Lower limb reconstruction involving osteosynthesis material: A retrospective study on propeller flaps outcomes
| Autor: | Gianluca Sapino, Olivier Borens, Eric Thein, Russell J. Bramhall, P.G. di Summa, David Guillier, Clara Schaffer |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Soft Tissue Injuries medicine.medical_treatment Lower limb 03 medical and health sciences 0302 clinical medicine medicine Internal fixation Humans General Environmental Science Fixation (histology) Retrospective Studies 030222 orthopedics Osteosynthesis business.industry Propeller Soft tissue 030208 emergency & critical care medicine Retrospective cohort study Bone fracture Plastic Surgery Procedures medicine.disease Surgery Treatment Outcome Lower Extremity General Earth and Planetary Sciences business Perforator Flap |
| Zdroj: | Injury. 52(10) |
| ISSN: | 1879-0267 |
| Popis: | Reconstruction of soft tissue defects in lower limb fractures requiring internal fixation remains a challenging scenario with the optimal surgical treatment still debated. This study aims to recommend, and eventually redefine, surgical indications for propeller flaps reconstruction in the distal lower limb, with a particular focus on the presence or not of metalwork.A retrospective study of lower limb soft tissue reconstructions performed between January 2015 and July 2018 was carried out including all patients treated with a propeller perforator flap (PPF) with at least 6-month follow-up. Patients were further divided in 2 groups depending on the presence of metalwork fixation beneath the flap (F group, propeller on Framework; NF group, propeller with No-Framework).21 patients were retained (F group, 11 patients; NF group, 10 patients). There were no significant differences between the two groups in age, BMI, ASA scores, comorbidities or defect size. There was a statistically significant difference between the groups (p0.05) in the cumulative hospital stay with a mean cumulative hospital stay of 22 ± 9 days in the F group and 12 ± 8 days in NF group. Failures were higher where PPF were used to cover hardware material, with 3 patients requiring a major secondary procedure in F group versus 1 patient in NF group.The presence of underlying metalwork significantly reduced the margin for small, day-case revision procedures such as flap readvancement or STSG. This study emphasizes clinical intuition that whilst PPF are a useful and elegant tool in lower limb reconstruction, their use should be limited when underlying metalwork is present. |
| Databáze: | OpenAIRE |
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