The interest of “ortho-plastic” collaboration in management of complex limb injury

Pasquesoone, L.; Barry, Louncény Fatoumata; Sturbois-Nachef, Nadine; Duquennoy-Martinot, V.; Chantelot, Christophe; Guerre, Elvire

doi:10.1016/j.anplas.2020.05.011

Cited by 10 publications

(4 citation statements)

References 58 publications

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“…The concept of lower extremity reconstruction using an orthoplastic approach speeds up and enhance the quality of care for patient who require collaborative integration between two specialties with aggressive debridement of the devitalized bone and soft tissues, rigid skeletal fixation, effective antimicrobial treatment and durable soft tissue coverage [28,29]. Some limitations of our study are the limited cases and short follow-up.…”

Section: Discussionmentioning

confidence: 94%

A Retrospective Comparative Study between Muscle Flaps and Fasciocutaneous Flaps in Reconstruction of Chronic Osteomyelitis Related Wounds of the Lower Limb in the Adult Population

Khatter

Elkabbani

Fahar

2022

The Egyptian Journal of Plastic and Reconstructive Surgery

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Introduction: Chronic osteomyelitis cases are challenging, as they require a multidisciplinary approach for reconstructive soft tissue coverage and orthopedic management. Proper debridement, stable coverage and effective antibiotic therapy are mandatory before application of flap coverage. Patients and Methods:We performed a retrospective comparative study between muscle and fasciocutaneous flaps used for coverage of chronic osteomyelitis related wounds of the lower limb. It included thirty patients who finished a 12 months of follow-up to assess the complications rate and the outcome of surgery. Color match, texture match and aesthetic satisfaction were compared between the 2 groups.Results: Thirty-one flaps including six free flaps and twenty-five local flaps were used to treat these cases. Complications included fluid collections in one case, sinus formation in two 2 cases, partial flap loss in one case. These complications were managed by prolonged antibiotic therapy and dressing changes. Cases in group B had higher scores (mean: 9.5±1.34) in comparison with cases in group A (mean: 7.25±1.29). Yet, there were no statistically significant differences between the 2 groups (p-value: 0.27). Conclusion:A multidisciplinary team is needed for management of cases with chronic osteomyelitis related wounds. Flap coverage can be achieved with either muscular or fasciocutaneous flaps with comparable successful rates.

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Section: Discussionmentioning

confidence: 94%

A Retrospective Comparative Study between Muscle Flaps and Fasciocutaneous Flaps in Reconstruction of Chronic Osteomyelitis Related Wounds of the Lower Limb in the Adult Population

Khatter

Elkabbani

Fahar

2022

The Egyptian Journal of Plastic and Reconstructive Surgery

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“…[49][50][51] The same principles can be applied in other parts of the body, and are not limited to soft tissue defects but may include any situation requiring the importation of vascularized tissue (bone, nerve, fascia, etc.). For this to be achieved an open and collaborative relationship between orthopaedic and plastic surgeons must be maintained and encouraged, 52 and both teams need to be aware of the surgical options available.…”

Section: Discussionmentioning

confidence: 99%

Vascularized Reconstruction of Recalcitrant Clavicular Nonunion with the Medial Femoral Condyle Free Flap: A Systematic Review of the Literature

Karunaratne

Romeo

2024

Journal of Hand and Microsurgery

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Recalcitrant clavicular nonunion is an uncommon but challenging problem. Vascularized bone reconstruction is not first-line therapy due to complexity and donor morbidity, though it has utility in select cases. A systematic review of Embase and Medline databases was undertaken for cases of medial femoral condyle reconstruction for clavicle nonunion. Ten studies met inclusion, encompassing 26 patients. Mean age was 38.9 years. Ten patients were male and 16 female. Mean time of nonunion was 37.79 months prior to intervention; mean time to union following medial femoral condyle flap was 7.60 months. Two patients did not achieve union. Of the 11 patients who previously had at least one failed fixation with bone graft, considered the current “gold standard”, 9 patients (81.81%) went on to achieve union, while 2 patients (18.19%) did not. There were six reported complications in five patients. Medial femoral condyle flap is a valuable option in recalcitrant clavicle nonunion.

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“…Unfortunately seeking to avoid microsurgical reconstruction prolonging NPWT has been associated with high infection rates including osteomyelitis 20 . The concept of a comprehensive treatment of the injured limb starts in the 16 th century with Jean-François Malgaigne, Ambroise Pare, Guillaume Dupuytren and Alfred Velpeau 21,22 but it was during the 60's and 70's that the groundwork for modern orthoplastic has been laid [23][24][25] . Microsurgery opened the borders to flaps, replantation and allo-replantations.…”

Section: Discussionmentioning

confidence: 99%

A Survey of Current State of Organization and Training in Microsurgery and Orthoplasty in Italy Between Orthopedics

Gerace,

Tos,

Crosio

et al. 2023

PRRS

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Objective. Complex limb traumas often involve both bone and soft tissue and can undermine the survival of the patient. In recent decades, with the spread of microsurgical techniques, it has been possible to treat both soft tissues and bone lesions at the same surgical moment. The purpose of this study is to evaluate the orthoplastic and microsurgery skills of Italian orthopaedists and their perception about the trauma network.Methods. An anonymous questionnaire of 24 questions was formulated and sent, between October 2022 and February 2023, to all members of two orthopaedic scientific societies: O.T.O.D.I (Ortopedici Traumatologi Ospedalieri D'Italia) and WOW (Women in Orthopedics Worldwide) Italia. Results. The survey was answered by 224 orthopaedists. 60% have not received any training in microsurgery and only 4% intend to start a training course in this field. More than 60% of the sample of orthopaedists who do not work in a microsurgery or orthoplastic center reports that they can hardly direct a patient to a reference center. 83% of them believe that some patients they treated could have benefited from microsurgery or orthoplastic expertise. 94% of respondents believe that the network of trauma centers in Italy would benefit from a greater spread of microsurgery and orthoplastic centers. Conclusions. This survey shows that a comprehensive network of reconstructive centers is a major need for the orthopedist working in a trauma setting. The current orthoplastic network unfortunately still does not fully permeate the entire national territory and microsurgery is not yet evenly spread.

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The interest of “ortho-plastic” collaboration in management of complex limb injury

Cited by 10 publications

References 58 publications

A Retrospective Comparative Study between Muscle Flaps and Fasciocutaneous Flaps in Reconstruction of Chronic Osteomyelitis Related Wounds of the Lower Limb in the Adult Population

A Retrospective Comparative Study between Muscle Flaps and Fasciocutaneous Flaps in Reconstruction of Chronic Osteomyelitis Related Wounds of the Lower Limb in the Adult Population

Vascularized Reconstruction of Recalcitrant Clavicular Nonunion with the Medial Femoral Condyle Free Flap: A Systematic Review of the Literature

A Survey of Current State of Organization and Training in Microsurgery and Orthoplasty in Italy Between Orthopedics

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