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 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

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.

Back to article page

ISSN: 1752-2897

Contact us

General enquiries: info@biomedcentral.com

Journal of Trauma Management & Outcomes

Contact us