Management of complex forearm defects: A multidisciplinary approach

Hu, Weiguo; Nen, D. Le; Kerfant, N.; Henry, Anne Claire; Trimaille, A.; Rouanet, M.; Letissier, Hoël; Perruisseau-Carrier, Anne; Ta, Pierre

doi:10.1016/j.anplas.2020.06.011

Cited by 3 publications

(5 citation statements)

References 56 publications

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“…9 However, radical debridement in the primary setting should be preferred over serial debridement. 10 Forearm complex injuries, especially associated with limb ischemia, often lead to compartment syndrome. In these cases, fasciotomies should be considered as early as possible, at the time of the initial debridement.…”

Section: Debridementmentioning

confidence: 99%

“…Free-functioning muscle transfer provides a functional motor unit along with a soft tissue coverage, increasing perfusion and resistance to infection. 28 The free-functioning muscle transfers we most often use are the latissimus dorsi, gracilis, and soleus (Fig. 4).…”

Section: Reconstructionmentioning

confidence: 99%

“…In these cases, negative pressure wound therapy presents a valuable alternative until the wound is ready for final soft tissue coverage, allowing for reduction of swelling, and infection control 9 . However, radical debridement in the primary setting should be preferred over serial debridement 10 …”

Section: Multidisciplinary Approachmentioning

confidence: 99%

“…Free-functioning muscle transfers are indicated in patients presenting with severe musculocutaneous defects without any local options available for reconstruction. Free-functioning muscle transfer provides a functional motor unit along with a soft tissue coverage, increasing perfusion and resistance to infection 28 . The free-functioning muscle transfers we most often use are the latissimus dorsi, gracilis, and soleus (Fig.…”

Section: Multidisciplinary Approachmentioning

confidence: 99%

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Management of Complex Forearm Injuries

et al. 2023

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The management of complex forearm injuries is challenging, not only because of the anatomical complexity of the region but also because of the dramatic functional consequences of these injuries. Preservation of the upper limb and restoration of hand function are the focus of the surgical management of these injuries. Decision making will consider several parameters such as the type of injury, the patient, the moment of reconstruction, the debridement, and the options available for reconstruction.A multidisciplinary approach joining plastic surgeons and orthopedic surgeons in a team effort is essential to achieve the best outcomes. On the basis of their experience, the authors conclude that the keystone in complex forearm injuries management is represented by a careful assessment of the lesions, an aggressive and early debridement, the prevention of complications such as infection and compartment syndrome, and an "as early as possible" reconstruction.

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Section: Debridementmentioning

confidence: 99%

Section: Reconstructionmentioning

confidence: 99%

Section: Multidisciplinary Approachmentioning

confidence: 99%

Section: Multidisciplinary Approachmentioning

confidence: 99%

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Management of Complex Forearm Injuries

et al. 2023

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“…Although less frequent than lower extremity bone defects, upper limb defects can be demanding to manage, as reconstruction must be attained while maintaining adjacent joint motion and hand dexterity to preserve function [2]. There is no single solution to all upper limb bone defects and one needs to individualise treatment from a variety of reconstructive options.…”

Section: Introductionmentioning

confidence: 99%

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Ferreira

Saini

Birkholtz

et al. 2021

Eur J Orthop Surg Traumatol

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Injuries to the long bones of the upper limb resulting in bone defects are rare but potentially devastating. Literature on the management of these injuries is limited to case reports and small case series. The aim of this study was to collate the most recent published work on the management of upper limb bone defects to assist with evidence based management when confronted with these cases.Methods: Following a preliminary search that confirmed the paucity of literature and lack of comparative trials, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was conducted. A literature search of major electronic databases was conducted to identify journal articles relating to the management of upper limb long bone defects published between 2010 and 2020.Results: A total of 46 publications reporting on the management of 341 patients were reviewed. Structural autograft, bone transport, one-bone forearm and the induced membrane technique were employed in an almost equal number of cases. The implemented strategies showed similar outcomes but different indications and complication profiles were observed. Conclusion:Contemporary techniques for the management of post-traumatic upper limb bone defects all produce good results. Specific advantages, disadvantages and complications for each modality should be considered when deciding on which management strategy to employ for each specific patient, anatomical location, and defect size.

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Complex Fractures of the Radial and Ulnar Shaft

Lynch,

Sabbag,

Wilson

et al. 2024

Journal of Orthopaedic Trauma

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Summary: Successful management of radial and ulnar shaft fractures is an essential skill for all orthopaedic surgeons. The frequent presentation of these injuries coupled with the nuanced anatomic considerations that must be observed for successful outcomes dictate that these injuries require a thorough understanding by the treating surgeon. Intraoperative care to restore the anatomic radial bow and rotation is essential for the resumption of functional forearm rotation postinjury. Often, problems arising during the operative treatment of radial and ulnar shaft fractures come in predictable patterns that can be mitigated with preoperative planning and sound technique. Cases of increased complexity with segmental bone defects and soft tissue defects require a variety of advanced reconstructive techniques.

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Management of complex forearm defects: A multidisciplinary approach

Cited by 3 publications

References 56 publications

Management of Complex Forearm Injuries

Management of Complex Forearm Injuries

Management of segmental bone defects of the upper limb: a scoping review with data synthesis to inform decision making

Complex Fractures of the Radial and Ulnar Shaft

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