Journal of plastic, reconstructive & aesthetic surgery : JPRAS
-
J Plast Reconstr Aesthet Surg · Jun 2017
Multicenter StudyOrthoplastic surgical collaboration is required to optimise the treatment of severe limb injuries: A multi-centre, prospective cohort study.
Open fractures are severe, complex, limb-threatening and high-energy injuries, often involving lesions of both bone and soft tissues. Traditionally, treatment has been piecemeal by orthopaedic and plastic surgeons. This study aimed to prospectively investigate whether combining orthopaedic and plastic surgery in treating these injuries is more effective than the conventional orthopaedic care. ⋯ Of these, 70% were treated with an orthoplastic approach, whereas 30% were treated by an orthopaedic team. All outcome measures were statistically improved by the orthoplastic approach. A coordinated, combined pathway to both the bony and the soft tissue components of open tibial fractures through orthoplastic surgery can be successfully delivered with attention to important timelines to achieve better patient outcomes in different socio-economic settings.
-
J Plast Reconstr Aesthet Surg · Jun 2017
Case ReportsRestoration of basic hand function following devastating hand injuries using a microsurgically fabricated chimeric iliac osteocutaneous flap.
Reconstruction following devastating hand injuries, with amputations of the thumb plus multiple digits, is challenging. Double flap or combined flap transfers may be options in such cases. Between 2012 and 2014, 6 patients underwent hand reconstruction following devastating injuries with amputations of the thumb and multiple digits. ⋯ All patients were able to perform basic hand functions after a median follow-up of 1.8 years. Microsurgically fabricated chimeric iliac osteocutaneous flaps may restore basic hand function to some extent. This procedure is an option worth considering for hand reconstruction following devastating injuries in carefully selected patients.