Journal of Musculoskeletal Trauma

Comparison of Treatment Outcomes of Infected Nonunion of the Tibia by Ilizarov Fixator according to Location of Nonunion and Reconstruction of Soft Tissue Defect: Soo Kyung Lee, Jung Ryul Kim, Jong Han Lim, Jun Mo Lee; J Korean Fract Soc 2010;23(1):57-63. Published online January 31, 2010; DOI: https://doi.org/10.12671/jkfs.2010.23.1.57

Abstract PDF: PURPOSE
To study clinical results and complications in the treatment of infected nonunion of the tibia according to location of nonunion and reconstruction for soft tissue defect.
MATERIALS AND METHODS
36 cases of tibia infected nonunion which were treated with the llizarov included in this study. There were proximal 1/3 in 14, middle 1/3 in 10, and distal 1/3 in 11 cases. Coverage of the soft tissue were treated with the free flap in 8 cases as classified group A and non-free flap in 17 cases classified group B. We evaluated the healing index, complications and comparing the results of each treatment by the Paley method.
RESULTS
Bone union was achieved in all cases. The proximal nonunion showed better results than those in the middle and distal area; average healing index: 35.6 days/cm (p=0.038), bone results: 92.9% (p=0.025), functional result: 90.5% (p=0.03). Group B showed significantly better results as it showed average healing index: 30.3 days/cm (p=0.015), bone results: 85.7% (p=0.025), functional results: 90.5% (p=0.015).
CONCLUSION
The nonunion of proximal 1/3 showed better results than other sites. Soft tissue reconstruction with free flap that control infection more effectively, could be improved the treatment outcomes.

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Anterolateral Thigh Island Flap: Jae Hoon Lee, Il Hoen Choi; J Korean Fract Soc 2008;21(3):207-212. Published online July 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.3.207

Abstract PDF: PURPOSE
To present the author's experience using the anterolateral thigh island flap for reconstruction of soft tissue defects around the hip and perineum.
MATERIALS AND METHODS
Proximal based anterolateral thigh island flaps were performed to reconstruct the soft tissue defects at the perineum (3 patients) and the greater trochanter of the hip (one patient) in 4 patients. All patients were male. Mean age was 43 years (range, 32 to 50 years) and mean follow-up was 8 months (range, 6 to 13 months). The causes of the defects were traffic accident in 2 cases, necrotizing fasciitis 1 case, and pressure sore 1 case. Average size of the flap was 14x9 cm. Fasciocutaneous flaps were performed in 3 patients and musculocutaneous flap was performed in one patient.
RESULTS
All flaps were survived. There were no necrosis of the flaps. One flap presented venous congestion after surgery, which resolved with the decompression of the pedicle. Reconstruction with the anterolateral thigh island flap resulted in no recurrence of the infection or ulcer and good esthetic contour.
CONCLUSION
The anterolateral thigh island flap is a reliable flap for reconstruction around the perineum and hip joint.

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Negative Pressure Wound Therapy for Traumatic Soft Tissue Defects: Keun Bae Lee, Jin Choi, Eun Sun Moon, Taek Rim Yoon, Keun Young Lim; J Korean Fract Soc 2006;19(1):67-71. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.67

PURPOSE
To evaluate the negative pressure wound therapy for traumatic soft tissue defects by vacuum-assised closure (V.A.C.(R)).
MATERIALS AND METHODS
33 patients with traumatic soft tissue defects were treated by using V.A.C.(R) which removes edema fluid, eliminates an extrinsic cause of microcirculatory embarrassment and may directly stimulate cellular proliferation of reparative granulation tissue. We removed all necrotic tissue prior to application of the V.A.C.(R). The foam dressing was placed into direct contact with wound and was changed every 48~72 hours. The setting for vacuum pump was continuous pressure of 100 to 125 mm Hg. C-reactive protein was checked to evaluate wound infection. We measured wound size and total duration of treatment.
RESULTS
Mean duration of treatment was 25.2 days and mean decrease of wound size was 31.9%. The concentration of CRP after V.A.C.(R) therapy reduced by day 8 below 1.0 mg/dl and gradually decreased to normal level by day 10. All patients showed hastened wound healing by rapid formation of granulation tissue.
CONCLUSION
Negative pressure wound therapy is useful in patients with traumatic soft tissue defects, which reduces treatment duration and cost by rapid wound healing and effective infection control.

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Negative-Pressure Wound Therapy Using Modified Vacuum-Assisted Closure in Patients with Diabetic Foot Ulcers
Bong Jae Kim, Ji Hye Suk, A Ra Jo, Jong Kun Ha, Chan Woo Jung, Seong Oh Park, Hyung Taek Park, Mi Kyung Kim
Journal of Korean Diabetes.2011; 12(2): 122. CrossRef
Acute Management of Soft Tissue Defect in Open Fracture
Ki-Chul Park
Journal of the Korean Fracture Society.2010; 23(1): 155. CrossRef

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