Tissue Loss ◽  
Injectable Fillers ◽  
Micro Fillers

Soft Tissue augmentation is a way to restore lost tissue and also a way to reshape confidence for patients who suffer from soft tissue loss. Materials that can realize such a function are called soft tissue fillers. Among the large number of fillers, injectable fillers have attracted widespread attention in facial cosmetic fields due to their convenience and competitive performance. Meanwhile, there is a huge demand for better injectable soft tissue fillers in medical cosmetology market. This review introduces several fillers which were once used in clinical or are now still in use. Furthermore, we update recent improvements and progress on injectable filling materials hoping to contribute to its further developments.

The Role of Cross-Finger Flaps in the Primary Management of Untidy Flexor Tendon Injuries

1993 ◽  
Vol 18 (3) ◽  
pp. 408-408
Author(s):  
D. T. Gault ◽  
A. A. Quaba
Keyword(s):  
Flexor Tendon ◽  
Favourable Outcome ◽  
Tendon Injuries ◽  
Tissue Loss ◽  
Traditional Teaching ◽  
Flexor Tendon Injuries ◽  
Soft Tissue Loss ◽  
Primary Management

This is a report of five patients who sustained untidy division of flexor tendons in zones 1 and 2, associated with overlying soft tissue loss. Contrary to traditional teaching, the tendon injuries were repaired primarily, and the tissue loss was made good with a cross-finger flap. At final evaluation, three cases were assigned excellent grades and two cases fair grades by Kleinert criteria. This unexpectedly favourable outcome may be due to a quality of the inner surface of the cross-finger flap and/or to staggering of the skin and tendon suture lines.

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