Modified classification and single-stage microsurgical repair of posttraumatic infected massive bone defects in lower extremities.

Abstract:

:Posttraumatic infected massive bone defects in lower extremities are difficult to repair because they frequently exhibit massive bone and/or soft tissue defects, serious bone infection, and excessive scar proliferation. This study aimed to determine whether these defects could be classified and repaired at a single stage. A total of 51 cases of posttraumatic infected massive bone defect in lower extremity were included in this study. They were classified into four types on the basis of the conditions of the bone defects, soft tissue defects, and injured limb length, including Type A (without soft tissue defects), Type B (with soft tissue defects of 10 × 20 cm or less), Type C (with soft tissue defects of 10 × 20 cm or more), and Type D (with the limb shortening of 3 cm or more). Four types of single-stage microsurgical repair protocols were planned accordingly and implemented respectively. These protocols included the following: Protocol A, where vascularized fibular graft was implemented for Type A; Protocol B, where vascularized fibular osteoseptocutaneous graft was implemented for Type B; Protocol C, where vascularized fibular graft and anterior lateral thigh flap were used for Type C; and Protocol D, where limb lengthening and Protocols A, B, or C were used for Type D. There were 12, 33, 4, and 2 cases of Types A, B, C, and D, respectively, according to this classification. During the surgery, three cases of planned Protocol B had to be shifted into Protocol C; however, all microsurgical repairs were completed. With reference to Johner-Wruhs evaluation method, the total percentage of excellent and good results was 82.35% after 6 to 41 months of follow-up. It was concluded that posttraumatic massive bone defects could be accurately classified into four types on the basis of the conditions of bone defects, soft tissue coverage, and injured limb length, and successfully repaired with the single-stage repair protocols after thorough debridement.

journal_name

J Reconstr Microsurg

authors

Yang YF,Xu ZH,Zhang GM,Wang JW,Hu SW,Hou ZQ,Xu DC

doi

10.1055/s-0033-1348064

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

593-600

issue

9

eissn

0743-684X

issn

1098-8947

journal_volume

29

pub_type

杂志文章
  • Liposuction in Lymphedema Treatment.

    abstract:BACKGROUND:Lymphedema leads to early deposition of adipose tissue. This may explain why conservative therapies such as complex decongestive therapy (CDT) and controlled compression therapy (CCT), as well as various forms of microsurgical reconstructions, cannot completely remove the excess volume in patients with a lar...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1549158

    authors: Brorson H

    更新日期:2016-01-01 00:00:00

  • The Role of Cadaver-Based Flap Course in Microsurgical Education and Practice Patterns of Attendees: A Survey Study.

    abstract:BACKGROUND: In 2017, our institution initiated a cadaver laboratory-based course dedicated to teaching reconstructive microsurgery indications, preoperative planning, and flap dissection. The goals of this study are to describe the demographics and experience of participants/instructors and to evaluate the learning obj...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0040-1716320

    authors: Azoury SC,Othman S,Colen DL,Broach RB,Lin I,Zenn MR,Kovach SJ,Levin LS

    更新日期:2021-02-01 00:00:00

  • Decellularized Nerves for Upper Limb Nerve Reconstruction: A Systematic Review of Functional Outcomes.

    abstract:BACKGROUND:This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons. METHODS:Literature rese...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0035-1558463

    authors: Deslivia MF,Lee HJ,Adikrishna A,Jeon IH

    更新日期:2015-11-01 00:00:00

  • Clinical anatomy of the internal oblique muscle.

    abstract::In recent years microvascular free tissue transfer has become a well accepted reconstructive technique. The current trend in flap research seems to be the development of more refined flaps to meet specific needs with minimal donor site morbidity. The internal oblique muscle provides a broad, thin, well-vascularized fl...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1007012

    authors: Ramasastry SS,Granick MS,Futrell JW

    更新日期:1986-01-01 00:00:00

  • Vessel-wall recovery after diode laser-assisted microvascular anastomosis: clinical and histologic analysis on long-term follow-up.

