Effects of a formalized collaboration between plastic and orthopedic surgeons in severe extremity trauma patients; a retrospective study

Sommar, Pehr; Granberg, Yamin; Halle, Martin; Skogh, Ann-Charlott Docherty; Lundgren, Kalle T; Jansson, Karl-Åke

doi:10.1186/s13032-015-0023-4

Table 1 Patients treated before start of multidisciplinary collaboration

From: Effects of a formalized collaboration between plastic and orthopedic surgeons in severe extremity trauma patients; a retrospective study

	Sex	Age (y)	Case	Trauma	Gustilo	Flap	Time to flap (d)	Time to coverage (d)
Free flaps included
1	M	59	Distal tibia fracture	Excavator accident	GIIIB	Latissimus dorsi muscle	6	129
2	M	42	Proximal tibia fracture, fibula fracture, femoral fracture, humeral fracture	MC accident	GIIIB	Fibula osteocutaneous flap (Medial gastro-cnemius flap)	49 (0)	425 Failed Medial gastrocnemius flap
3	M	48	Distal femoral fracture	Bus accident	GIIIC	Latissimus dorsi muscle	7	Amputation 2 d after flap
Free flaps excluded
4	M	54	Osteomyelitis calcaneal fracture 1 year earlier	MC accident	GIIIA	Gracilis muscle	360	7
5	M	21	Osteomyelitis proximal tibia after fracture 5 years earlier	Moped accident	GIIIB	Latissimus dorsi muscle	5 years	65
Pedicled flap included
1	M	26	Multitrauma, calcaneal fractures with skin necrosis	Fall injury	GIIIA	Sural island flap	220	21
2	M	60	Diaphyseal tibia fracture	Fall injury	GIIIB	Fasciocutaneous rotation flap	26	52
Pedicled flap excluded
3	M	64	Tibia condyle fracture and abundant soft tissue injury	Outboard motor accident	GIIIC	Lateral gastrocnemius muscle	26	72
4	F	30	Tibia pilon fracture, secondary skin necrosis after surgery	Fall injury	-	Sural island flap	38	4
5	F	54	Osteomyelitis, distal tibia fracture 2 years earlier, skin necrosis after secondary surgery	Fall injury	-	Fasciocutaneous transposition flap	21	Partial flap necrosis Free flap 2011 Pat 15 Table 2
6	F	27	Multitrauma, proximal tibia fracture, admitted 1 month after trauma	Car accident	GIIIB	Medial gastrocnemius muscle	51	57
7	M	26	Diaphyseal tibia fracture, admitted 1.5 months after trauma	Climbing accident	GIIIB	Soleus muscle	51	334

Patients treated before start of multidisciplinary collaboration with a free or pedicled flap for soft tissue reconstruction after lower extremity trauma. Patients excluded in the subgroup analysis of acute extremity trauma were patients recieving flaps due to skin necrosis/infection after fracture surgery, chronic osteomyelitis, or patients referred to Karolinska University Hospital later than 14 days after the trauma. Time to flap is counted from trauma/admission at Karolinska University Hospital, or in the secondary cases from occurrence of wounds, fistulation or exposed bone. Time to complete soft tissue coverage after flap surgery was determined as no remaining skin wounds at clinical evaluation at follow up.

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ISSN: 1752-2897

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