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        Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

        Chui, Christopher Hoe-Kong,Wong, Chin-Ho,Chew, Winston Y.,Low, Mun-Hon,Tan, Bien-Keem Korean Society of Plastic and Reconstructive Surge 2012 Archives of Plastic Surgery Vol.39 No.2

        Background : Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods : A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results : We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from $4{\times}9cm$ ($36cm^2$) to $15{\times}30cm$ ($450cm^2$) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11 to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was $102^{\circ}$ (range, $45^{\circ}$ to $140^{\circ}$). Conclusions : In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and, access to fascia lata grafts for reconstruction of the triceps tendon.

      • KCI등재

        Use of the Fix and Flap Approach to Complex Open Elbow Injury: The Role of the Free Anterolateral Thigh Flap

        Christopher Hoe-Kong Chui,Chin-Ho Wong,Winston Y Chew,Mun-Hon Low,Bien-Keem Tan 대한성형외과학회 2012 Archives of Plastic Surgery Vol.39 No.2

        Background Complex elbow injuries with associated nerve, muscle, or joint injury commonly develop post-inury stiffness. In order to preserve function, joint congruency, elbow stability and durable wound coverage must be achieved in a timely manner. Methods A retrospective review of patients who underwent orthopaedic fixation followed by free anterolateral thigh (ALT) flap soft tissue coverage was performed. Five patients were identified and included in this study. Results We present a series of 5 cases managed with this principle. Soft tissue defects ranged in size from 4×9 cm (36 cm2) to 15×30 cm (450 cm2) and were located either posteriorly (n=4) or anteriorly (n=1). Associated injuries included open fractures (n=3) and motor nerve transection (n=2). Wound coverage was achieved in a mean duration of 18.8 days (range, 11to 42 day). There were no flap failures and no major complications. The mean postoperative active elbow motion was 102° (range, 45° to 140°). Conclusions In our small series we have highlighted the safety and utility of using the free ALT flap in complex elbow injuries. The ALT flap has many advantages which include abundant skin and subcutaneous tissue; vascularised vastus lateralis muscle that was used in our series to obliterate dead space, provide a vascular bed for nerve grafts and combat infection; and,access to fascia lata grafts for reconstruction of the triceps tendon.

      • KCI등재

        Men’s Health Index: A Pragmatic Approach to Stratifying and Optimizing Men’s Health

        Hui Meng Tan,Wei Phin Tan,Jun Hoe Wong,Christopher Chee Kong Ho,Chin Hai Teo,Chirk Jenn Ng 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.11

        Purpose: The proposed Men’s Health Index (MHI) aims to provide a practical and systematicframework for comprehensively assessing and stratifying older men with theintention of optimising their health and functional status. Materials and Methods: A literature search was conducted using PubMed from 1980to 2012. We specifically looked for instruments which: assess men’s health, frailty andfitness; predict life expectancy, mortality and morbidities. The instruments were assessedby the researchers who then agreed on the tools to be included in the MHI. Whenthere was disagreements, the researchers discussed and reached a consensus guidedby the principle that the MHI could be used in the primary care setting targetting menaged 55-65 years. Results: The instruments chosen include the Charlson’s Combined Comorbidity-AgeIndex; the International Index of Erectile Function-5; the International ProstateSymptom Score; the Androgen Deficiency in Aging Male; the Survey of Health, Ageingand Retirement in Europe Frailty Instrument; the Sitting-Rising Test; the SeniorFitness Test; the Fitness Assessment Score; and the Depression Anxiety StressScale-21. A pilot test on eight men was carried out and showed that the men’s healthindex is viable. Conclusions: The concept of assessing, stratifying, and optimizing men’s health shouldbe incorporated into routine health care, and this can be implemented by using the MHI. This index is particularly useful to primary care physicians who are in a strategic positionto engage men at the peri-retirement age in a conversation about their life goalsbased on their current and predicted health status.

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