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OTA international : the open access journal of orthopaedic trauma最新文献

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Preventing biological waste: Effective use of viable tissue in traumatized lower extremities. 防止生物废物：有效利用下肢创伤的存活组织。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-11 eCollection Date: 2023-07-01 DOI: 10.1097/OI9.0000000000000242
Jefferson L Lansford, Conor F McCarthy, Jason M Souza, Ean R Saberski, Benjamin K Potter
{"title":"Preventing biological waste: Effective use of viable tissue in traumatized lower extremities.","authors":"Jefferson L Lansford, Conor F McCarthy, Jason M Souza, Ean R Saberski, Benjamin K Potter","doi":"10.1097/OI9.0000000000000242","DOIUrl":"10.1097/OI9.0000000000000242","url":null,"abstract":"<p><p>Severe open lower extremity trauma requires debridement to remove contamination and devitalized tissues. Aggressive debridement should be balanced with preservation of viable tissue. These often damaged but preserved viable tissues are \"spare parts\" that augment the options available for reconstruction. The long-term goal of reconstruction should be functional limb restoration and optimization. Injury patterns, levels, and patient factors will determine whether this endeavor is better accomplished with limb salvage or amputation. This article reviews the rationale and strategies for preserving spare parts throughout debridement and then incorporating them as opportunistic grafts in the ultimate reconstruction to facilitate healing and maximize extremity function.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e242"},"PeriodicalIF":0.0,"publicationDate":"2023-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10337847/pdf/oi9-6-e242.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9825839","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}
引用次数: 0
Soft tissue coverage: techniques for the orthopaedic trauma surgeon 软组织覆盖:骨科创伤外科医生的技术
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/oi9.0000000000000271
D. Stinner, J. Hsu, J. Blair
{"title":"Soft tissue coverage: techniques for the orthopaedic trauma surgeon","authors":"D. Stinner, J. Hsu, J. Blair","doi":"10.1097/oi9.0000000000000271","DOIUrl":"https://doi.org/10.1097/oi9.0000000000000271","url":null,"abstract":"","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47225961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Negative pressure wound therapy: Where are we in 2022? 负压伤口治疗:2022年我们在哪里?
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/OI9.0000000000000247
Michael A Quacinella, Taylor M Yong, William T Obremskey, Daniel J Stinner
{"title":"Negative pressure wound therapy: Where are we in 2022?","authors":"Michael A Quacinella,&nbsp;Taylor M Yong,&nbsp;William T Obremskey,&nbsp;Daniel J Stinner","doi":"10.1097/OI9.0000000000000247","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000247","url":null,"abstract":"<p><p>The use of negative pressure wound therapy (NPWT) continues to be an important tool for surgeons. As the use and general acceptance of NPWT have grown, so have the indications for its use. These indications have expanded to include soft tissue defects in trauma, infection, surgical wound management, and soft tissue grafting procedures. Many adjuvants have been engineered into newer generations of NPWT devices such as wound instillation of fluid or antibiotics allowing surgeons to further optimize the wound healing environment or aid in the eradication of infection. This review discusses the recent relevant literature on the proposed mechanisms of action, available adjuvants, and the required components needed to safely apply NPWT. The supporting evidence for the use of NPWT in traumatic extremity injuries, infection control, and wound care is also reviewed. Although NPWT has a low rate of complication, the surgeon should be aware of the potential risks associated with its use. Furthermore, the expanding indications for the use of NPWT are explored, and areas for future innovation and research are discussed.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e247"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/6e/oi9-6-e247.PMC10337842.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180908","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}
引用次数: 0
Simplified soft tissue coverage of the distal lower extremity: The reverse sural flap. 简化下肢远端软组织覆盖:腓肠逆行皮瓣。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/OI9.0000000000000235
George A Puneky, Kathryn A Batchler, Sai S Kollapaneni, James A Blair, Jana M Davis
