Periodicidad semestral: flujo continuo.
ISSN - Electrónico: 2661-6947 / DOI: 10.36015 • LILACS BIREME (19784); LATINDEX (20666)
Introduction: Due to intrinsic and extrinsic factors to the patient, exposed leg fractures are common, and they are often accompanied by complex soft tissue injuries. Case report: We present seven cases of male patients, six injured in road traffic accidents and one with a gun shot trauma sequel. One had a fracture in the proximal third and coverage was made with medial gastrocnemius muscle flap; four had lesions in the middle third, three were treated with hemisoleus muscle flap and one with a reverse sural fasciocutaneous flap. The last two patients had compromised the distal third of their legs, both were covered with sural flap. Discusion: Two cases had partial flap necrosis but they did not require another surgery. Regarding fractures consolidation, outcome depended on exposure time, having better outcomes those with shorter times. Those with longer times required more often internal bone fixation procedures. Conclusions: In case of leg fractures with internal fixation material, exposed time should be taken into account. Patients with lap times shorter than 15 days could keep the material, as long as, an antibiotic prophylaxis scheme is followed. Otherwise, fixation material replacement is warranted.
Saleh Y, Waheeb B, Abd-Elaziz M, El-Oteify M. A suggested algorithm for post-traumatic lower limb soft tissue reconstruction. Egypt J Plast Reconstr Surg. 2007; 31(1): 87-96
Vaienti L, Di Matteo A, Gazzola R, Pierannunzii L, Palitta G and Marchesi A. First results with the immediate reconstructive strategy for internal hardware exposure in non-united fractures of the distal third of the leg: case series and literature review. Journal of Orthopaedic Surgery and Research [Internet]. 2012[citado 6 Oct 2014]; 7(30): 1-7. Disponible en: http://www.josr-online.com/content/7/1/30
Park J, Campbell K et al. Updates in the management of orthopedic soft-tissue injuries associated with lower extremity trauma Am J Orthop[Internet]. 2012[citado 5 Ago 2014];41(2): E27-E35. Disponible en: http://www.ecardiologynews.com/fileadmin/qhi_archive/ArticlePDF/AJO/041020027.pdf
Tan K-J, Lim C-T, Lim A-Y. The use of muscle flaps in the salvage of infected wxposed implants for internal fixation. J Bone Joint Surg [Br]. 2010;92-B(3):401-5.
Vaienti L, Di Matteo A, Gazzola R, Randelli P, Lonigro J. Distally based sural fasciomusculocutaneous flap for treatment of wounds of the distal third of the leg and ankle with exposed internal hardware. J Orthopaed Traumatol [Internet]. 2012; 13(1):35–39. Disponible en: http://link.springer.com/article/10.1007/s10195-011-0175-6/fulltext.html
Viol A, Pradka S, Baumeister S, Wang D, et al. Soft-tissue defects and exposed hardware: A review of indications for soft-tissue reconstruction and hardware preservation. Plast Reconstr Surg. 2009; 123: 1256-1263
Klebuc M, Menn Z Muscle flaps and their role in limb salvage. Methodist DeBakey Cardiovascular Journal [Internet]. 2013; 9 (2): 95-98. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3693523/
Pollak A, McCarthy M et al. Short-term wound complications after application of flaps for coverage of traumatic soft-tissue defects about the tibia. J Bone Joint Surg (American Volume). 2000; 82(12): 1681-1691
Kadam D. Limb salvage surgery. Indian J Plast Surg[Internet]. 2013 May-Aug [citado 30 Jun 2014] ; 46(2): 265–274. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901908/?report=reader#!po=4.54545
Chung K, Saddawi-Konefka D, Haase S, Kaul G. A cost-utiliy analysis of amputation versus salvage for Gustilo type IIIB and IIIC open tibial fractures. Plast Reconstr Surg. 2009; 124(6): 1965-1973.
Fodor L, Horesh Z, Lerner A, Ramon Y, Peled I, Ullman Y. The distally based sural musculoneurocutaneous flap for treatment of distal tibial osteomyelitis. Plast Reconstr Surg. 2007; 119(7): 2127-2136
Pu LL. Soft-tissue coverage of an extensie mid-tibial wound with the combined medial gastrocnemius and medial hemisoleus muscle flaps: Ther role of local muscle flaps revisited. J Plast Reconstr Aesthet Surg. 2010; 63(8): 605-610.
Pu LL. Soft-tissue reconstruction of an open tibial woind in the distal third of the leg: a new treatment algorithm. Ann Plast Surg. 2007; 58(1): 78-83
Pu LL. Medial hemisoleus muscle flap: a reliable flap for soft tissue reconstrucción of the middlethird tibial wound.Int Surg. 2006;91(4):194-200.
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