Complex foot and ankle wounds present multiple challenges for the reconstructive surgeon. Soft tissue deficits must be closed to protect underlying structures from infection and to provide a stable environment for healing. Surgical options commonly used include healing by secondary intention, local flap closure, skin grafts, pedicled flaps, and free tissue transfer. Despite a surgeon's best operative efforts, these strategies may fail because of postoperative shear forces created by premature joint motion or pressure (either weight bearing or decubitus). In the properly selected patient population, external fixators serve as an indispensable adjunct to wound healing by providing temporary offloading or immobilization of joints.
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http://dx.doi.org/10.1016/j.fcl.2007.12.001 | DOI Listing |
Int J Surg Case Rep
January 2025
Department of Plastic Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
Introduction: Soft tissue defect in the lower limb presents as a difficult reconstructive challenge. Cross-leg flap was routinely used in the past for the salvage of the lower limb but is seldom used nowadays due to advances in microsurgical procedures.
Case Presentation: We present a case of an 18-year-old male who presented with a complex soft tissue defect of 25 × 10 cm on the anterolateral aspect of the right leg following a motor vehicle accident.
JBJS Case Connect
January 2025
Department of Surgery, Plastic and Reconstructive Surgical Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Case: Wide resection of a synovial sarcoma of the anteromedial distal leg involving the dimetaphyseal tibia and posterior tibial tendon produced an 8.5-cm osseous defect. To keep the free flap from invaginating into the defect and prevent kinking of the anastomosis, six 1.
View Article and Find Full Text PDFIowa Orthop J
January 2025
Department of Orthopaedic Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas, USA.
Background: This study aims to determine the rate of surgical intervention in children with type IIA supracondylar humerus fractures (SCHF) following routine post-casting radiographic assessment. We hypothesized that no cases would convert to operative management following one-week post-casting alignment assessments.
Methods: This single-center retrospective study focused on pediatric patients diagnosed with type IIA SCHF from 2019 to 2022.
Cureus
December 2024
Department of Orthopedics, Jordanain Royal Medical Services, Amman, JOR.
Orthopedic injuries in Gaza, many of which would be straightforward to manage under normal circumstances, have become increasingly complex and challenging due to ongoing conflict, severe healthcare limitations, and delayed treatment. This review highlights cases of injuries that, if treated promptly, could have been managed with standard protocols but have evolved into complicated and difficult-to-treat conditions. Delayed care, lack of resources, and restricted rehabilitation significantly increase the complexity of treatment and lead to higher rates of complications, and impaired outcomes.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients.
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