압궤 손상을 입은 80대 환자의 양측 하지 구제 증례

• 영문명: Salvage of Both Lower Limbs with Multiple Crushing Injuries in an Octogenarian
• 발행기관: 대한임상노인의학회
• 간행물 정보: 『대한임상노인의학회지』대한임상노인의학회지 제23권 제1호, 67~71쪽, 전체 5쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2022.06.30

영문 초록

Salvage and reconstruction of crushed lower extremities is a complicated and difficult process, even more so in geriatric patients. An 82-year-old female on hypertension and diabetes medication including anticoagulants with normal pre-injury functional status was admitted for extensive crushing injuries to both lower limbs inflicted by a truck. After orthopedic initial management of multiple open fractures, the patient was referred for wound coverage of the mangled extremities. Though extensive injuries to the joints compounded with her advanced age forecasted poor functional prognosis, limb salvage was attempted to avoid amputation and its consequences. Employing serial debridement and negative pressure wound therapy, the exposed right proximal tibia was covered with a lateral gastrocnemius and hemisoleus flap, and the left ankle open fracture was covered with a delayed reverse sural flap. Skin defects and necrotic areas were ultimately reconstructed with skin grafts. A new right ankle wound caused by a neglected fracture was covered with an anterolateral thigh free flap after fracture fixation. Establishing a proper reconstructive strategy with reliable aspects can enable successful salvage of what initially appeared to be almost hopelessly mangled lower extremities, even in geriatric patients over 80 years of age.

목차

서론

증례

고찰

PATIENT CONSENT

FUNDING

CONFLICT OF INTEREST

REFERENCES

키워드

Crush injuries Limb salvage Octogenarian