1/3. Local muscle flap in a venous hypertensive environment.Local rotation muscle flaps are useful for soft tissue reconstruction in open grade III fractures of the lower extremity. Gastrocnemius or soleus muscle flaps provide early bone coverage and avoid a more demanding free tissue transfer. Deep vein thrombosis is common in injured limbs and venous hypertension may result in acute muscle flap necrosis. Loss of bone coverage and an increased risk of osteomyelitis follow. We present a successful soleus rotation flap for tibial coverage in a lower extremity with a documented major venous thrombosis.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/3. Fixation of a talar osteochondral fracture with cyanoacrylate glue.Cyanoacrylate glue was invented by Ardis in 1949 and was first used in surgery in 1959 by Coover. By further modifications, a nonhistotoxic form, butyl-2-cyanoacrylate, which had strong tissue binding properties even in nondry environments, was developed. Its use in the fixation of fractures and osteotomies is still under investigation and has had promising results in treatment of craniofacial and mandibular injuries. We fixed a talar osteochondral fracture with cyanoacrylate. After 3 months, magnetic resonance imaging showed an anatomically reduced and intact chondral surface. The clinical result was excellent. We believe cyanoacrylate glue may form an alternative means of fixation for osteochondral and, possibly, for chondral fractures.- - - - - - - - - - ranking = 0.25keywords = environment (Clic here for more details about this article) |
3/3. Importunate fractures.The treatment of compound fractures has been discussed extensively in the literature. Little has been written, however, about the closed fracture that compounds in the hospital environment. This paper discusses three cases of importunate fracture, with skin breakdown and exposed fracture fragments, and their treatment with tobramycin beads (and in two cases, external fixateurs).- - - - - - - - - - ranking = 0.25keywords = environment (Clic here for more details about this article) |