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Table 2 Patients treated after 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 flap included         
1 M 31 Traumatic arm amputation Work accident GIIIC Palmar free flap 0 75
2 F 33 Calcaneus fracture, ankle fracture, pelvic fracture Run over by a lorry GIIIB Latissimus dorsi muscle 4 203
3 M 55 Diaphyseal tibia fracture with bone defect Gunshot GIIIC Fibula osteo-cutaneous flap 4 100 Flap failure and amputation
4 M 42 Diaphyseal tibia fracture Car accident GIIIC Anterolateral thigh flap 11 192
5 M 33 Multitrauma, diaphyseal tibia fracture MC accident GIIIC Latissimus dorsi muscle 8 63
6 M 61 Distal tibia fracture MC accident GIIIC Latissimus dorsi muscle 3 87
7 F 46 Distal tibia/fibula fracture Riding accident GII Anterolateral thigh flap 7 31
8 F 31 Multitrauma, proximal tibia/fibula fracture Bicycle accident GIIIC Latissimus dorsi muscle 16 148
9 M 20 Multitrauma, distal tibia fracture Car accident GIIIB Latissimus dorsi muscle 6 23 Amputation 1 year after flap due to pain
10 M 27 Soft tissue defect tibia MC accident - Gracilis muscle 7 104
11 M 34 Distal tibia fracture MC accident GIIIA Gracilis muscle 29 35
12 M 66 Ankle fracture Work accident GIIIA Anterolateral thigh flap 22 16
13 M 36 Distal tibia fracture Car accident GIIIA Gracilis muscle 3 21
14 M 27 Multitrauma, tibia fracture with bone defect MC accident GIIIC Fibula osteo- cutaneous flap 5 10
Free flap excluded         
15 F 60 Osteomyelitis, distal tibia fracture 6 years earlier Fall injury - Anterolateral thigh flap 5.5 years 40 Pedicled flap 2006 Pat 5 Table 1
16 M 32 Infection after distal tibia fracture, referred 2 months after trauma Car accident GIIIB Anterolateral thigh flap (Sural island flap) 120 (105) 42 Failed Sural island flap
17 F 53 Distal tibia fracture, secondary skin necrosis after surgery Fall injury - Anterolateral thigh flap 456 29
18 M 76 Trimalleolar ankle fracture, referred 2.5 months after trauma Fall injury GIIIA Gracilis muscle 105 128
19 M 44 Osteomyelitis, tibia fracture 15 months earlier Moped accident GIIIC Latissimus dorsi muscle 432 24
20 F 63 Osteomyelitis, tibia pilon fracture 11 months earlier Fall injury - Anterolateral thigh flap (Gracilis muscle) 295 (288) 134 Failed gracilis muscle
Pedicled flap included         
1 M 40 Proximal tibia fracture MC accident GIIIB Propeller flap and lateral gastrocnemius muscle 3 457 Partial flap necrosis
2 M 70 Soft tissue injury to elbow, and humeral fracture Lawn mower accident GIIIB Radial forearm flap 7 23
3 M 17 Soft tissue defect over knee Moped accident - Medial gastrocnemius muscle 11 9
4 M 37 Proximal tibia fracture Bus accident GIIIA Medial gastrocnemius muscle 51 28
5 M 31 Multitrauma, diaphyseal tibia fracture Car accident GIIIB Fasciocutaneous rotation flap 4 16
6 M 65 Humeral fracture Gunshot GIIIB Latissimus dorsi muscle 3 35
7 F 64 Proximal tibia fracture Run over by a bus GIIIA Medial gastrocnemius muscle 16 65
8 F 15 Proximal tibia fracture Moped accident GIIIB Medial gastrocnemius muscle 1 21
9 F 43 Multitrauma, soft tissue defect over patella Train accident - Medial gastrocnemius muscle 34 10
10 M 55 Diaphyseal tibia fracture Bicycle accident GIIIB Soleus muscle 4 4
11 M 36 Radial fractures Gunshot GIIIC Fasciocutaneous transposition flap 0 15 Partial flap necrosis
Pedicled flap excluded         
12 F 59 Osteomyelitis, ankle fracture 5.5 years earlier Fall injury - Extensor digitorum brevis muscle 5.5 years 112
13 M 55 Distal tibia fracture 7 years earlier, secondary skin necrosis after surgery Fall injury - Extensor digitorum brevis muscle 7 years 49
14 M 47 Tibia pilon fracture, secondary skin necrosis after surgery Fall injury - Sural island flap 28 143 Partial flap necrosis
15 M 55 Osteomyelitis, tibia condyle fracture 17 months earlier secondary skin necrosis after surgery MC accident - Medial gastrocnemius muscle 156 8 Amputation 8 d after flap
16 F 71 Ulnar fracture, secondary skin necrosis after surgery Fall injury - Fasciocutaneous rotation flap 63 18
17 F 86 Proximal tibia fracture, secondary skin necrosis after surgery Fall injury - Medial gastrocnemius muscle 61 11
18 F 62 Distal tibia fracture 3 years earlier, wound infection after hardware removal Fall injury - Soleus muscle 239 17 Partial flap necrosis
19 M 63 Multitrauma, patellar fracture, secondary skin necrosis after surgery Car accident - Medial gastrochnemius muscle (Fasciocutaneous rotation flap) (103) 51 190 Partial flap necrosis rotation flap
20 F 67 Distal tibia fracture, secondary skin necrosis after surgery Fall injury - Propeller flap 135 Not healed by inclusion
21 M 76 Distal tibia fracture, secondary skin necrosis after plaster Wheelchair accident - Sural island flap 42 Flap failure, Amputation 70 d. after flap
  1. Patients treated after 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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Journal of Trauma Management & Outcomes

ISSN: 1752-2897

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