TECHNICAL SUCCESSES AND FUNCTIONAL FAILURES AFTER FREE TISSUE TRANSFER TO THE TIBIA

被引:17
作者
YAKUBOFF, KP [1 ]
STERN, PJ [1 ]
NEALE, HW [1 ]
机构
[1] UNIV CINCINNATI,COLL MED,DEPT SURG,DIV PLAST & RECONSTRUCT SURG,CINCINNATI,OH 45221
关键词
D O I
10.1002/micr.1920110112
中图分类号
R61 [外科手术学];
学科分类号
摘要
A retrospective study evaluated functional outcome in 59 patients with 61 successful free tissue transfers performed after open tibial fractures. Twentyone patients had transfers done within 7 days, 13 between 7 and 21 days, and 25 were done greater than 3 weeks after injury. All 59 patients had Type III injuries as classified by Gustilo and Anderson. Nineteen patients (32%) were identified as late functional failures. Each of these patients underwent as average of 10 procedures. In this group chronic osteomyelitis was noted in 13 of 19 patients and chronic venous insufficiency with skin ulceration in 9 of 19 patients. Fracture nonunion was seen in 8 of 19. Degenerative joint problems and foot deformities were identified in 7 or 19 patients. Seven patients (12%) ultimately required below‐knee amputation. Functional failure did not correlate with the timing of flap application, but rather with the severity of the initial injury. Free tissue transfer is not a panacea. It is but one step in the overall reconstruction of complex tibial wounds. Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company
引用
收藏
页码:59 / 62
页数:4
相关论文
共 24 条
[1]  
Allen RR, Franklin JD, Withers EH, Davis JL, Extremity salvage utilizing neurovascular free tissue transfer, Surgery, 90, (1981)
[2]  
Byrd HS, Cierny G, Tebbetts JB, Management of open tibial fractures, Plast Reconstr Surg, 68, pp. 73-79, (1981)
[3]  
Daniel RK, Taylor GI, Distant transfer of an island graft by microvascular anastomosis: A clinical technique, Plast Reconstr Surg, 52, (1973)
[4]  
Lung VCL, Frykman GK, Free vascularized flaps for lower extremity reconstruction, Orthopedics, 9, (1986)
[5]  
McConnell CM, Hyland WT, Neale HW, Microvascular free groin flap for soft tissue coverage of the extremities, J Trauma, 20, pp. 593-598, (1980)
[6]  
Serafin D, Voci VE, Reconstruction of the lower extremity. Microsurgical composite tissue transplantation, Clin Plast Surg, 10, (1983)
[7]  
Smith DJ, Loewenstein PW, Bennett JE, Surgical options in the repair of lower extremity soft tissue wounds, J Trauma, 22, pp. 374-381, (1982)
[8]  
Weiland AJ, Daniel RK, Microvascular anastomosis for bone grafts in the treatment of massive defects in bone, J Bone Joint Surg, 61 A, pp. 98-104, (1979)
[9]  
Weiland AJ, Moore JR, Daniel RK, Vascularized bone autografts. Experience with 41 cases, Clin. Orthop, 174, pp. 87-95, (1983)
[10]  
Stern PJ, Neale HW, Gregory RO, McDonough JJ, Functional reconstruction of an extremity by free tissue transfer, J Bone Joint Surg, 65 A, pp. 729-737, (1983)