Background: In patients with total elbow arthroplasty (TEA), the soft-tissue around the elbow can be vulnerable to soft-tissue complications. This study aims to assess the outcomes after soft-tissue reconstruction following TEA.
Methods: We retrospectively included nine adult patients who underwent soft-tissue reconstruction following TEA. Demographic data and disease characteristics were collected through medical chart reviews. Additionally, we contacted all four patients that were alive at the time of the study by phone to assess any current elbow complications. Local tissue rearrangement was used for soft-tissue reconstruction in six patients, and a pedicle flap was used in three patients. The median follow-up period was 1.3 years (range, 6 months-14.7 years).
Results: Seven patients (78%) underwent reoperation. Four patients (44%) had a reoperation for soft-tissue complications, including dehiscence or nonhealing of infected wounds. Five patients (56%) had a reoperation for implant-related complications, including three infections and two peri-prosthetic fractures. At the final follow-ups, six patients (67%) achieved successful wound healing and two patients had continued wound healing issues, while two patients had an antibiotic spacer in situ and one patient underwent an above-the-elbow amputation.
Conclusions: This study reports a complication rate of 78% for soft-tissue reconstructions after TEA. Successful soft-tissue healing was achieved in 67% of patients, but at the cost of multiple surgeries. Early definitive soft-tissue reconstruction could prove to be preferable to minor interventions such as irrigation, debridement, and local tissue advancement, or smaller soft-tissue reconstructions using local tissue rearrangement or a pedicled flap at a later stage.
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http://dx.doi.org/10.5397/cise.2021.00409 | DOI Listing |
Case Rep Dent
January 2025
Department of Cranio-Maxillofacial Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India.
For managing peri-implantitis, a variety of treatment modalities involving both surgical and nonsurgical methods including implantoplasty have been proposed. Implants that are placed in a free fibula flap are more prone to peri-implantitis due to the absence of firm, keratinized mucosa. Prosthetic design that offers adequate hygiene access should be designed whenever possible; otherwise, it may lead to the accumulation of plaque or biofilm that may lead to peri-implant diseases.
View Article and Find Full Text PDFPlast Reconstr Surg Glob Open
January 2025
From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
Background: Soft tissue defects on the palm side of the thumb can be effectively covered by using the radial midpalmar (RMP) flap, which is usually harvested as a pedicled flap. However, previous anatomical studies on this flap are limited. We analyzed multidetector-row computed tomography angiograms of the radial midpalm of hands to more precisely characterize the 3-dimensional anatomical structure of the perforators in living patients.
View Article and Find Full Text PDFDermatofibrosarcoma protuberans (DFSP) is a rare, low to intermediate-grade soft tissue sarcoma that presents significant diagnostic and therapeutic challenges. We report the case of a 40-year-old male patient who presented with a slow-growing, asymptomatic lesion on his forehead that had developed over two years. Clinical examination revealed a firm, non-tender multinodular mass measuring 5 x 3 cm in the supraorbital region.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
January 2025
Shonan Kamakura General Hospital, Kamakura, Japan.
Introduction: Blunt brachial artery injuries (BAI) require reconstruction with an extensive vein graft due to the wide area of arterial damage. In the upper arm, safe options for pedicle flaps are limited, and selecting recipient vessels for free-flap surgery is challenging, complicating the treatment of soft tissue injuries associated with blunt BAI. This study aimed to analyze the characteristics and soft tissue reconstruction of blunt BAI and propose treatment strategies for treating associated soft tissue injuries.
View Article and Find Full Text PDFZhonghua Kou Qiang Yi Xue Za Zhi
January 2025
Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology, Beijing 100034, China.
The anatomical structure of the gingival papilla around the implant is special, and it is difficult to recover after injury. The reduction of its height will have a negative impact on function and esthetics, and it is one of the many problems in implant treatment at present. This paper analyzes the influencing factors of implant gingival papilla height from three aspects: anatomical factors, implant surgical design and implant restorative design, including the classical influencing factors such as the shape of natural teeth, interproximal distance between the implant and the adjacent tooth, soft tissue grafting, and contour of implant restorations, as well as the hot and controversial influencing factors in recent years such as the thickness of soft tissues around the implant, the implant surgical timing, the flap design, and the surgical incision, in order to provide reference for clinicians in the process of implant treatment for gingival papilla preservation and reconstruction.
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