BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported...BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.展开更多
Perforator-pedicled propeller flaps, which base their blood supply on isolated perforators, have been gaining popularityamong plastic surgeons over the past two decades. They have proven to be of great value in the re...Perforator-pedicled propeller flaps, which base their blood supply on isolated perforators, have been gaining popularityamong plastic surgeons over the past two decades. They have proven to be of great value in the reconstruction of soft tissue defects in different areas of the body but are, thanks to their maximal mobility, mostly used in the reconstruction of extremities. In this article, we focus on perforator-pedicled propeller flaps in lower limb reconstruction, where they can be implemented in the coverage of primary as well as secondary soft tissue defects. Firstly, a brief literature review on evolution of propeller flap use in lower extremity is provided. Moreover, we present our surgical technique including the use of indocyanine green real-time angiography for reliable flap transfer. In addition, we report 3 cases of patients in whom we used a local propeller flap for the closure of skin defects in different parts of the leg.展开更多
The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherap...The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherapy,followed by wide excision and soft tissue reconstruction in the form of vascularised soft tissue transfer. Although limb salvage is now readily achievable, the resultant functional disabilities following excision of major musculotendinous and neurovascular structures can be life changing. In recent years, there has been a move towards functional limb reconstruction in the form of free functioning muscle transfer. This paper reviews the advances in functional limb reconstruction in the setting of preoperative radiation and reports our experience in this challenging reconstructive field.展开更多
文摘BACKGROUND The Limb Lengthening and Reconstruction Society(LLRS)is a premier orthopedic specialty organization that promotes limb reconstruction for all ages.LLRS membership characteristics,however,are poorly reported.This study delineates orthopedic surgeon LLRS members’demographic traits,academic achievement,leadership attainment,and geographical distribution across the United States.AIM To inform aspiring orthopedic professionals,as well as to promote growth and diversity in both the LLRS organization and overarching field.METHODS This cross-sectional study examined United States LLRS members’academic,leadership,demographic,and geographical attributes.After reviewing the 2023 LLRS member directory,Google search results were matched to the listings and appended to the compiled data.Sex and ethnicity were evaluated visually utilizing retrieved images.The Hirsch index(H-index)of academic activity,residency and fellowship training,other graduate degrees,leadership positions,practice type(academic or non-academic),and spoken languages were categorized.LLRS members per state and capita determined geographic distribution.The Mann Whitney U test was applied to compare H-index between males and females,as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.RESULTS The study included 101 orthopedic surgeons,78(77.23%)Caucasian and 23(22.77%)non-Caucasian,79(78.22%)male and 22(21.78%)female.Surgeons with DO degrees comprised only 3.96%(4)of the cohort,while the vast majority held MDs[96.04%(97)].Mean H-index was 10.55,with male surgeons having a significantly higher score(P=0.002).Most orthopedic surgeons(88.12%,)practiced in academic centers.Of those professionals who occupied leadership positions,14%were women,while 86%were men.Additionally,19(37.25%)United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon.Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.CONCLUSION Over 21%of LLRS members are women,surpassing prior benchmarks noted in orthopedic faculty reporting.LLRS members’high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space.Gender disparities in leadership remain,however,necessitating greater equity efforts.A low rate of LLRS representation per capita must be addressed geographically as well,to affect improvements in regional care access.This study can serve to support aspiring orthopedic professionals,inform diversity,leadership,and field advancement strategies,and maintain the continued goal of enhanced patient care worldwide.
文摘Perforator-pedicled propeller flaps, which base their blood supply on isolated perforators, have been gaining popularityamong plastic surgeons over the past two decades. They have proven to be of great value in the reconstruction of soft tissue defects in different areas of the body but are, thanks to their maximal mobility, mostly used in the reconstruction of extremities. In this article, we focus on perforator-pedicled propeller flaps in lower limb reconstruction, where they can be implemented in the coverage of primary as well as secondary soft tissue defects. Firstly, a brief literature review on evolution of propeller flap use in lower extremity is provided. Moreover, we present our surgical technique including the use of indocyanine green real-time angiography for reliable flap transfer. In addition, we report 3 cases of patients in whom we used a local propeller flap for the closure of skin defects in different parts of the leg.
文摘The management of extremity soft tissue sarcoma is constantly evolving, and, in recent decades, limb salvage has been the main goal. More commonly, this is being achieved with a combination of neo-adjuvant radiotherapy,followed by wide excision and soft tissue reconstruction in the form of vascularised soft tissue transfer. Although limb salvage is now readily achievable, the resultant functional disabilities following excision of major musculotendinous and neurovascular structures can be life changing. In recent years, there has been a move towards functional limb reconstruction in the form of free functioning muscle transfer. This paper reviews the advances in functional limb reconstruction in the setting of preoperative radiation and reports our experience in this challenging reconstructive field.
