Ibrahim Tabakan

and 3 more

Background: The aim of the study is to make epidemiologic analysis of pediatric maxillafacial traumas and discuss the mechanisms of injury, etiology, treatment approaches and complications by comparing with adult maxillofacial traumas. Method: Pediatric maxillofacial trauma patients who presented to the Department of Plastic, Reconstructive and Aesthetic Surgery at our hospital, for 5 years between 2014 and 2018 were evaluated retrospectively. Age and gender distributions of the patients were determined. Duration of hospitalization, etiology of trauma, location of the fracture, and treatment methods applied were determined, and the results of these treatments and complications that developed were evaluated. Results: The fractures were the most common at the age of 17 years (17.2%). The most common cause of trauma in patients operated for maxillofacial trauma was fall (48.3%). Most operations were performed in the age range of 12–18 years (49.4%), and panfacial fractures were the most frequently operated fracture localization (27.58%). Conclusion: The simplest and most effective treatment should be applied for pediatric maxillofacial trauma. While conservative treatments may be sufficient in minimally displaced fractures, open reduction and internal fixation methods are applied in fractures with greater displacement. Fixation materials must necessarily be removed since they prevent bone growth. The use of bioabsorbable plates has been limited in recent years due to their high costs.

Cengiz Eser

and 5 more

Background: Reconstruction of Achilles tendon and the overlying tissue defects is a challenging undertaking. The spectrum of available repair methods range from secondary healing to use of free flaps. Method: In this study, we retrospectively evaluated 14 patients who underwent reconstruction of Achilles region defect between 2016 and 2019 at a single center. Results: Reconstructions were performed with secondary healing (n=2), negative pressure wound therapy and skin grafting (n=2), free flaps (n=6), and local and distant flaps (n=4). Satisfactory aesthetic and functional outcomes were achieved in all patients. One patient developed partial skin graft loss. Marginal necrosis occurred in one of the local flaps. Wound dehiscence and flap retraction occurred in one of the free (superficial circumflex iliac artery perforator) flaps. One patient undergoing reconstruction with ulnar artery perforator flap developed intraoperative atrial fibrillation; the operation was terminated and reconstruction completed with skin grafting. Conclusion: Orthoplastic reconstruction should be kept in mind for Achilles tendon defects. Use of special digital imaging techniques facilitates flap surgery and helps minimize the risk of flap complications. Conventional approaches are suitable for shallow small skin lesions. Local flaps are good options for deeper skin defects owing to superior aesthetic outcomes. Superthin free flaps offer a distinct advantage in skillful hands. Use of multi-content free chimeric flaps for reconstruction of complex defects facilitates better anatomical repair. Cross leg or flow-through flaps may be considered in patients with compromised distal circulation. Selection of the most reliable approach for Achilles reconstruction is a key imperative to achieve favorable outcomes.