Reconstruction Options for Lower Extremity Traumatic Wounds.
Journal
The Journal of the American Academy of Orthopaedic Surgeons
ISSN: 1940-5480
Titre abrégé: J Am Acad Orthop Surg
Pays: United States
ID NLM: 9417468
Informations de publication
Date de publication:
15 Aug 2022
15 Aug 2022
Historique:
received:
27
10
2021
accepted:
15
03
2022
entrez:
6
9
2022
pubmed:
7
9
2022
medline:
9
9
2022
Statut:
ppublish
Résumé
The senior author first coined the "orthoplastic" approach to traumatic lower extremity reconstruction, by which multidisciplinary surgeons and specialists work together for optimal patient success. The goals of lower extremity salvage are to optimize limb appearance, restore unrestricted pain-free ambulation, and improve quality of life. Composite traumatic defects require an organized approach, and the reconstructive ladder is used for strategies of varying complexity for repair of soft-tissue wounds. The lower rungs of the ladder include simpler reconstructive options such as the use of skin grafts and local flaps, and the higher rungs represent complex techniques such as free tissue transfer. Although there is no notable difference between muscle and fasciocutaneous/perforator flaps in reconstructive outcomes, there has been a trend toward perforator flaps to minimize donor site morbidity.
Identifiants
pubmed: 36067459
doi: 10.5435/JAAOS-D-21-01081
pii: 00124635-202208150-00001
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
735-746Informations de copyright
Copyright © 2022 by the American Academy of Orthopaedic Surgeons.
Références
Levin LS: The reconstructive ladder. An orthoplastic approach. Orthop Clin North Am 1993;24:393-409.
Azoury SC, Stranix JT, Othman S, et al.: Outcomes following soft-tissue reconstruction for traumatic lwoer extremity defects at an orthoplastic limb salvage center: The need for Lower Extremity Guidelines fo Salvage (L.E.G.S.0). Orthoplast Surg 2021;3:1-7.
Klifto KM, Azoury SC, Othman S, Klifto CS, Levin LS, Kovach SJ: The value of an orthoplastic approach to management of lower extremity trauma: Systematic review and meta-analysis. Plast Reconstr Surg Glob Open 2021;9:e3494.
Klifto KM, Azoury SC, Othman S, Klifto CS, Levin LS, Kovach SJ: Direct admission versus transfer to a tertiary hospital for definitive management of lower extremity injuries: Systematic review and meta-analysis. J Trauma Acute Care Surg 2021;90:756-765.
Sbitany H, Au AF, Kovach SJ, Levin LS: Orthoplastic approach to composite tissue loss, in Pu LLQ, Levine JP, Wei FC, eds: Reconstructive Surgery of the Lower Extremity. St. Louis, MO, Quality Medical Publishing, 2013, pp 1025-1045.
Azoury SC, Stranix JT, Kovach SJ, Levin LS: Principles of orthoplastic surgery for lower extremity reconstruction: Why is this important? J Reconstr Microsurg 2021;37:42-50.
Masquelet AC, Kishi T, Benko PE: Very long-term results of post-traumatic bone defect reconstruction by the induced membrane technique. Orthop Traumatol Surg Res 2019;105:159-166.
Tong K, Zhong Z, Peng Y, et al.: Masquelet technique versus Ilizarov bone transport for reconstruction of lower extremity bone defects following posttraumatic osteomyelitis. Injury 2017;48:1616-1622.
Hollenbeck ST, Woo S, Komatsu I, Erdmann D, Zenn MR, Levin LS: Longitudinal outcomes and application of the subunit principle to 165 foot and ankle free tissue transfers. Plast Reconstr Surg 2010;125:924-934.
Bosse MJ, McCarthy ML, Jones AL, et al.: The insensate foot following severe lower extremity trauma: An indication for amputation? J Bone Joint Surg Am 2005;87:2601-2608.
