RESUMO
The reconstruction of the injured tissue around the knee is a complex procedure for the plastic and orthopaedic surgeon. The objective is to provide an acceptable function and aesthetic result. Successful wound management includes meticulous debridement, planning and proper execution of the surgical procedure. An 11-year-old male patient with a right patellar fracture using an anterolateral thigh flap with reverse flow to cover the skin defect. For such purposes, the reverse flow anterolateral flap is an effective, trustworthy and well-documented option. The correct obtaining and implantation of the flap reduces the morbidity of the donor site, offers options in size and design, an adequate length of the pedicle and the possible combination with the fascia lata in case it is required. The versatility of the reverse flow anterolateral flap makes it a possible therapeutic alternative in reconstructive surgery since it is aesthetic and functional for the reconstruction of tissue near the knee joint.
RESUMO
Background: Scleroderma is a rare disease of the tissues that is characterized for being inflammatory and developing fibrosis in the skin. Typically, this disease affects middle-aged women.Methods: A study was conducted in which 10 patients with scleroderma with involvement in the sclerotic stage were included. One of the hands was chosen randomly for treatment with fatty graft processed by Coleman technique and the other hand, physiological solution was placed. Patients were evaluated at 45 and 90 days after the procedure using the Cochin Hand Functional Scale (CHFS) questionnaire, modified Rodnan scale for the skin (mRSS), grip strength with dynamometer and measurement of fingertip to palm of hand in flexion.Results: The average of CHFS before treatment was 42.30 and 25.70 at 90 days p=0.007. The average strength in the experimental hand before treatment was 11.67 and 14.58 at 90 days p=0.007, in the control hand p=0.873. The mean finger-palm tip distance before treatment was 44.80 and from 36.00 to 90 days p=0.019, in the control hand p=0.149. There is a significant difference in the degree of severity at 90 days of the mRSS of the back of the hands p=0.011 and phalanges p=0.000 between the patients with lipoinjection and physiological solution.Conclusion: Significant improvement was observed in patients with scleroderma treated with autologous lipoinjection.