Hirohiko Suzuki | PubMed Health

PubMed2006

Devastating massive knee defect reconstruction using the cornucopian chimera flap from the subscapular axis: two case reports.

Two cases of successful reconstruction of massive defects around the knee with multiple-island combined flaps based on the subscapular axis are reported. Both defects resulted from aggressive debridement for acute osteomyelitis after open fixation of high-energy fractures around the knee. In Case 1, a four-island combined flap consisting of the scapular flap, the lattissimus dorsi muscle flap, the serratus anterior muscle flap, and the scapular osseous flap, based on the same subscapular axis, was used. Partial bone transport using the Ilizarov apparatus was added as reinforcement of arthrodesis. In Case 2, a five-island combined flap, consisting of the scapular, parascapular flap, the lattissimus dorsi muscle flap, the serratus anterior fascial flap, and the scapular osseous flap, was used. Consequent ankylosis of the knee joint afforded the patient painless full weight bearing without secondary arthrodesis. Multiple-island combined flaps based on the subscapular axis can provide three-dimensional reconstruction of destructive knee defects.

Adult↗

PubMed2003

[Clinical results of hemiarthroplasty for femoral neck fracture].

UNLABELLED: Subsequent clinical results of hemiarthroplasty for the femoral neck fracture over 80 years old was examined. SUBJECTS AND METHODS: One hundred and sixteen post-op. femoral neck fractures (22 males and 94 females, mean age 86 y.o.) were included in this series. Investigation in each case was done about 10 factors (see the article) which might deteriorate post-op. mobility and mortality. RESULTS: In 74.2% of all cases in which 45.5% with senile dementia and 86.7% without senile dementia were included, ability to walk was maintained after the operation with variable degree. In 65 cases without senile dementia, ability to walk after operation was doomed by low degree of ability to walk before the injury, comparable long waiting periods till the operation and consumed condition against some post-op. inflammated complications. The post-op. mortality within 3 months was 3.5% of all cases and 1.5% without senile dementia. DISCUSSION: Since approximately half of the patients with senile dementia completely lost their gait after the operation, even if they could before the injury, an alternative approach which is not aimed to achieve the impractical gait might be needed for such patients. To achieve of better functional and vital prognosis, patients without senile dementia should be operated as soon as possible and organized their pos-op. general conditions intensively.

English Abstract↗