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Free and pedicle flaps in lower extremity trauma

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Abstract

Improvements in microsurgical techniques and perioperative management have led to more attempts at limb salvage surgery after severe extremity trauma. Although some microsurgery-trained orthopedic surgeons will perform extremity soft tissue reconstruction, many rely on plastic surgeons or hand surgeons. However, the orthopedic trauma surgeon often remains the principle decision maker in the follow-up of these patients. Therefore, orthopedic surgeons should have a clear understanding of the planning and execution of flap reconstruction of the traumatized extremities. Collaboration with the microsurgery team will also improve planning of orthopedic procedures and facilitate a better understanding of the expected outcomes after tissue transfer. This becomes especially important when considering, debridement, early amputation versus extensive soft tissue reconstruction and when discussing these alternatives with patients and family as well as postoperative course. The goals of this article are to provide orthopedic trauma surgeons with an understanding of the selection, planning, and execution of tissue transfers for posttraumatic extremity reconstruction and to review their successes and outcomes in the literature. Communication between teams involved in reconstruction of the traumatized extremity and an understanding of limitations are paramount to successful outcomes after reconstruction.

Level of Evidence: Not ratable.

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Conflict of interest

Dr. Sen has the following consulting and disclosures a consultant for Stryker Orthopedics and has consulted for Smith and Nephew as well. He has also recently received research funding from Synthes USA. However, regarding this paper, he has no conflicts with this paper.

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Authors and Affiliations

  1. Division of Trauma, Critical Care and General Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, USA

    Johnathon M. Aho

  2. University of Texas Medical School at Houston, Houston, TX, USA

    Milan K. Sen

  3. Plastic and Reconstructive Surgery, Mayo Clinic, 200 1st ST SW, Rochester, MN, USA

    Michel Saint-Cyr

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  1. Johnathon M. Aho
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  2. Milan K. Sen
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  3. Michel Saint-Cyr
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Correspondence to Michel Saint-Cyr.

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Aho, J.M., Sen, M.K. & Saint-Cyr, M. Free and pedicle flaps in lower extremity trauma. Eur J Plast Surg 38, 171–182 (2015). https://doi.org/10.1007/s00238-014-1056-z

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  • DOI: https://doi.org/10.1007/s00238-014-1056-z

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