Mini-Review: Tendon-Exposed Wound Treatments.

BACKGROUND: Tendon-exposed wounds are complex injuries with challenging reconstructions and no unified treatment mode. Furthermore, insufficient tissue volume and blood circulation disorders affect healing, which increases pain for the patient and affects their families and caretakers. REVIEW: As modern medicine advances, considerable progress has been made in understanding and treating tendon-exposed wounds, and current research encompasses both macro-and micro-studies. Additionally, new treatment methods have emerged alongside the classic surgical methods, such as new dressing therapies, vacuum sealing drainage combination therapy, platelet-rich plasma therapy, and live-cell bioengineering. CONCLUSIONS: This review summarizes the latest treatment methods for tendon-exposed wounds to provide ideas and improve their treatment.

Solitary bone plasmacytoma of the tibia presenting as chronic osteomyelitis: A rare case report and literature review.

RATIONALE: Plasmacytoma is a rare plasma cell dyscrasia that grows within the axial skeleton or soft tissue structures as solitary or multiple masses. The primary types are solitary plasmacytoma, including solitary bone plasmacytoma (SBP) and solitary extramedullary plasmacytoma, and multiple solitary plasmacytomas. SBP is characterized by localized proliferation of monoclonal plasma cells and is rare. However, SBP with chronic osteomyelitis is even rarer. PATIENT CONCERNS: A 47-year-old man previously diagnosed with chronic osteomyelitis presented with repeated discharge and ulceration in the front of his right tibia. DIAGNOSIS, INTERVENTIONS AND OUTCOMES: Lower extremity magnetic resonance imaging (MRI) and computed tomography (CT) examinations showed dead bone formation and surrounding inflammatory edema. Thus, the patient underwent dead bone excision and fenestration of the bone marrow cavity. The histopathologic examination results indicated plasmacytoma. Therefore, we administered radiotherapy with satisfactory results. LESSONS: Physicians should pay close attention to chronic osteomyelitis because it may be accompanied by plasmacytoma. Postoperative pathological and immunohistochemical examinations are crucial, and surgical resection of the lesion and local radiotherapy are effective treatment methods.

The efficacy and safety of platelet-rich plasma in the tendon-exposed wounds: a preliminary study.

OBJECTIVE: Currently, among wounds with large skin tissue defects caused by various reasons, the treatment of refractory wounds is still a major clinical problem. This study is aimed to preliminarily assess the therapeutic potentials of platelet-rich plasma (PRP) in refractory wounds with exposed tendons, as well as corresponding efficacy and safety. METHODS: A total of 12 patients (5 males and 7 females) with refractory wounds and exposed tendons who were admitted to our hospital from June 2018 to December 2020 were included in this study. After the preparation of PRP, the included patients underwent the PRP injection after the debridement of wounds, and the efficacy and prognosis were assessed by the same group of senior surgeons. RESULTS: The average age of included patients was 42.7 ± 12.9 years, and the causes of injury included traffic accidents (3 cases), contusion (2 cases), burns (2 cases), diabetes complications (4 cases), and melanoma complications (1 cases). The average healing time was 23.0 ± 5.0 days, and the mean size of the wound was 3.1 × 5.1 cm2. During the whole treatment process, Vancouver Scar Scale (VSS) decreased from 7.4 ± 1.6 before PRP treatment to 3.6 ± 0.9 after treatment (P < 0.001), Manchester Scar Scale (MSS) decreased from 12.3 ± 4.5 before PRP treatment to 5.4 ± 1.2 after treatment (P < 0.001), and no redness and swelling were observed around wounds, the size and degree of wounds gradually reduced, the coverage rate of granulation tissue was acceptable, overall quality of scar was relatively good, skin sensitivity around wounds was normal, there was no local wounds secretion, and postoperative patient's satisfaction was relatively good during follow-up. CONCLUSIONS: Our study has preliminarily indicated that PRP can promote the wounds healing, reduce the inflammation around wounds, and improve the granulation tissue and angiogenesis, thereby effectively polishing up the safety and efficacy.

Clinical application of multiple 3D-printed guide plates for precise reduction and fixation of comminuted patellar fractures.

Because of the lack of anatomical landmarks during reduction of multiple articular surfaces and fragments in comminuted patellar fractures, loss of bone fragments or aggravation of soft tissue and ligament injuries readily occurs. In the present case, we used multiple three-dimensional (3D)-printed guide plates to reduce and fix a comminuted patellar fracture. A 22-year-old man was hospitalized for 2 days because of left knee joint pain and limited movement caused by a traffic accident. Preoperative imaging revealed a comminuted fracture of the left patella (type 34-C3 according to the AO/OTA classification). Throughout a 2-year follow-up, the patient remained in generally good condition with no significant limitation of his left knee joint activity. Application of multiple 3D-printed guide plates is a safe and effective auxiliary technique for the treatment of comminuted patellar fractures. This novel technique can shorten the operation time, reduce the number of fluoroscopic procedures, and ensure fracture healing and recovery of knee joint function through reliable reduction of the articular surface.