Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2011
ReviewClinical applications of venous flaps in the reconstruction of hands and fingers.
In recent years, the venous flap has been highly regarded in microsurgical and reconstructive surgeries, especially in the reconstruction of hand and digit injuries. It is easily designed and harvested with good quality. ⋯ All these advantages make it an optimal candidate for hand and digit reconstruction when conventional flaps are limited or unavailable. In this article, we review its classifications and the selection of donor sites, update its clinical applications, and summarize its indications for all types of venous flaps in hand and digit reconstruction.
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Arch Orthop Trauma Surg · Jan 2011
Management of non-union of humeral fractures with the Stryker T2 compression nail.
Fractures of the humeral shaft are relatively common injuries and the majority achieve union uneventfully; however, non-union rates of up to 13% are reported when managed either conservatively or operatively. Despite the many surgical techniques described for the management of non-unions, including plate fixation, intramedullary nailing or external fixation, some cases remain resistant to treatment with ongoing problems achieving union. ⋯ We conclude that this technique of intramedullary nailing with a novel compression technique is effective in the treatment of humeral shaft fracture non-union.
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Arch Orthop Trauma Surg · Jan 2011
Case ReportsAnomalous external jugular vein: clinical concerns in treating clavicle fractures.
Operative treatment of clavicle fractures has seen growing acceptance, as evidence emerges to support its use over nonoperative management. Of particular popularity, more recently, is the percutaneous intramedullary techniques for fixation of these injuries. The complex neurovascular anatomy in close proximity to the clavicle requires precision with these procedures. ⋯ Here, we present a case report of an anomalous external jugular vein coursing anterior to the clavicle that was encountered during an open surgical approach to a clavicle fracture. The purpose of this case presentation is to serve as a caution to surgeons treating clavicle fractures by both open and percutaneous means. Inadvertent injury to anomalous neurovascular structures can be devastating to the patient and can be avoided by the careful surgical approaches recommended.
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Arch Orthop Trauma Surg · Jan 2011
Fixation and reconstruction of severe tibial shaft fractures with vascularized fibular grafting.
Based on the considerable experience for management of combined bone and composite soft-tissue defects in the limbs by free vascularized fibula or osteocutaneous fibular flap grafting, the authors present the effective alternative for management of the severe comminuted tibial shaft fractures in one-stage reconstructive technique. ⋯ The attached fibular flap can also provide a large piece of mobile skin to cover the soft-tissue defect in grade III open-tibial fractures. It demonstrates that this early free vascularized fibula graft is a useful and effective option for treating the severe comminuted tibial shaft fractures.