Secondary Bony Defects after Soft Tissue Reconstruction in Limb-Threatening Lower Extremity Injuries: Does the Approach to Flap Elevation Matter?

• DOI: 10.1055/s-0043-1768219
• Publication Date: 2023-04-26T19:12:14Z
• Authors: Cynthia E. Burke; Lily R. Mundy; Jayesh Gupta; Alison L. Wong; Blessing Enobun; Nathan N. O'Hara; Abdulai Bangura; Katherine C. O'Co...; Julio J. Jauregui; Nathan F. Miller; Robert V. O'Toole; Raymond A. Pensy
• Keywords: 0302 clinical medicine; 3. Good health

Limb-threatening lower extremity injuries often require secondary bone grafting after soft tissue reconstruction. We hypothesized that there would be fewer wound complications when performing via a remote surgical approach rather than direct flap elevation. A retrospective cohort study was performed at single Level 1 trauma center comparing in patients who had undergone previous reconstruction open tibia fractures between 2006 and 2020. Comparing incision versus elevation, we evaluated dehiscence requiring return to the operating room as primary outcome. Secondary outcomes were deep infection delayed amputation. identified 129 (mean age: 40 years, 82% male) with 159 procedures. 54% (n = 86) elevation 46% 73) of cases. Wound occurred one patient group (1%) none approach. The odds (OR, 1.77; p 0.31) or amputation 1.43; 0.73) did not significantly differ approaches. No significant differences found reconstructive surgeon elevating re-insetting orthopaedic re-inset. Direct for result more These findings should reassure surgeons allow other clinical factors influence grafting.