    abstract::The authors recently reported an experimental study on diode laser-assisted microvascular anastomosis (LAMA) in the femoral arteries and veins of rats. Good success rates and very promising histologic results obtained in this preliminary phase suggested an extension of the investigation with a larger number of rats an...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006405

    authors: Gelli R,Pini R,Toncelli F,Chiarugi C,Reali UM

    更新日期:1997-04-01 00:00:00

  • Erratum to: A Novel Method of Neo-osseous Flap Prefabrication: Induction of Free Calvarial Periosteum with Bioactive Glass.

    abstract:: ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,已发布勘误

    doi:10.1055/s-0038-1646944

    authors: Aliyev A,Ekin Ö,Bitik O,Korkusuz P,Yersal NC,Çelik HH,Tunçbilek G

    更新日期:2018-06-01 00:00:00

  • A simple method of controlling rotation in replanted digits.

    abstract::A method of fixation for replanted digits is described. It consists of axial fixation with a wire passed longitudinally through the replanted digit, supplemented with a transverse wire passed across all the digits. In this way, splinting is provided and rotation is controlled. The method is simple, rapidly applied, an...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1007067

    authors: Vlastou C,Earle AS

    更新日期:1984-10-01 00:00:00

  • Impact of Obesity on Outcomes in Breast Reconstruction: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND: Increased rates of both breast cancer and obesity have resulted in more obese women seeking breast reconstruction. Studies demonstrate that these women are at increased risk for perioperative complications. A systematic review was conducted to assess the outcomes in obese women who underwent breast reconstr...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,meta分析,评审

    doi:10.1055/s-0038-1627449

    authors: Panayi AC,Agha RA,Sieber BA,Orgill DP

    更新日期:2018-06-01 00:00:00

  • Digital neural loops: classification and implications of variation in hand surgery.

    abstract:BACKGROUND:The "neural loop" describes a digital artery passing through a digital nerve, after which both the structures progress distally to supply the digit. While rare, past descriptions refer to neural loops located around the common palmar digital arteries, with no reports of more distal loops. METHODS:We describ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0033-1348899

    authors: Niumsawatt V,Rozen WM

    更新日期:2014-01-01 00:00:00

  • Characterization of neurotrophic activity in the silicone-chamber model for nerve regeneration.

    abstract::In the present study, the authors reevaluated the temporal course and properties of neurotrophic activities present in the fluid accumulating in the silicone-chamber model for nerve regeneration. The fluid collected from silicone chambers was tested in four different dissociated neuronal cell cultures. Furthermore, th...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006537

    authors: Danielsen N,Varon S

    更新日期:1995-05-01 00:00:00

  • Reconstruction of complex radiation-induced injuries using free-tissue transfer.

    abstract::The purpose of this study was to evaluate the use of free-tissue transfers for the reconstruction of radiation-induced complex injuries. The case files for patients who underwent reconstruction for radiation-induced injuries between May 1988 and November 1995 at The University of Texas M.D. Anderson Cancer Center were...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000187

    authors: Gürlek A,Miller MJ,Amin AA,Evans GR,Reece GP,Baldwin BJ,Schusterman MA,Kroll SS,Robb GL

    更新日期:1998-07-01 00:00:00

  • Microvascular anastomoses using an Nd-YAG laser.

    abstract::The authors performed anastomoses of small vessels with the Nd-YAG laser, comparing these with conventional suture anastomoses. Some arteries were sutured with 10-0 nylon with about eight suture sites, and others were held by stay sutures at three points with laser irradiation performed between them. Two surgeons perf...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2000-8399

    authors: Nakamura T,Fukui A,Maeda M,Kugai M,Inada Y,Teramoto N,Ishida A,Tamai S

    更新日期:2000-10-01 00:00:00

  • Surgical tattooing as an aesthetic improvement in facial reconstruction with a free radial forearm flap.

    abstract::Free flaps are usually needed for the reconstruction of extensive facial burns, but the final result is often a poor texture and color match. The authors report a burn case managed with a radial forearm free flap. The aesthetic result was improved by surgical tattooing of the flap, including the appearance of a beard....