{"title":"Simplified soft tissue coverage of the distal lower extremity: The reverse sural flap.","authors":"George A Puneky,&nbsp;Kathryn A Batchler,&nbsp;Sai S Kollapaneni,&nbsp;James A Blair,&nbsp;Jana M Davis","doi":"10.1097/OI9.0000000000000235","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000235","url":null,"abstract":"<p><p>Soft tissue defects involving the distal lower extremity present challenging problems for orthopaedic surgeons to manage. Historically, wounds not amenable to primary closure have necessitated assistance from multidisciplinary teams using plastic surgeons to obtain adequate soft tissue coverage through rotational flap or free tissue transfer procedures. Techniques related to soft tissue rearrangement and local rotational flap coverage have advanced over the years with a growing knowledge of local anatomy and vasculature. The reverse sural flap may be performed to cover soft tissue defects within 10 cm of the foot or ankle region, negating the need for microvascular intervention. The simplistic nature of the reverse sural flap is appealing to orthopaedic surgeons as a means to provide timely patient care without additional support because it does not require microvasculature work or the need for intraoperative microscopes and has been popularized among orthopaedic trauma surgeons as a necessary tool to possess. Here, we discuss the reverse sural flap to include history, relevant anatomy, clinical indications, and a description of the technique for application.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e235"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c0/46/oi9-6-e235.PMC10337849.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199015","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}
引用次数: 0
Acute shortening and angulation for complex open fractures: an updated perspective. 复杂开放性骨折的急性缩短和成角:一个更新的视角。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/OI9.0000000000000245
Sarah N Pierrie, Michael J Beltran
{"title":"Acute shortening and angulation for complex open fractures: an updated perspective.","authors":"Sarah N Pierrie,&nbsp;Michael J Beltran","doi":"10.1097/OI9.0000000000000245","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000245","url":null,"abstract":"<p><p>Reestablishing an intact, healthy soft tissue envelope is a critical step in managing lower extremity injuries, particularly high-grade open tibia fractures. Acute shortening and angulation can be used independently or together to address complex soft tissue injuries, particularly when bone loss is present. These techniques facilitate management of difficult wounds and can be combined with local soft tissue rearrangement or pedicled flaps as needed, avoiding the need for free tissue transfer. After angular deformity correction, adjacent bone loss can be addressed with bone grafting or distraction histogenesis. This article discusses the indications for, surgical technique for, and limitations of acute shortening and angulation for management of open lower extremity fractures.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e245"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e1/fc/oi9-6-e245.PMC10337845.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877688","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}
引用次数: 0
How to get the most out of your gastrocnemius and soleus flaps. 如何充分利用腓肠肌和比目鱼肌瓣。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/OI9.0000000000000255
Paul E Matuszewski, Gary L Ulrich
{"title":"How to get the most out of your gastrocnemius and soleus flaps.","authors":"Paul E Matuszewski,&nbsp;Gary L Ulrich","doi":"10.1097/OI9.0000000000000255","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000255","url":null,"abstract":"<p><p>Gastrocnemius and soleus flaps represent the workhorse local flaps to cover soft tissue defects of the proximal 1/3 and middle 1/3 of the leg, respectively. An important consideration before conducting a local flap is whether the flap can provide adequate coverage. The utility of the gastrocnemius flap can be increased using multiple techniques to increase the arc of rotation including the posterior midline approach, dissection at the pes anserinus and medial femoral condyle origin, scoring the fascia, and inclusion of a skin paddle. Concerning the soleus flap, the hemisoleus flap represents a technique to increase the arc of rotation. With a soleus flap, one must consider the soft tissue defect location, size, and perforator blood supply because these factors influence what soleus flap technique to use. This article discusses how to make the most out of gastrocnemius flaps and soleus flaps regarding maximizing coverage and ensuring successful flap outcome.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e255"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2e/dd/oi9-6-e255.PMC10337844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9877683","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}
引用次数: 0
The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider? 异种真皮基质在四肢开放性伤口中的应用:何时何地考虑?
