OBJECTIVE: This review aimed to present the experience of the Micro-surgery Unit of the Department of Orthopedics of the UP-PGH, in the use of fasciocutaneous rotation-advancement flap coverage for sacral decubitus ulcers.

METHODS: A review of patient referred to the unit of management of sacral decubitus ulcers, from 2003-2009. All patients with grades III or IV ulcers, managed with fasciocutaneous flap coverage, and with a minimum follow-up of 1 month were included in the study. Demographic data for all patients were retrieved including albumin level at the time of surgery, operative time, blood loss, complication and status of flap.

RESULTS: Twenty-five patients were included in the analysis. The mean age of the patients was 57 years (with a range of 18-78 years). The average operative time was 2.7 hours±1.1 hours and the average blood loss was 428 ml (range, 100 - 500 ml). With a mean follow-up of 9.6 months, there were 3 recurrences and 2 mortalities. Twelve complications were documented in the 25 patients. Seventy-two percent (18/25) had healed sacral flaps on final follow-up.

Human ; Pressure Ulcer ; Ulcer ; Orthopedics ; Operative Time ; Surgical Flaps ; Bleeding Time ; Sacrum ; Orthopedic Procedures ; Recurrence ; Albumins

Introduction: Controversies exist in treatment of proximal humerus fractures as treatment options vary greatly from conservative management, closed pinning, stacked intramedullary nails, plating and hemi-arthroplasty. The purpose of this study is to study the fracture patterns of each case and document the functional outcome and complications post-operative in the management of proximal humerus fractures operated with proximal humerus plate. Materials and Methods: Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded. Results: In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4- part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer’s type 3, 60-year-old female) and one had varus collapse (Neer’s type 3, 45-year-old male). Conclusion: Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.