"External Fixation Tower" for Lower Extremity Microvascular Reconstruction With All-around Protection and...

Area of Science:

• Orthopedics
• Plastic Surgery
• Reconstructive Surgery

Background:

• Traditional splinting methods are inadequate for complex lower extremity free flap reconstructions.
• Existing methods often fail to prevent complications such as equinus contracture and pressure ulcers.
• Proper postoperative management is crucial for flap survival and functional recovery.

Purpose of the Study:

• To introduce and evaluate a novel external fixation tower system for postoperative management in lower extremity free flap reconstruction.
• To demonstrate the efficacy of the Hoffmann 3 external fixation system in protecting reconstructed flaps and preventing complications.
• To assess the system's role in facilitating early rehabilitation and ambulation.

Main Methods:

• A case report detailing the use of the Hoffmann 3 external fixation system in a 73-year-old male patient with diabetic gangrene requiring Achilles tendon and heel reconstruction.
• Application of the external fixation tower for circumferential foot protection, pressure offloading, and ankle joint stabilization.
• Progressive adaptation of the external fixator configuration during the postoperative recovery period.

Main Results:

• The external fixation tower provided comprehensive protection, including vascular anastomotic site security, total pressure offloading, and flap elevation.
• The system effectively prevented equinus contracture and pressure ulcers, while allowing for gauze placement.
• The patient experienced an uneventful postoperative course, with successful flap perfusion stabilization and progressive simplification of the fixator.
• Rehabilitation and ambulation were initiated while the patient was still wearing the external fixation device.

Conclusions:

• The Hoffmann 3 external fixation system offers a versatile and effective solution for postoperative management in lower extremity free flap reconstruction.
• This method provides all-around protection, allows for clinical adaptability, and facilitates early rehabilitation and ambulation.
• The use of the external fixation tower can significantly reduce postoperative complications and the burden of postoperative care, leading to favorable outcomes.