{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:13:42Z","timestamp":1788434022754,"version":"build-2803163510"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 70-year-old woman who sustained Gustilo type III open and comminuted tibial fractures presented with extensive soft-tissue defect. Definitive surgery was performed using a free latissimus dorsi muscle flap for the extensive soft-tissue defect and Ilizarov external fixation (IEF) to stabilize the fractures and arthrodese the ankle. Ankle arthrodesis was accomplished by the wires penetrating the implanted muscle flap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The combined free flap and IEF management protocol described in this report was effective in achieving early weight-bearing and prompt bone healing in an elderly patient with poor bone quality and extensive open and comminuted fractures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00346","type":"journal-article","created":{"date-parts":[[2020,6,17]],"date-time":"2020-06-17T10:01:44Z","timestamp":1592388104000},"page":"e19.00346-e19.00346","source":"Crossref","is-referenced-by-count":6,"title":["Gustilo Type III Open and Comminuted Tibial Fractures Managed by Simultaneous Combination of a Free Latissimus Dorsi Muscle Flap and Ilizarov External Fixation"],"prefix":"10.2106","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8134-1098","authenticated-orcid":false,"given":"Mitsuhiko","family":"Takahashi","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7929-603X","authenticated-orcid":false,"given":"Joji","family":"Iwase","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-2491","authenticated-orcid":false,"given":"Mitsunobu","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3587-3552","authenticated-orcid":false,"given":"Hirofumi","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7050-0567","authenticated-orcid":false,"given":"Hiroshi","family":"Egawa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-3749","authenticated-orcid":false,"given":"Hiromichi","family":"Sedo","sequence":"additional","affiliation":[{"name":"Plastic and Reconstructive Surgery, Tokushima Prefectural Central Hospital, Tokushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020]]},"reference":[{"issue":"332","key":"bib1-20230720","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00003086-199611000-00007","article-title":"Combined muscle flap and Ilizarov reconstruction for bone and soft tissue defects","author":"Lowenberg","year":"1996","journal-title":"Clin Orthop Relat Res."},{"issue":"4","key":"bib2-20230720","first-page":"371","article-title":"The lower extremity functional scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network","volume":"79","author":"Binkley","year":"1999","journal-title":"Phys Ther."},{"issue":"2","key":"bib3-20230720","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1111\/j.1532-5415.1991.tb01616.x","article-title":"The timed \u201cup & go\u201d: a test of basic functional mobility for frail elderly persons","volume":"39","author":"Podsiadlo","year":"1991","journal-title":"J Am Geriatr Soc."},{"issue":"6","key":"bib4-20230720","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1007\/s00264-010-1023-7","article-title":"Role of early Ilizarov ring fixator in the definitive management of type II, IIIA and IIIB open tibial shaft fractures","volume":"35","author":"Wani","year":"2011","journal-title":"Int Orthop."},{"issue":"4","key":"bib5-20230720","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.injury.2015.01.025","article-title":"Grade 3 open tibial shaft fractures treated with a circular frame, functional outcome and systematic review of literature","volume":"46","author":"Dickson","year":"2015","journal-title":"Injury."},{"issue":"2","key":"bib6-20230720","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1177\/230949900401200215","article-title":"Unreamed interlocking nailing in open fractures of tibia","volume":"12","author":"Joshi","year":"2004","journal-title":"J Orthop Surg (Hong Kong)."},{"issue":"1","key":"bib7-20230720","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1097\/SAP.0b013e31803403c8","article-title":"Gustilo grade IIIB tibial fractures requiring microvascular free flaps: external fixation versus intramedullary rod fixation","volume":"59","author":"Rohde","year":"2007","journal-title":"Ann Plast Surg."},{"issue":"4","key":"bib8-20230720","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1097\/00006534-198110000-00022","article-title":"Latissimus dorsi free muscle flap in lower-extremity reconstruction","volume":"68","author":"May","year":"1981","journal-title":"Plast Reconstr Surg."},{"issue":"2","key":"bib9-20230720","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1097\/00006534-198208000-00008","article-title":"Free latissimus dorsi muscle flap with split-thickness skin graft cover: a report of 16 cases","volume":"70","author":"Gordon","year":"1982","journal-title":"Plast Reconstr Surg."},{"issue":"5","key":"bib10-20230720","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1097\/00006534-198105000-00010","article-title":"The latissimus dorsi muscle: a fresh cadaver study of the primary neurovascular pedicle","volume":"67","author":"Bartlett","year":"1981","journal-title":"Plast Reconstr Surg."},{"issue":"1","key":"bib11-20230720","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.fcl.2016.09.010","article-title":"Primary arthrodesis for tibial pilon fractures","volume":"22","author":"Ho","year":"2017","journal-title":"Foot Ankle Clin."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:44:47Z","timestamp":1787751887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00346"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.19.00346","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]}}}