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Treatment of Osteochondral Defects in the Rabbit's Knee Joint by Implantation of Allogeneic Mesenchymal Stem Cells in Fibrin Clots
Published on: May 21, 2013
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[Options for soft tissue reconstruction in pseudarthrosis].
T Cordts1, A K Bigdeli2, C Hirche2
1Klinik für Hand‑, Plastische und Rekonstruktive Chirurgie, Mikrochirurgie - Schwerbrandverletztenzentrum, BG Klinik Ludwigshafen, Ludwig-Guttmann-Str. 13, 67071, Ludwigshafen, Deutschland. tomke.cordts@bgu-ludwigshafen.de.
Der Unfallchirurg
|August 2, 2020
Summary
Treating pseudarthrosis with soft tissue defects requires interdisciplinary collaboration. Vascularized flaps are preferred for reconstruction, optimizing bone consolidation and wound healing in complex orthopedic cases.
Area of Science:
- Orthopedic Surgery
- Plastic Surgery
- Reconstructive Surgery
Background:
- Pseudarthrosis is a challenging complication following fracture treatment or orthopedic surgery.
- Large soft tissue defects and impaired wound healing complicate pseudarthrosis treatment.
- Interdisciplinary coordination between trauma and plastic surgeons is essential for effective management.
Purpose of the Study:
- To outline an interdisciplinary approach for managing pseudarthrosis with soft tissue defects.
- To highlight the importance of timely soft tissue reconstruction.
- To discuss surgical strategies for bone and soft tissue reconstruction.
Main Methods:
- Prioritizing timely soft tissue reconstruction using pedicled vascularized or free flaps.
- Optimizing limb circulation through vascular intervention or bypass surgery if compromised.
- Performing consecutive bone and soft tissue reconstruction in a single procedure for aseptic pseudarthrosis.
- Resecting infected debris before wound closure for septic pseudarthrosis.
Main Results:
- Vascularized flaps promote bone consolidation and aid in managing osteomyelitis.
- Specific flap examples include latissimus dorsi muscle and anterolateral thigh (ALT) flaps.
- Fasciocutaneous flaps are advantageous when future bone consolidation interventions are anticipated.
Conclusions:
- Effective pseudarthrosis management necessitates a coordinated, interdisciplinary approach.
- Timely soft tissue reconstruction with vascularized flaps is crucial for successful outcomes.
- Surgical strategy should be tailored to the specific type of pseudarthrosis (aseptic vs. septic) and anticipated future interventions.
