Orthoplastic Surgery最新文献

{"title":"Erratum regarding previously published articles","authors":"","doi":"10.1016/j.orthop.2024.08.001","DOIUrl":"10.1016/j.orthop.2024.08.001","url":null,"abstract":"","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"18 ","pages":"Page 1"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000149/pdfft?md5=d1cef1764a60a8bda30caa2fef3f78bc&pid=1-s2.0-S2666769X24000149-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spino-plastic surgery","authors":"Casey Martinez , Isra Abdulwadood , Diego A. Gomez , Jonathan Jeger , Karim Bakri , Michael Bohl , Alexander E. Ropper , Sebastian Winocour , Edward M. Reece","doi":"10.1016/j.orthop.2024.09.001","DOIUrl":"10.1016/j.orthop.2024.09.001","url":null,"abstract":"","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"18 ","pages":"Pages 2-7"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142530882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand surgery as a paradigm for orthoplastic surgery","authors":"William C. Pederson","doi":"10.1016/j.orthop.2024.11.001","DOIUrl":"10.1016/j.orthop.2024.11.001","url":null,"abstract":"<div><div>The concepts of “Orthoplastic Surgery” had their beginnings between the World Wars in the early 20th century. The approach to traumatic injuries of the hand changed with the appreciation of the need to manage the hard and soft tissues, as well as nerves simultaneously. This led to the development of Hand Surgery as a speciality which emphasized knowledge of fractures, soft tissue injuries, vascular, and nerve injuries. Specialized training in Hand Surgery gave a single surgeon the ability to manage all of the tissues involved in injury to the upper extremity. This has translated into management of injuries of all the extremities and leading to the development of the concept of “Orthoplastic” surgery.</div></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"18 ","pages":"Pages 8-9"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why the orthoplastic approach","authors":"","doi":"10.1016/j.orthop.2024.08.002","DOIUrl":"10.1016/j.orthop.2024.08.002","url":null,"abstract":"","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"17 ","pages":"Page 30"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000150/pdfft?md5=7dd56d4d4c37aec1a2698969cf01d7aa&pid=1-s2.0-S2666769X24000150-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142151458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascularized bone grafts in spinal reconstruction: An updated comprehensive review","authors":"Isra Abdulwadood ,&nbsp;Diego A. Gomez ,&nbsp;Casey Martinez ,&nbsp;Michael Bohl ,&nbsp;Alexander E. Ropper ,&nbsp;Sebastian Winocour ,&nbsp;Edward M. Reece","doi":"10.1016/j.orthop.2024.08.003","DOIUrl":"10.1016/j.orthop.2024.08.003","url":null,"abstract":"<div><p>In the past two decades, plastic surgeons have advanced to the forefront of spinal surgery, joining orthopedic and neurosurgeons in the multidisciplinary field of spino-plastics. As the global disease burden grows with an increased incidence of spinal pathologies, vascularized bone grafts (VBGs) define the current frontier of spino-plastic surgery. Vascularized bone grafting involves lifting segments of bone with the muscular attachments but without the inclusion of a named vessel. When compared to traditional nonvascular bone grafts and allografts, VBGs have come forward as a favored technique for complex spinal reconstruction due to the unique opportunity to capitalize on the relationship between the tendons and Sharpey's fibers which maintain blood flow to both the bone and muscular segments. This technique ensures robust autologous tissue rearrangement and also takes advantage of the osteoinductive properties of the bone segments, promoting adequate structural support and the perfusion necessary for efficient direct healing and fusion in intricate spine reconstructions. Another one of the many favorable qualities of VBGs is the diversity of sources available to surgeons. The review explores the role of VBGs in enhancing spinal fusion rates and minimizing morbidity compared to traditional approaches. Additionally, a detailed examination of six common VBG sources-the iliac crest, ribs, medial scapula, occiput, spinous processes, and clavicle is included, highlighting each graft's specific techniques and emphasizing the range of options available to spino-plastic surgeons.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"17 ","pages":"Pages 7-14"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000162/pdfft?md5=2bfba19dd3c612b38f2ad1793cc918cc&pid=1-s2.0-S2666769X24000162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Composite osteo-tendino-cutaneous reverse radial forearm flap for complex thumb reconstruction: A case report","authors":"Alexander J. Kammien,&nbsp;David L. Colen","doi":"10.1016/j.orthop.2023.11.002","DOIUrl":"10.1016/j.orthop.2023.11.002","url":null,"abstract":"<div><p>The reverse radial forearm flap is a powerful tool in the reconstruction of dorsal hand defects. Traditionally, only fasciocutaneous tissues perfused by retrograde flow through the radial artery are harvested to resurface the dorsal hand. Including vascularized tendon and bone within the flap, however, makes reconstruction of complex composite defects in a single stage possible, thereby decreasing morbidity and improving functional