同时内固定和背阔肌蒂皮瓣覆盖:一种治疗开放性骨折并伴有上肢大量软组织损失的可靠方案。

IF 1.5 4区 医学 Q3 ORTHOPEDICS Journal of Orthopaedic Science Pub Date : 2024-09-01 DOI:10.1016/j.jos.2023.09.005
{"title":"同时内固定和背阔肌蒂皮瓣覆盖:一种治疗开放性骨折并伴有上肢大量软组织损失的可靠方案。","authors":"","doi":"10.1016/j.jos.2023.09.005","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p><span>The optimal treatment protocol for open fractures with accompanying sizable </span>soft tissue defect<span> of the upper extremities has not been specifically delineated. The authors described the concurrent use of internal fixation and latissimus dorsi (LD) pedicle flap coverage in managing such complex fractures.</span></p></div><div><h3>Methods</h3><p>Twenty patients with open fractures accompanied by large soft tissue defect of the upper extremities (8 clavicle fractures and 12 humeral fractures) were treated by fix &amp; LD pedicle flap. The dimension of the defect, time to fix &amp; flap, post-operative complications, time to union and clinical measurements were recorded.</p></div><div><h3>Results</h3><p>The mean size of the defect was 132.45 cm<sup>2</sup> (range 6–12 x 2–20 cm<sup>2</sup><span>). The average time to fix &amp; flap was 9.9 days (range 7–14). Fractures union<span><span> was achieved in all patients with an average duration of 18.5 weeks (range 14–28). Regarding post-operative complications, distal flap necrosis occurred in 3 patients, retained </span>seroma<span> in 3 and heterotopic ossification in 1. By the Mayo Elbow Performance (MEP) score, 3 cases were considered to be excellent, 6 were good, 7 were fair and 4 were poor. By the University of California–Los Angeles (UCLA) shoulder score, 2 cases were considered to be excellent, 7 were good, 7 were fair and 4 were poor. The average Disabilities of Arm, Shoulder and Hand (DASH) score was 31.29 (range 12.5–58.3).</span></span></span></p></div><div><h3>Conclusion</h3><p><span>Fix &amp; LD pedicle flap is a reliable regimen for open fractures with sizable soft tissue defect of the clavicle and </span>humerus.</p></div>","PeriodicalId":16939,"journal":{"name":"Journal of Orthopaedic Science","volume":"29 5","pages":"Pages 1287-1293"},"PeriodicalIF":1.5000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Simultaneous internal fixation and latissimus dorsi pedicle flap coverage: A reliable regimen for open fractures with accompanying sizable soft tissue loss of the upper extremities\",\"authors\":\"\",\"doi\":\"10.1016/j.jos.2023.09.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p><span>The optimal treatment protocol for open fractures with accompanying sizable </span>soft tissue defect<span> of the upper extremities has not been specifically delineated. The authors described the concurrent use of internal fixation and latissimus dorsi (LD) pedicle flap coverage in managing such complex fractures.</span></p></div><div><h3>Methods</h3><p>Twenty patients with open fractures accompanied by large soft tissue defect of the upper extremities (8 clavicle fractures and 12 humeral fractures) were treated by fix &amp; LD pedicle flap. The dimension of the defect, time to fix &amp; flap, post-operative complications, time to union and clinical measurements were recorded.</p></div><div><h3>Results</h3><p>The mean size of the defect was 132.45 cm<sup>2</sup> (range 6–12 x 2–20 cm<sup>2</sup><span>). The average time to fix &amp; flap was 9.9 days (range 7–14). Fractures union<span><span> was achieved in all patients with an average duration of 18.5 weeks (range 14–28). Regarding post-operative complications, distal flap necrosis occurred in 3 patients, retained </span>seroma<span> in 3 and heterotopic ossification in 1. By the Mayo Elbow Performance (MEP) score, 3 cases were considered to be excellent, 6 were good, 7 were fair and 4 were poor. By the University of California–Los Angeles (UCLA) shoulder score, 2 cases were considered to be excellent, 7 were good, 7 were fair and 4 were poor. The average Disabilities of Arm, Shoulder and Hand (DASH) score was 31.29 (range 12.5–58.3).</span></span></span></p></div><div><h3>Conclusion</h3><p><span>Fix &amp; LD pedicle flap is a reliable regimen for open fractures with sizable soft tissue defect of the clavicle and </span>humerus.</p></div>\",\"PeriodicalId\":16939,\"journal\":{\"name\":\"Journal of Orthopaedic Science\",\"volume\":\"29 5\",\"pages\":\"Pages 1287-1293\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Science\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0949265823002646\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Science","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0949265823002646","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

