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Concurrent plate fixation and pedicled flap coverage for open fractures complicated by soft tissue loss of the tibia in pediatric cohort: a clinical series.
Jitprapaikulsarn, Surasak; Sengpanich, Pasit; Rungsakaolert, Ployphailin; Sukha, Kritsada; Reingrittha, Pissanu; Gromprasit, Arthit.
Afiliación
  • Jitprapaikulsarn S; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand. surasak_hand@yahoo.co.th.
  • Sengpanich P; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand.
  • Rungsakaolert P; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand.
  • Sukha K; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand.
  • Reingrittha P; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand.
  • Gromprasit A; Department of Orthopedics, Buddhachinaraj Hospital, 90 Srithamtraipidok Road, Phitsanulok, 65000, Thailand.
Eur J Orthop Surg Traumatol ; 34(6): 3241-3250, 2024 Aug.
Article en En | MEDLINE | ID: mdl-39127835
ABSTRACT

BACKGROUND:

The optimal treatment of open fractures complicated by soft tissue loss of pediatric tibial fractures remains inconclusive. The author described a protocol of concurrent plate fixation and pedicled flap coverage and retrospectively reviewed the outcomes of such injuries.

METHODS:

A total of 25 pediatric cases with Gustilo lllB open tibial fracture were treated by single-stage plate fixation and pedicled flap reconstruction. The reviewed information consisted of time to fix and flap, type of plate, type of pedicled flap, fracture union time, postoperative complication and the clinical outcomes by objective scoring system.

RESULTS:

Fix and flap was undergone between 7 and 12 days after injury with the average time of 8.2 days. Regarding the type of plate, narrow LCP was applied in 8, 3.5 mm precontoured LCP in 10, 5.0 mm precontoured in 2 and double LCP in 5. According to soft tissue reconstruction, the medial gastrocnemius flap was selected in 6 cases, myocutaneous medial gastrocnemius flap in 2, soleus flap in 3, hemisoleus flap in 5, reverse sural flap in 6 and combined medial gastrocnemius and hemisoleus flaps in 3. No flap-related complication was demonstrated. All cases established fracture union in between 12 and 24 weeks with an average time to union of 17.7 weeks. According to postoperative complications, infected plate occurred in 2 cases and implant irritation in 5. According to Puno functional score, excellent results were presented in 7 cases and good results in 18 cases.

CONCLUSION:

Single-stage plate fixation and pedicled flap coverage are a reliable regimen for pediatric open fractures complicated by soft tissue loss of the tibia.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Quirúrgicos / Fracturas de la Tibia / Placas Óseas / Traumatismos de los Tejidos Blandos / Fijación Interna de Fracturas / Fracturas Abiertas Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Orthop Surg Traumatol Año: 2024 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colgajos Quirúrgicos / Fracturas de la Tibia / Placas Óseas / Traumatismos de los Tejidos Blandos / Fijación Interna de Fracturas / Fracturas Abiertas Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: Eur J Orthop Surg Traumatol Año: 2024 Tipo del documento: Article País de afiliación: Tailandia Pais de publicación: Francia