Head LK, Hicks K, Wolff G, Boyd KU: Clinical outcomes of nerve transfers in peroneal nerve palsy: A systematic review and meta-analysis. J Reconstr Microsurg 2019;35:57-65.
Carayon A, Bourrel P, Bourges M, Touze M: Dual transfer of the posterior tibial and flexor digitorum longus tendons for drop foot. Report of thirty-one cases. J Bone Joint Surg Am 1967;49:144-148.
Ninkovic M, Ninkovic M: Neuromusculotendinous transfer: An original surgical concept for the treatment of drop foot with long-term follow-up. Plast Reconstr Surg 2013;132:438e-445e.
Stranix JT, Lee ZH, Jacoby A, et al.: Not all Gustilo type IIIB fractures are created equal: Arterial injury impacts limb salvage outcomes. Plast Reconstr Surg 2017;140:1033-1041.
Momeni A, Lanni MA, Levin LS, Kovach SJ: Does the use of arteriovenous loops increase complications rates in posttraumatic microsurgical lower extremity reconstruction? A matched-pair analysis. Microsurgery 2018;38:605-610.
Colen DL, Colen LB, Levin LS, Kovach SJ: Godina's principles in the twenty-first century and the evolution of lower extremity trauma reconstruction. J Reconstr Microsurg 2018;34:563-571.
Gustilo RB, Anderson JT: Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: Retrospective and prospective analyses. J Bone Joint Surg Am 1976;58:453-458.
Veber M, Vaz G, Braye F, et al.: Anatomical study of the medial gastrocnemius muscle flap: A quantitative assessment of the arc of rotation. Plast Reconstr Surg 2011;128:181-187.
Cho EH, Shammas RL, Carney MJ, et al.: Muscle versus fasciocutaneous free flaps in lower extremity traumatic reconstruction: A multicenter outcomes analysis. Plast Reconstr Surg 2018;141:191-199.
Mastorakos DP, Disa JJ, Athanasian E, Boland P, Healey JH, Cordeiro PG: Soft-tissue flap coverage maximizes limb salvage after allograft bone extremity reconstruction. Plast Reconstr Surg 2002;109:1567-1573.
Nelson JA, Fischer JP, Brazio PS, Kovach SJ, Rosson GD, Rad AN: A review of propeller flaps for distal lower extremity soft tissue reconstruction: Is flap loss too high? Microsurgery 2013;33:578-586.
Elswick SM, Wu P, Arkhavan AA, et al.: A reconstructive algorithm after thigh soft tissue sarcoma resection including predictors of free flap reconstruction. J Plast Reconstr Aesthet Surg 2019;72:1304-1315.
Ricciardi BF, Henderson PW, McLawhorn AS, Westrich GH, Bostrom MP, Gayle LB: Gluteus maximus advancement flap procedure for reconstruction of posterior soft tissue deficiency in revision total hip arthroplasty. Orthopedics 2017;40:e495-e500.
Wong JK, Deek N, Hsu CC, Chen HY, Lin CH, Lin CH: Versatility and “flap efficiency” of pedicled perforator flaps in lower extremity reconstruction. J Plast Reconstr Aesthet Surg 2017;70:67-77.
Namgoong S, Yoon YD, Yoo KH, Han SK, Kim WK, Dhong ES: Alternative choices for anterolateral thigh flaps lacking suitable perforators: A systematic review. J Reconstr Microsurg 2018;34:465-471.
Scaglioni MF, Enrique Carrillo Jimenez L, Kuo YR, Chen YC: Pedicled posteromedial thigh (PMT) flap: A new alternative for groin defect reconstruction. Microsurgery 2017;37:339-343.
Hallock GG: Local knee random fasciocutaneous flaps. Ann Plast Surg 1989;23:289-296.
Dusseldorp JR, Pham QJ, Ngo Q, Gianoutsos M, Moradi P: Vascular anatomy of the medial sural artery perforator flap: A new classification system of intra-muscular branching patterns. J Plast Reconstr Aesthet Surg 2014;67:1267-1275.
