{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:54Z","timestamp":1787755314941,"version":"build-2784847793"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 46-year-old man with vascular Ehlers-Danlos syndrome (EDS) had an open ankle fracture with a 10 \u00d7 5-cm skin defect on the medial side of the ankle. The patient underwent open reduction and internal fixation, as well as coverage of the skin defect with a posterior tibial artery perforator flap, which led to successful outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We present the successful implementation of a posterior tibial artery perforator flap for the reconstruction of skin defects in a patient with vascular EDS. Despite the fragility of soft tissues, favorable surgical outcomes were observed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.23.00336","type":"journal-article","created":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T14:14:34Z","timestamp":1697724874000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Ankle Skin Defects with Vascular Ehlers-Danlos Syndromes Treated by Posterior Tibial Artery Perforator Flap"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9951-9483","authenticated-orcid":false,"given":"Hideo","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9743-7898","authenticated-orcid":false,"given":"Kenji","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihito","family":"Kawai","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-2706","authenticated-orcid":false,"given":"Takuma","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syunsuke","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Minami","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-8088","authenticated-orcid":false,"given":"Hiroshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2300-611X","authenticated-orcid":false,"given":"Yasuhito","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Nara Medical University, Nara, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,10]]},"reference":[{"issue":"5","key":"bib1-20240805","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1177\/1941738112452385","article-title":"Ehlers-Danlos syndrome in orthopaedics: etiology, diagnosis, and treatment implications","volume":"4","author":"Shirley","year":"2012","journal-title":"Sports Health."},{"issue":"1","key":"bib2-20240805","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.jvs.2005.03.053","article-title":"The spectrum, management and clinical outcome of Ehlers-Danlos syndrome type IV: a 30-year experience","volume":"42","author":"Oderich","year":"2005l","journal-title":"J Vasc Surg."},{"issue":"1","key":"bib3-20240805","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1001\/jamafacial.2017.0793","article-title":"Characteristics, diagnosis, and management of Ehlers-Danlos syndromes: a 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