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-07-01 DOI: 10.1097/OI9.0000000000000237
Nainisha Chintalapudi, Olivia M Rice, Joseph R Hsu
{"title":"The use of xenogenic dermal matrices in the context of open extremity wounds: where and when to consider?","authors":"Nainisha Chintalapudi,&nbsp;Olivia M Rice,&nbsp;Joseph R Hsu","doi":"10.1097/OI9.0000000000000237","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000237","url":null,"abstract":"<p><p>Optimal treatment of orthopaedic extremity trauma includes meticulous care of both bony and soft tissue injuries. Historically, clinical scenarios involving soft tissue defects necessitated the assistance of a plastic surgeon. While their expertise in coverage options and microvascular repair is invaluable, barriers preventing collaboration are common. Acellular dermal matrices represent a promising and versatile tool for orthopaedic trauma surgeons to keep in their toolbox. These biological scaffolds are each unique in how they are used and promote healing. This review explores some commercial products and offers guidance for selection in different clinical scenarios involving traumatic wounds.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 4 Suppl","pages":"e237"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/c9/oi9-6-e237.PMC10337846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9823251","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}
引用次数: 0
Duodenal injury: A challenging diagnostic enigma for clinicians 十二指肠损伤:一个具有挑战性的诊断谜的临床医生
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-06-23 DOI: 10.17352/ojt.000040
Ravindranath Thyyar M
{"title":"Duodenal injury: A challenging diagnostic enigma for clinicians","authors":"Ravindranath Thyyar M","doi":"10.17352/ojt.000040","DOIUrl":"https://doi.org/10.17352/ojt.000040","url":null,"abstract":"The objective of the article is to familiarize clinicians with duodenal injury and to recognize timely intervention to prevent morbidity and mortality associated with such injury. Although uncommon, duodenal injury challenges a clinician’s ability to diagnose and treat it in a timely fashion to prevent any associated mortality. The retroperitoneal anatomy makes duodenal injury difficult to diagnose. However, a high degree of suspicion based on the mechanism of injury and appropriate, timely diagnostic study leads to the correct identification of injury to the duodenum. The specific treatment depends on the type of injury that is detected. In conclusion, early recognition, and timely intervention of duodenal injury leads to a successful outcome.","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89786030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pilon fractures: Consensus and controversy. 椎弓根骨折：共识与争议。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-06-16 eCollection Date: 2023-06-01 DOI: 10.1097/OI9.0000000000000236
Michael Flores, Matthew Ciminero, Stephen A Kottmeier, Daniel Botros, Boris A Zelle, David W Shearer
{"title":"Pilon fractures: Consensus and controversy.","authors":"Michael Flores, Matthew Ciminero, Stephen A Kottmeier, Daniel Botros, Boris A Zelle, David W Shearer","doi":"10.1097/OI9.0000000000000236","DOIUrl":"10.1097/OI9.0000000000000236","url":null,"abstract":"<p><p>Pilon fractures are complex injuries that require an individualized approach to treatment to avoid complications and achieve good outcomes. Staged open reduction internal fixation remains the gold standard for most cases to achieve anatomic articular reduction while minimizing soft tissue complications and infection. Careful preoperative planning based on computed tomography dictates the surgical approach for reduction. A subset of cases may be amenable to early definitive or provisional open reduction and internal fixation based on fracture pattern. In some cases of severe articular comminution where reconstruction is not possible, primary ankle arthrodesis may be a good alternative.</p>","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 3 Suppl","pages":"e236"},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/da/oi9-6-e236.PMC10392439.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10289975","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}
引用次数: 0
Adjunct neutralization plating in patella fracture fixation: a technical trick-Erratum. 髌骨骨折内固定辅助中和镀:一个技术技巧。
OTA international : the open access journal of orthopaedic trauma Pub Date : 2023-06-01 DOI: 10.1097/OI9.0000000000000265
{"title":"Adjunct neutralization plating in patella fracture fixation: a technical trick-Erratum.","authors":"","doi":"10.1097/OI9.0000000000000265","DOIUrl":"https://doi.org/10.1097/OI9.0000000000000265","url":null,"abstract":"","PeriodicalId":74381,"journal":{"name":"OTA international : the open access journal of orthopaedic trauma","volume":"6 2","pages":"e265"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/4f/otai-6-e265.PMC10005821.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9538085","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}
引用次数: 0
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