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006739

    authors: Coessens B,Van Geertruyden J,De Mey A

    更新日期:1993-09-01 00:00:00

  • Blood flow and microcirculatory changes in an ischemia-reperfusion injury model: experimental study in the rabbit.

    abstract::This is the first in a series of studies designed to investigate the simultaneous changes in blood flow and microcirculation in an island flap during ischemia, in an ischemia-reperfusion model in the rabbit. An island groin flap based on the inferior epigastric vessels was harvested in 17 rabbits. The flap was rendere...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006414

    authors: Gürlek A,Schusterman MA,Evans GR,Gherardini G

    更新日期:1997-07-01 00:00:00

  • Z-plasty and microvascular anastomosis.

    abstract::An experimental study in rats was designed to determine the effects of z-plasty on the patency of microvascular anastomosis. Eighty Sprague-Dawley rats of mixed sex were divided into two groups. In all animals, the left carotid arteries were used. In the first group (n = 40), a single z-plasty was done at the anterior...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000153

    authors: Yildirim AM,Güzel MZ,Yücel A,Aygit AC

    更新日期:1998-02-01 00:00:00

  • Nerve regeneration in rat composite-tissue allografts.

    abstract::Reinnervation of composite-tissue allografts was examined in a rat hind-limb transplant model under Cyclosporin A (CyA) immunosuppression. Two groups of animals were studied. Group 1 consisted of 10 composite-tissue allografts using inbred Fisher rats (F344) as recipients and inbred Lewis rats (LEW) as donors. Recipie...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006787

    authors: Maeda N,Ishiguro N,Inoue G,Miura T,Sugimura K

    更新日期:1991-10-01 00:00:00

  • Nerve repair by means of tubulization: past, present, future.

    abstract::Peripheral nerve injury may result in injury without gaps or injury with gaps between nerve stumps. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. The clinical employment of tubes as an alternative to autogenous nerve grafts is mainly j...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0032-1333316

    authors: Konofaos P,Ver Halen JP

    更新日期:2013-03-01 00:00:00

  • Diagnostic accuracy of three sensory tests for diagnosis of sensory disturbances.

    abstract:BACKGROUND:Clinical diagnosis of sensory disturbances is extremely challenging, partly because the utility of sensory tests is questionable. Transection of C7 nerve root provides an objective assessment model to determine the diagnostic accuracy of sensory tests. The purpose of this study was to investigate the diagnos...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0034-1384819

    authors: Li XM,Yang Y,Hou Y,Yang JT,Qin BG,Fu G,Gu LQ

    更新日期:2015-01-01 00:00:00

  • Reporting Practices on Immunosuppression and Rejection Management in Face Transplantation: A Systematic Review.

    abstract:BACKGROUND: Face transplantation is a demanding operation requiring complex planning and expert technical performance. While the documentation of successes of the first transplants is impressive, there are lacunae in reporting of institutional protocols for other critical operation components, namely, immunosuppression...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0039-1691787

    authors: Daneshgaran G,Stern CS,Garfein ES

    更新日期:2019-11-01 00:00:00

  • Extra and Intramuscular Distribution of the Thoracodorsal Nerve with Regard to Nerve Reconstruction Surgeries.

    abstract::Background The lateral branch of the thoracodorsal nerve (LBTN) is used for nerve transfer in facial, musculocutaneous, axillary nerve injuries and for irreparable C5, C6 spinal nerve lesions and accessory nerve defects. For a successful surgical outcome, the nerve to be used in nerve transfer should be of adequate le...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0036-1579541

    authors: Malalasekera A,Beneragama T,Kanesu S,Sahathevan V,Jayasekara R

    更新日期:2016-06-01 00:00:00

  • Pathology of the shoulder as it relates to the differential diagnosis of thoracic outlet compression.

    abstract::Shoulder pathology and its diagnosis must be considered in evaluation of the patient suspected of having thoracic outlet syndrome (TOS). Overlooking usually treatable conditions in the shoulder may lead to unfavorable results, if treatment is directed, instead, to neurolysis of the brachial plexus or first rib resecti...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006714

    authors: Levin LS,Dellon AL

    更新日期:1992-07-01 00:00:00

  • The arterialized antebrachial skin flap for hand reconstruction.

    abstract::The authors present 20 microvascular flaps based on arteriovenous perfusion, harvested from the distal anterior forearm, and configured in three different designs. Indications were small palmar, dorsal, and commissural defects, when other conventional procedures were not available; problematic cases of open reduction ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000235

    authors: Reynoso R,Espinosa A,Mendoza M,Clifton J

    更新日期:1997-05-01 00:00:00

  • The combined gracilis and semitendinosus free flap in the rat.