摘要

背景:开放性骨折伴上肢软组织缺损的最佳治疗方案尚未明确。作者描述了内固定和背阔肌(LD)蒂皮瓣覆盖在治疗此类复杂骨折中的同时使用。方法:对20例开放性骨折伴上肢大面积软组织缺损的患者(锁骨骨折8例,肱骨骨折12例)采用固定-LD蒂皮瓣进行治疗。记录缺损的尺寸、固定和皮瓣的时间、术后并发症、愈合时间和临床测量结果。结果:缺陷的平均大小为132.45 cm2(范围6-12 x 2-20 cm2)。固定和皮瓣的平均时间为9.9天(范围7-14)。所有患者骨折愈合,平均持续18.5周(范围14-28)。关于术后并发症,远端皮瓣坏死3例,残留浆膜瘤3例,异位骨化1例。根据Mayo肘关节功能(MEP)评分,3例为优秀,6例为良好,7例为一般,4例为差。根据加州大学洛杉矶分校(UCLA)的肩部评分,2例为优秀,7例为良好,7例一般,4例为差。平均臂、肩和手残疾(DASH)评分为31.29(范围12.5-58.3)。结论:固定-LD椎弓根瓣是治疗锁骨和肱骨软组织缺损的开放性骨折的可靠方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Simultaneous internal fixation and latissimus dorsi pedicle flap coverage: A reliable regimen for open fractures with accompanying sizable soft tissue loss of the upper extremities

Background

The optimal treatment protocol for open fractures with accompanying sizable soft tissue defect of the upper extremities has not been specifically delineated. The authors described the concurrent use of internal fixation and latissimus dorsi (LD) pedicle flap coverage in managing such complex fractures.

Methods

Twenty patients with open fractures accompanied by large soft tissue defect of the upper extremities (8 clavicle fractures and 12 humeral fractures) were treated by fix & LD pedicle flap. The dimension of the defect, time to fix & flap, post-operative complications, time to union and clinical measurements were recorded.

Results

The mean size of the defect was 132.45 cm2 (range 6–12 x 2–20 cm2). The average time to fix & flap was 9.9 days (range 7–14). Fractures union was achieved in all patients with an average duration of 18.5 weeks (range 14–28). Regarding post-operative complications, distal flap necrosis occurred in 3 patients, retained seroma in 3 and heterotopic ossification in 1. By the Mayo Elbow Performance (MEP) score, 3 cases were considered to be excellent, 6 were good, 7 were fair and 4 were poor. By the University of California–Los Angeles (UCLA) shoulder score, 2 cases were considered to be excellent, 7 were good, 7 were fair and 4 were poor. The average Disabilities of Arm, Shoulder and Hand (DASH) score was 31.29 (range 12.5–58.3).

Conclusion

Fix & LD pedicle flap is a reliable regimen for open fractures with sizable soft tissue defect of the clavicle and humerus.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of Orthopaedic Science
Journal of Orthopaedic Science 医学-整形外科
CiteScore
3.00
自引率
0.00%
发文量
290
审稿时长
90 days
期刊介绍: The Journal of Orthopaedic Science is the official peer-reviewed journal of the Japanese Orthopaedic Association. The journal publishes the latest researches and topical debates in all fields of clinical and experimental orthopaedics, including musculoskeletal medicine, sports medicine, locomotive syndrome, trauma, paediatrics, oncology and biomaterials, as well as basic researches.
期刊最新文献
Clinical characteristics and results after conservative treatment or interfascicular neurolysis of 100 limbs with spontaneous anterior interosseous nerve palsy: A prospective Japanese multicenter study. Minimal clinically important difference in the Japanese Orthopedic Association Score and shoulder 36 after arthroscopic rotator cuff repair in a Japanese population: A retrospective cohort study. What is the appropriate revascularisation approach in traumatic popliteal artery injury? Platelet-rich plasma in the treatment of delayed union and nonunion fractures: An umbrella meta-analysis. Analysis of cancer multigene panel testing for osteosarcoma in pediatric and adults using the center for cancer genomics and advanced therapeutics database in Japan.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1