Azoury SC, Stranix JT, Piper M, Kovach SJ, Hallock GG: Attributes of perforator flaps for prophylactic soft tissue augmentation prior to definitive total knee arthroplasty. J Reconstr Microsurg 2021;37:51-58.
Lin CH, Zelken J, Hsu CC, Lin CH, Wei FC: The distally based, venous supercharged anterolateral thigh flap. Microsurgery 2016;36:20-28.
Tobin GR: Hemisoleus and reversed hemisoleus flaps. Plast Reconstr Surg 1985;76:87-96.
Mendieta M, Cabrera R, Siu A, Altamirano R, Gutierrez S: Perforator propeller flaps for the coverage of middle and distal leg soft-tissue defects. Plast Reconstr Surg Glob Open 2018;6:e1759.
Lai CS, Lin SD, Chou CK: Clinical application of the adipofascial turnover flap in the leg and ankle. Ann Plast Surg 1992;29:70-75.
Gir P, Cheng A, Oni G, Mojallal A, Saint-Cyr M: Pedicled-perforator (propeller) flaps in lower extremity defects: A systematic review. J Reconstr Microsurg 2012;28:595-601.
Vaienti L, Calori GM, Leone F, Brioschi M, Parodi PC, Marchesi A: Posterior tibial artery perforator flaps for coverage of Achilles region defects. Injury 2014;45(suppl 6):S133-S137.
Houtmeyers P, Opsomer D, Van Landuyt K, Monstrey S: Reconstruction of the Achilles tendon and overlying soft tissue by free composite anterolateral thigh flap with vascularized fascia lata. J Reconstr Microsurg 2012;28:205-209.
Scaglioni MF, Rittirsch D, Giovanoli P: Reconstruction of the heel, middle foot sole, and plantar forefoot with the medial plantar artery perforator flap: Clinical experience with 28 cases. Plast Reconstr Surg 2018;141:200-208.
Lee YH, Rah SK, Choi SJ, Chung MS, Baek GH: Distally based lateral supramalleolar adipofascial flap for reconstruction of the dorsum of the foot and ankle. Plast Reconstr Surg 2004;114:1478-1485.
Holmes J, Rayner CR: Lateral calcaneal artery island flaps. Br J Plast Surg 1984;37:402-405.
May JW Jr, Halls MJ, Simon SR: Free microvascular muscle flaps with skin graft reconstruction of extensive defects of the foot: A clinical and gait analysis study. Plast Reconstr Surg 1985;75:627-641.
Chiang YC, Wei FC, Wang JW, Chen WS: Reconstruction of below-knee stump using the salvaged foot fillet flap. Plast Reconstr Surg 1995;96:731-738.
Stranix JT, Piper ML, Azoury SC, et al.: Medial femoral condyle free flap reconstruction of complex foot and ankle pathology. Foot Ankle Orthop 2019;4:1-10.
Deng AD, Innocenti M, Arora R, Gabl M, Tang JB: Vascularized small-bone transfers for fracture nonunion and bony defects. Clin Plast Surg 2017;44:267-285.
Piccolo PP, Ben-Amotz O, Ashley B, Wapner KL, Levin LS: Ankle arthrodesis with free vascularized fibula autograft using saphenous vein grafts: A case series. Plast Reconstr Surg 2018;142:806-809.
Hollenbeck ST, Woo S, Ong S, Fitch RD, Erdmann D, Levin LS: The combined use of the Ilizarov method and microsurgical techniques for limb salvage. Ann Plast Surg 2009;62:486-491.
Capanna R, Campanacci DA, Belot N, et al.: A new reconstructive technique for intercalary defects of long bones: The association of massive allograft with vascularized fibular autograft. Long-term results and comparison with alternative techniques. Orthop Clin North Am 2007;38:51-60, vi.