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. 2023 Sep-Dec;18(3):133-139.
doi: 10.5005/jp-journals-10080-1599.

Artificial Deformity Creation as a Method for Limb Salvage for Patients with Massive Tibial and Soft Tissue Defects: A Report of 26 Cases

Konstantins Plotnikovs  1 , Jekaterina Kamenska  1 , Jevgenijs Movcans  2 , Vitalijs Pasters  2 , Leonid Solomin  3 , Haralds Plaudis  4
Affiliations

Artificial Deformity Creation as a Method for Limb Salvage for Patients with Massive Tibial and Soft Tissue Defects: A Report of 26 Cases

Konstantins Plotnikovs et al. Strategies Trauma Limb Reconstr. 2023 Sep-Dec.

Abstract

Soft tissue and bone defects that occur consequence of high-energy trauma are serious and challenging problems. The aim of this retrospective cohort study is to show that the artificial deformity creation (ADCr) method allows the closure of soft-tissue defects, avoids amputation, and can facilitate the reconstruction of bone defects and restore limb length.

Patients and methods: Twenty-six adult patients (age range 20-81 years) with soft tissue defects of the lower limb were treated at the Riga East University Hospital from 2018 to 2021. All patients were treated using the ADCr method which is the technique of establishing an interim deformity for resolving tissue loss. The lower extremity functional scale (LEFS) and application of methods of ilizarov (ASAMI) criteria were used for the evaluation of bone healing and lower extremity function.

Results: Complete union was achieved in all cases. The functional evaluation showed that most patients could achieve excellent and good results and return to activities of daily living. The functional result was poor in one case of a multi-fragmentary distal tibial articular fracture for which an ankle fusion was performed. Final union in this case was achieved with some residual deformity.

Conclusion: The method of ADCr is an effective surgical technique in cases of severe tibial injuries with concomitant loss of bone and soft tissues. This method could be used in cases when either a plastic or microsurgeon is not available or for instances when closing the defect with a flap is either impossible or contraindicated. Excellent and good functional results are possible without severe complications.

How to cite this article: Plotnikovs K, Kamenska J, Movcans J, et al. Artificial Deformity Creation as a Method for Limb Salvage for Patients with Massive Tibial and Soft Tissue Defects: A Report of 26 Cases. Strategies Trauma Limb Reconstr 2023;18(3):133-139.

Keywords: Artificial deformity creation; Ilizarov; Interim deformity; Limb lengthening; Limb salvage; Ortho-SUV frame.

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Conflict of interest statement

Source of support: Nil Conflict of interest: None

Figures

Fig. 1
Fig. 1
Clinical appearance of the injured limb
Fig. 2
Fig. 2
Clinical appearance after surgical debridement
Fig. 3
Fig. 3
Clinical appearance after application of ADCr method
Fig. 4
Fig. 4
Digital subtraction angiography (DSA) showing vessels in the area of interim limb deformity
Fig. 5
Fig. 5
Tubular external fixator conversion to circular frame
Fig. 6
Fig. 6
Deformity correction using circular fixator hexapod ortho-SUV
Fig. 7
Fig. 7
Clinical appearance of the limb after deformity correction and after hexapod and foot ring removal
See this image and copyright information in PMC

References

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