outcomes. The current case describes a single-stage reconstruction of a composite amputation defect of the dorsal hand and thumb with loss of dorsal and first webspace soft tissue, the metacarpophalangeal joint, and a segment of the extensor pollicis longus tendon. Reconstruction was performed using a chimeric osteo-tendino-cutaneous reverse radial forearm flap with vascularized intrasynovial flexor carpi radialis tendon. The flap healed with no complications, and the patient returned to work two months postoperatively. At five months follow-up, the patient was still working and could abduct his thumb to the proximal interphalangeal flexural crease of his small finger. Seven months postoperatively, he underwent scar revision for hypertrophic scarring and z-plasty of the first web space to further improve thumb abduction.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"17 ","pages":"Pages 15-22"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000246/pdfft?md5=f5847002206958bad2690f195b00cbcb&pid=1-s2.0-S2666769X23000246-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower extremity degloving soft tissue injuries: Patterns, treatment, and short-term Outcome in Sudan: A Sub-Saharan African setting","authors":"Ammar Ahmed Hassan ,&nbsp;Osama Murtada Ahmed ,&nbsp;Talal Mohammed Geregandi ,&nbsp;Mohammed Yousof Bakhiet","doi":"10.1016/j.orthop.2024.07.001","DOIUrl":"10.1016/j.orthop.2024.07.001","url":null,"abstract":"<div><h3>Background</h3><p>Degloving soft tissue injury is among the most devastating trauma types, especially when involving the lower extremities. This study aims to identify degloving soft tissue injury (DSTI) Patterns, Treatment, and Short-term Outcomes.</p></div><div><h3>Methods</h3><p>This is a prospective, cross-sectional, hospital-based study of patients with DSTIs over six months.</p></div><div><h3>Results</h3><p>Fifty-six patients with lower extremity DSTIs were included. The mean age of the patients was. 29.2 years.</p><p>Males were predominant (71.4 %). The common site for DSTIs is the dorsum of the foot. Fourteen patients with degloving injury to the foot dorsum had open fractures with type 3 A Gustilo classification. Participants with MESS 1 did not have underlying fractures. Patients with higher MESS scores experienced a more severe form of injury. Most of the patients presented late to plastic surgery services. Definitive management offered to the patients includes secondary intention, direct closure, SSG, and loco-regional flap. The loco-regional flaps used were random fascia-cutaneous, sural, saphenous, Lateral gastrocnemius, and medial gastrocnemius. Thirty-nine of the participants had no complications following management. The complications encountered include Surgical site infection, wound dehiscence, and partial graft or flap loss. These complications were managed by local wound care and a local flap. More extended hospital stay was observed in patients with low revised trauma scores.</p></div><div><h3>Conclusion</h3><p>Lower extremity DSTIs are common injuries in Sudan, and it is management is challenging. DSTIs with underlying fractures are the most common pattern of injury, with the dorsum of the foot being the most commonly affected part. A multidisciplinary approach is essential for management.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"17 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000125/pdfft?md5=fcf3904f60dc041a37249b29091e97a2&pid=1-s2.0-S2666769X24000125-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The keystone island perforator flap: An “ideal” local soft tissue flap for the lower extremity","authors":"Geoffrey G. Hallock","doi":"10.1016/j.orthop.2023.10.001","DOIUrl":"10.1016/j.orthop.2023.10.001","url":null,"abstract":"<div><h3>Background</h3><p>Lower extremity reconstruction best requires co-operation between orthopedic and plastic surgeons to preserve the musculoskeletal integrity while establishing essential skin coverage. Traditional dogma suggests microvascular tissue transfers alone would be preferable, but today inherent risks can be avoided by instead using mainly local perforator flaps.</p></div><div><h3>Methods</h3><p>Over a 5 year timeframe, 68 local flaps were used in 66 patients for non-specific lower extremity problems in all regions of the lower extremity in lieu of a free flap. These included both muscle and perforator flaps, the latter including peninsular, propeller, “true” island, and advancement variations. Particular emphasis on the choice of the keystone advancement flap alternative was here undertaken.</p></div><div><h3>Results</h3><p>All chosen lower extremity local flaps were successful without resorting to a second flap or skin graft to treat complications. Muscle flaps were used only on 4 occasions, whereas the remaining flaps were perforator flaps. Of these, the keystone island perforator flap was by far the most common choice, [27 (42.2 %)], even exceeding the combined use of propeller and peninsular flaps [26 (40.6 %)]. Keystone flap complications were virtually nil. Keystone flaps were most often used within the flexible tissues of the thigh, but could be used throughout the lower extremity.</p></div><div><h3>Conclusion</h3><p>Perforator flaps may be the optimal local flap choice for the lower extremity. Since no discrete perforator need be dissected, the simplest variation is the keystone flap. Harvest and insetting is facile, reliable, aesthetically acceptable, and often sensate. The keystone island perforator flap indeed is an “ideal” lower extremity local soft tissue flap.