Orthoplastic reconstruction in children: are the risk factors similar to those observed in adults?

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorIAMAGUCHI, Raquel Bernardelli
dc.contributor.authorCARTOLANO, Ricardo
dc.contributor.authorSILVA, Gustavo Bersani
dc.contributor.authorTORRES, Luciano Ruiz
dc.contributor.authorCHO, Alvaro Baik
dc.contributor.authorWEI, Teng Hsiang
dc.contributor.authorREZENDE, Marcelo Rosa de
dc.contributor.authorJR, Rames Mattar
dc.date.accessioned2022-02-24T17:17:52Z
dc.date.available2022-02-24T17:17:52Z
dc.date.issued2022
dc.description.abstractFree flaps in the pediatric population are less common and when indicated the expectations to avoid amputation are high. The objective of this study is to describe indications and results of free flaps for limb reconstruction. Patients undergoing microsurgical free flaps in an orthopedic hospital were consecutively included in this cross-sectional study, from 2014 to 2020. Data regarding personal medical history, intraoperative microsurgical procedure and laboratory tests were collected. Patients under 18 years of age were included. Complications and free flap outcomes were observed during follow-up. This study included 23 free flaps in 23 patients with orthoplastic reconstruction. The free flap was performed as a reconstructive elevator concept. The most common indications were skin or bone defects caused by trauma (nine patients), tumor (six patients) and congenital pseudarthrosis of the tibia (four patients). The most indicated flap was a vascularized fibular flap in 10 patients, followed by an anterolateral thigh flap in 5 patients. Complications were observed in five patients. In total 93% of patients with inferior limb reconstruction walked at the final evaluation. Among risk factors studied, cases had a higher incidence of complications (P = 0.03) when only the superficial venous system was used. Free flaps in children are well-tolerated and indications are restricted to precise indications to provide alternatives to amputations and improve patient's function. We observed an increase in the incidence of complications when only superficial veins were used for free flap outflow in children.eng
dc.description.indexMEDLINEeng
dc.identifier.citationJOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B, v.31, n.2, p.E227-E235, 2022
dc.identifier.doi10.1097/BPB.0000000000000900
dc.identifier.eissn1473-5865
dc.identifier.issn1060-152X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/44506
dc.language.isoeng
dc.publisherLIPPINCOTT WILLIAMS & WILKINSeng
dc.relation.ispartofJournal of Pediatric Orthopaedics-Part B
dc.rightsrestrictedAccesseng
dc.rights.holderCopyright LIPPINCOTT WILLIAMS & WILKINSeng
dc.subjectchildreneng
dc.subjectfree flapseng
dc.subjectmicrosurgeryeng
dc.subjecttraumaeng
dc.subjecttumoreng
dc.subject.otherfree tissue transfereng
dc.subject.otherlower-extremity traumaeng
dc.subject.otherflap reconstructioneng
dc.subject.othertopical vasodilatorseng
dc.subject.otherdefectseng
dc.subject.othercomplicationseng
dc.subject.othermanagementeng
dc.subject.otherfractureseng
dc.subject.othervasospasmeng
dc.subject.otherserieseng
dc.subject.wosOrthopedicseng
dc.subject.wosPediatricseng
dc.titleOrthoplastic reconstruction in children: are the risk factors similar to those observed in adults?eng
dc.typearticleeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng
dspace.entity.typePublication
hcfmusp.citation.scopus0
hcfmusp.contributor.author-fmusphcIAMAGUCHI, Raquel Bernardelli
hcfmusp.contributor.author-fmusphcCARTOLANO, Ricardo
hcfmusp.contributor.author-fmusphcSILVA, Gustavo Bersani
hcfmusp.contributor.author-fmusphcTORRES, Luciano Ruiz
hcfmusp.contributor.author-fmusphcCHO, Alvaro Baik
hcfmusp.contributor.author-fmusphcWEI, Teng Hsiang
hcfmusp.contributor.author-fmusphcREZENDE, Marcelo Rosa de
hcfmusp.contributor.author-fmusphcJR, Rames Mattar
hcfmusp.description.beginpageE227
hcfmusp.description.endpageE235
hcfmusp.description.issue2
hcfmusp.description.volume31
hcfmusp.jcrJ PEDIATR ORTHOP B
hcfmusp.origemWOS
hcfmusp.origem.pubmed34285161
hcfmusp.origem.scopus2-s2.0-85123968527
hcfmusp.origem.wosWOS:000748918500033
hcfmusp.publisher.cityPHILADELPHIAeng
hcfmusp.publisher.countryUSAeng
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hcfmusp.scopus.lastupdate2024-10-12
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