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PubMedDate not supplied

The stubbed great toe: importance of early recognition and treatment of open fractures of the distal phalanx.

Stubbing injuries to the great toe can be a cause of occult open fractures and osteomyelitis. Five such patients were identified after conducting a retrospective review of injuries to the hallux between January 1998 and December 1998. The study was conducted to draw attention to the association between this trivial trauma and its possible complications. All five children had open fractures of the distal phalanx of the great toe. Osteomyelitis did not develop in the children whose injuries were recognized early and who were treated with antibiotics. However, three children with delayed diagnoses and treatment developed osteomyelitis. At a mean follow-up of 10 months (range, 9-11) after injury, all five fractures had healed with no active signs of infection. Two of these children experienced a partial growth arrest and two experienced a full growth arrest of the distal phalanx of the great toe, the significance of which is yet unknown. Clinical signs such as bleeding from the eponychium and a laceration proximal to the nail bed should alert physicians to the presence of a possible open fracture. Early detection and treatment of these injuries may reduce or eliminate hospital stays and prolonged intravenous antibiotic treatment for osteomyelitis.

Child↗
PubMed1994

Cross-leg free muscle flaps for reconstruction of open fractures of the tibia.

In two patients in whom the injured leg was not suitable for reconstruction using a routine free tissue transfer, a cross-leg free muscle flap was used, i.e. the vessels of a free muscle flap were anastomosed to donor vessels on the uninjured leg and the muscle flap used to reconstruct a defect on the opposite leg. Both operations were successful, with the transferred muscle becoming well vascularized from the recipient bed at the site of injury. In both cases, use of the uninjured leg to transfer the free flap caused minimal morbidity.

Adolescent↗
PubMed1989

[Reconstruction of open fractures of the leg associated with extensive loss of skin and soft tissues using muscular and cutaneo-muscular flaps].

The author draws attention to the serious character of open fractures of the leg with extensive losses of the skin and soft tissues. He emphasizes the need of high standard primary surgical treatment and osteosynthesis of the fracture by external fixation device according to a therapeutic plan. To ensure an undisturbed consolidation of the fracture in indicated cases, the author implements the reconstruction of acute skin losses and soft tissue losses by a muscular flap of the m. soleus or m. tibialis ant. and by dermatomuscular flaps of the gastrocnemius muscle. Of 42 casualties with open fractures of the leg with losses of soft tissues the author made in 9 reconstructions of acute losses by muscular and dermatomuscular flaps. The author presents the documentation of two patients with open fractures of the leg who were treated by muscular and dermatomuscular flaps.

Fracture Fixation, Internal↗