Clinical applications of free arterialized venous flaps

WOS: 000345527100026PubMed ID: 24961162Venous flaps are flaps by which tissue perfusion is accessed through the venous network. Despite originally being questioned due to potential perfusion problems, as the dynamics of tissue perfusion have been more fully comprehended, venous flaps appear to have a far wider range of application than first thought. In our study, we analyzed the clinical results of the applications of free arterialized venous flaps along with the factors that can affect flap survival. Forty-one flaps were assessed retrospectively. Type of the trauma, traumatized area, the time duration between trauma and application of the flap, donor area, type and count of the anastomosis, encountered complications, and flap survival rates were analyzed. Regression and classification trees were used to study the relationship between flap surface area, anastomosis count, and flap survival. Circulatory abnormalities such as early congestion and edema were seen in 53.6% of the applied flaps. A total of four flaps (9.7%) developed necrosis which presented as full thickness in three flaps and partial thickness in one flap. It can be said that there was a weak but positive correlation between the size of the flap area and the number of anastomosis. Although the results of arterialized venous flaps are inconsistent in the literature, those flaps can be preferred as an alternative treatment option in single finger defects where tissue compatibility and cosmetic results are quite impressive. In the meantime, syndactylized venous flaps are the preferred method regarding multiple finger soft-tissue defects. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved

Ultrasonic Evaluation of the Flexor Pollicis Longus Tendon Following Volar Plate Fixation for Distal Radius Fractures

WOS: 000372018800007PubMed: 26787412Purpose To evaluate with ultrasound the thickness of the flexor pollicis longus (FPL) tendon and its relationship to the volar locking plate after the fixation of distal radius fractures. Methods We evaluated 27 type C2 and C3 distal radius fractures with ultrasound to evaluate damage to the FPL tendon after volar plate fixation. The thickness of the FPL tendon and its distance to the volar plate in the involved wrists and to the volar rim in the contralateral uninjured wrist were measured on sonograms taken 12 months postoperatively. Measurements of the involved wrists were compared with those of the intact wrists. Results The mean plate-tendon distance in the involved wrist was considerably shorter than the mean volar rim-tendon distance in the intact wrist, and the FPL tendon was considerably thicker in the involved wrist than in the intact wrist. Conclusions In distal radial fractures treated with volar locking plates, increases in the thickness of the FPL tendon and a consequent decrease in the distance between the tendon and the plate can be determined with ultrasonography. This finding is a warning that asymptomatic tenosynovitis may eventually cause tendon ruptures. (Copyright (C) 2016 by the American Society for Surgery of the Hand. All rights reserved.

Validity of ultrasonography in surgically treated zone 2 flexor tendon injuries

Objectives: The purpose of this study was to determine the validity of ultrasonography (USG) with surgical confirmation in surgically treated zone 2 flexor tendon injuries

Comparison of ultrasound and dorsal horizon radiographic view for the detection of dorsal screw penetration

WOS: 000422850300004PubMed ID: 29092760Objective: The aim of this study was to compare the efficiency of dorsal tangential fluoroscopy and ultrasonography in detecting dorsal screw penetration in distal radius volar locking plate applications. Methods: Ten cadaveric forearms were operated. The distal four screws were protruded 0, 1 and 2 mm into each of the second, third and fourth dorsal compartments of distal radius. Dorsal horizon views were taken using fluoroscopy. Each radiographic image was evaluated by two orthopedic surgeons who are blinded to procedure. Sonographic evaluations were performed by an orthopedic surgeon blinded to the procedure. Both dorsal horizon view and ultrasonography assessments were noted by the evaluators whether the tip of the screw penetrated or not the dorsal cortex for each compartment. Results: No significant difference was observed on correct detection of 0 mm, 1 mm and 2 mm screw penetrations at second and third compartments. In the fourth compartment, there was no difference with 0 mm and 2 mm penetrations but correct detection accuracy of 1 mm screw penetration was 87% in ultrasonography group and 71% in dorsal horizon view group. Conclusions: The accuracy of ultrasonography on 1 mm penetration at the fourth compartment is better than dorsal horizon view. However, dorsal horizon view and ultrasonography accuracy is similar for the other compartments and penetration levels. Ultrasonography is a reliable and effective procedure for detection of dorsal screw penetrations. (c) 2017 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V