    abstract::A free-flap model in rats is presented, that consists of gracilis and semitendinosus muscles pedicled on the femoral vessels, in continuation with deep femoral and saphenous vessels. This flap was transferred to the contralateral side in 40 rats and yielded a 95 percent survival rate. The weight of the flaps averaged ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1000175

    authors: Ionac M,Geishauser M

    更新日期:1998-05-01 00:00:00

  • Cortical brain mapping of peripheral nerves using functional magnetic resonance imaging in a rodent model.

    abstract::The regions of the body have cortical and subcortical representation in proportion to their degree of innervation. The rat forepaw has been studied extensively in recent years using functional magnetic resonance imaging (fMRI), typically by stimulation using electrodes directly inserted into the skin of the forepaw. H...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0028-1088231

    authors: Cho YR,Jones SR,Pawela CP,Li R,Kao DS,Schulte ML,Runquist ML,Yan JG,Hudetz AG,Jaradeh SS,Hyde JS,Matloub HS

    更新日期:2008-11-01 00:00:00

  • Recurrent phyllodes tumor of the breast: defining the role for skin-sparing mastectomy and autologous reconstruction.

    abstract::Phyllodes tumors (PTs) are uncommon fibroepithelial tumors of the breast, noteworthy for their difficult excisions and high recurrence rates. In the setting of recurrence, there is no consensus in the literature as to the extent of excision or the impact on reconstructive options. Breast-conserving surgery and simple ...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章,评审

    doi:10.1055/s-0031-1275493

    authors: Atalla MA,Rozen WM,Grinsell D,Hyett A,Prakash S,Cham A

    更新日期:2011-05-01 00:00:00

  • Successful correction of severe contracture of the palm using arterialized venous flaps.

    abstract::Severe contracture of the palm causes great difficulty in the performance of the tasks required in daily life. Resurfacing with skin grafts may be sufficient for treating mild and small contractures; but severe and extensive contractures involving the joints, tendons, and neurovascular bundles should be covered with t...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2004-836124

    authors: Nakazawa H,Nozaki M,Kikuchi Y,Honda T,Isago T

    更新日期:2004-10-01 00:00:00

  • Rationale for reconstruction of large scalp defects using the anterolateral thigh flap: structural and aesthetic outcomes.

    abstract::The advent of free tissue transfer has provided multiple options that allow preservation and maintain both the structural and aesthetic status of the scalp. Since the first report of the anterolateral thigh flap in 1984, it has become one of the most commonly used flaps for the reconstruction of various soft-tissue de...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2005-922433

    authors: Ozkan O,Coskunfirat OK,Ozgentas HE,Derin A

    更新日期:2005-11-01 00:00:00

  • Rat ear transplantation: a feasibility study.

    abstract::The feasibility of rat ear replantation and its inherent advantages as an experimental model have previously been demonstrated. The purpose of this study was to validate the technical feasibility of rat ear transplantation. To eliminate immunologic rejection as a complicating factor, highly inbred Lewis rats (strain L...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2007-1006636

    authors: Chiu DT,Ascherman JA,Patsis MC

    更新日期:1993-01-01 00:00:00

  • Nerve repair at different angles of attachment: experiment in rats.

    abstract::Sixteen rats underwent two procedures to test the efficacy of oblique vs. transverse nerve repair. On the left, the peroneal nerve was transected at an oblique angle (30-degree) with subsequent oblique end-to-end repair performed. On the right, the peroneal nerve was transected at a transverse angle (90-degree) with s...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-2002-36503

    authors: Yan YH,Yan JG,Sanger JR,Zhang LL,Riley DA,Matloub HS

    更新日期:2002-11-01 00:00:00

  • Donor-site morbidity of the sensate extended lateral arm flap.

    abstract::The free extended lateral arm flap (ELAF) has gained increasing popularity thank to its slimness and versatility, longer neurovascular pedicle, and greater flap size when compared with the original flap design. The aim of this study was to assess the donor-site morbidity associated with this extended procedure. A retr...

    journal_title:Journal of reconstructive microsurgery

    pub_type: 杂志文章

    doi:10.1055/s-0031-1289165

    authors: Depner C,Erba P,Rieger UM,Iten F,Schaefer DJ,Haug M

    更新日期:2012-02-01 00:00:00