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"17 ","pages":"Pages 23-29"},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000222/pdfft?md5=2ff44b7967ca2e3a5a92db37b2578145&pid=1-s2.0-S2666769X23000222-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142129363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- medullary nail fixation as a treatment method for impending fracture non-union of a near-total trans-metacarpal amputation initially treated with K-wire fixation – A case report","authors":"Brendan Podszus BS ,&nbsp;Jessica Bigner MD ,&nbsp;Manas Nigam MD ,&nbsp;Ramon DeJesus MD","doi":"10.1016/j.orthop.2024.01.003","DOIUrl":"10.1016/j.orthop.2024.01.003","url":null,"abstract":"<div><p>In hand and digital replantation, Kirschner wires (K-wires) osteosynthesis is regularly used for bone fixation. Percutaneous K-wire fixation (PKWF) has several disadvantages, such as restriction of range of motion (ROM)—as it often crosses the soft tissues of the joints—, need for early extraction before bone-union prolonging immobilization, potentially increasing pin tract infection, and the fact that it does not offer the strongest type of fixation construct compared to other methods.</p><p>All these factors limit early ROM rehabilitation protocols, therefore impacting functional outcomes. We present a case report of a near-total trans metacarpal (MCP) hand crush amputation by a hydraulic press injury that initially underwent PKWF. The K- wires were extracted at seven weeks post-operatively. The concern of impending non-union and the need for prolonged immobilization after K-wire extraction was addressed by intra-medullary nail fixation (IMNF).</p><p>In this case, we decided to utilize a less conventional method of osteo-synthesis IMNF to address the concern of impending non-union after initial fixation with K-wires in TMCHR. It provided a stronger fixation construct, no splint immobilization time, and early ROM rehabilitation protocol. All these factors facilitate bone union and improve functional outcomes.</p><p>This should stimulate further research for this type of situation between IMNF and other types of osteosynthesis by studying the incidence of non-union, infection rates, functional results, and other outcomes. This could also stimulate fabrication, in the laboratory, of intra-medullary nails for metacarpals with antibiotic impregnated hydroxyapatite/poly-L-lactide (HPLLA)—which are not only bioabsorbable, but also osteoconductive—for osteosynthesis in crushed amputations or comminuted fractures. There are several reports in the literature for digital replantation, but none found for amputations at the MCP level.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"16 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000034/pdfft?md5=098444445d9e5543eae16efa7dadf689&pid=1-s2.0-S2666769X24000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the cutaneous blood supply and vascular territories of the wrist","authors":"Kareme D. Alder ,&nbsp;Joshua J. Meaike ,&nbsp;Punnose K. Kattil . ,&nbsp;Nirusha Lachman ,&nbsp;Alexander Y. Shin ,&nbsp;Nicholas Pulos","doi":"10.1016/j.orthop.2024.05.002","DOIUrl":"https://doi.org/10.1016/j.orthop.2024.05.002","url":null,"abstract":"<div><h3>Purpose</h3><p>To determine and evaluate the distal forearm and wrist's cutaneous blood supply and vascular territories.</p></div><div><h3>Methods</h3><p>Four cadaveric upper extremities were injected with a radiopaque, lead-based contrast agent through the brachial artery. After the lead-based contrast agent set, the cadaveric limbs underwent computed tomographic (CT) scanning to assess the perforators to the cutaneous skin of the distal forearm and wrist. High-resolution axial CT and three-dimensional reconstructions were generated to highlight perforating vessels stemming from their parent arteries. Subsequently, anatomic <strong>micro</strong>dissections were performed to identify and trace the perforating vessels identified on CT.</p></div><div><h3>Results</h3><p>CT analysis and anatomic <strong>micro</strong>dissection demonstrated that the dorsal surface of the distal forearm and wrist are supplied by numerous perforators stemming predominantly from the anterior interosseous artery with some anastomotic contribution from the posterior interosseous, radial, and ulnar arteries. Perforators from the radial and ulnar arteries supply the volar surface. There are large anastomotic networks formed between the perforating vessels.</p></div><div><h3>Conclusions</h3><p>The distal forearm and wrist have a robust anastomotic blood supply that has contributions from the anterior interosseous, posterior interosseous, radial, and ulnar arteries.</p></div><div><h3>Clinical relevance</h3><p>The extensive perforator-derived blood supply to the skin likely accounts for the excellent soft tissue healing potential of the wrist following surgery utilizing multiple incisions.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"16 ","pages":"Pages 20-30"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000101/pdfft?md5=5a604ee892aaf669adb86294e36a9789&pid=1-s2.0-S2666769X24000101-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}