Carla Baldrighi - Academia.edu (original) (raw)

Papers by Carla Baldrighi

Physical & Occupational Therapy In Pediatrics

Clinical Orthopaedics & Related Research, 2014

Background Conventional pedicled flaps for soft tissue reconstruction of lower extremities have s... more Background Conventional pedicled flaps for soft tissue reconstruction of lower extremities have shortcomings, including donor-site morbidity, restricted arc of rotation, and poor cosmetic results. Propeller flaps offer several potential advantages, including no need for microvascular anastomosis and low impact on donor sites, but their drawbacks have not been fully characterized. Questions/purposes We assessed (1) frequency and types of complications after perforator-based propeller flap reconstruction in the lower extremity and (2) association of complications with arc of rotation, flap dimensions, and other potential risk factors. Methods From 2007 to 2012, 74 patients (44 males, 30 females), 14 to 87 years old, underwent soft tissue Each author certifies that she or he, or a member of her or his immediate family, has no funding or commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

Journal of Children's Orthopaedics

The use of microsurgery has spread during the last decades, making resolvable many complex defect... more The use of microsurgery has spread during the last decades, making resolvable many complex defects considered hitherto inapproachable. Although the small vessel diameter in children was initially considered a technical limitation, the increase in microsurgical expertise over the past three decades allowed us to manage many pediatric conditions by means of free tissue transfers. Pediatric microsurgery has been shown to be feasible, gaining a prominent place in the treatment of children affected by limb malformations, tumors, nerve injuries, and post-traumatic defects. The aim of this current concepts review is to describe the more frequent pediatric upper limb conditions in which the use of microsurgical reconstructions should be considered in the range of treatment options.

Supplemental material, sj-pdf-5-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (si... more Supplemental material, sj-pdf-5-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (sirolimus) in isolated limb overgrowth: a systematic review by Mohamed Badawy, Yangmyung Ma, Carla Baldrighi, Kerstin Oestreich and Andrea Jester in Journal of Hand Surgery (European Volume)

Supplemental material, sj-jpg-1-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (si... more Supplemental material, sj-jpg-1-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (sirolimus) in isolated limb overgrowth: a systematic review by Mohamed Badawy, Yangmyung Ma, Carla Baldrighi, Kerstin Oestreich and Andrea Jester in Journal of Hand Surgery (European Volume)

Supplemental material, sj-pdf-3-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (si... more Supplemental material, sj-pdf-3-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (sirolimus) in isolated limb overgrowth: a systematic review by Mohamed Badawy, Yangmyung Ma, Carla Baldrighi, Kerstin Oestreich and Andrea Jester in Journal of Hand Surgery (European Volume)

Supplemental material, sj-pdf-2-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (si... more Supplemental material, sj-pdf-2-jhs-10.1177_17531934211073866 for Efficacy of mTOR inhibitors (sirolimus) in isolated limb overgrowth: a systematic review by Mohamed Badawy, Yangmyung Ma, Carla Baldrighi, Kerstin Oestreich and Andrea Jester in Journal of Hand Surgery (European Volume)

Journal of Hand Surgery (European Volume), 2022

We systematically assessed the literature on the use of sirolimus for the treatment of isolated l... more We systematically assessed the literature on the use of sirolimus for the treatment of isolated limb overgrowth conditions and its various modalities of administration in PubMed, Scopus, Ovid MEDLINE, Web of Science, Google Scholar, Cochrane Database of Systematic Reviews, references of journals and grey literature using pre-trialled Medical Subject Headings terms and articles. Eleven articles were included, and 39 patients were identified for review. Sirolimus was given orally in 38 patients and topically in one patient. Sirolimus was found to be highly effective in treatment of isolated limb overgrowth conditions with improvement of symptoms (physical, emotional, social) reported in all but one patient. Dosage and adverse effects seemed to be closely correlated. The result of our study suggests that sirolimus should be considered as an adjuvant or first-line management in isolated limb overgrowth in prospective trials.

Objectives/Interrogation: Standard practise during pollicization is to detach and re-attach intri... more Objectives/Interrogation: Standard practise during pollicization is to detach and re-attach intrinsic musculature from the MCP region into the PIP region. Most surgeons are reluctant to change their technique once they feel safe with their chosen approach. We have adapted our technique from detachment[for full text, please go to the a.m. URL]

The Journal of Hand Surgery (Asian-Pacific Volume), 2021

Background: Although hand and upper limb malformations are quite frequent, up to now very few rep... more Background: Although hand and upper limb malformations are quite frequent, up to now very few reports have been published on epidemiology. The aim of this study is to evaluate the number of infants who presented with hand and upper limb malformations from 2010 to 2015 in Italy. Methods: A retrospective analysis of a pediatric population presenting with hand and upper extremity malformations was carried out, gathering reports achieved from eight Italian Centers of pediatric hand surgery. Other factors such as gender, date and region of birth, family distribution of malformations and associated syndromes, were analysed. Results: Out of 3,100,421 live births, 765 children presented with hand and upper limb malformations. The incidence was 2,5/10,000 live births with a predominance of males and the right side. Radial polydactyly was the anomaly with the highest percentage, closely followed by simple syndactyly, simbrachidactyly and complex syndactyly. Less common conditions were the tri...

Annals of Plastic Surgery

HAND

Ganglion cysts are the most common soft tissue tumor of the hand and wrist, affecting pediatric a... more Ganglion cysts are the most common soft tissue tumor of the hand and wrist, affecting pediatric and adult populations. Despite their frequency, there is no consensus within the literature regarding the best management of pediatric wrist ganglia, and there are few recent publications examining this topic. We provide an up-to-date literature review examining the current issues and controversies in the management of pediatric wrist ganglia.

Handchirurgie · Mikrochirurgie · Plastische Chirurgie

Background Dorsal complex cutaneotendinous lesions of the hand represent a reconstructive challen... more Background Dorsal complex cutaneotendinous lesions of the hand represent a reconstructive challenge. The use of composite microvascular flaps and vascularized tendon grafts represent the gold-standard. The radial anti-brachial region can still represent an excellent donor site, to the detriment of the possible sacrifice of the radial artery. The reverse radial anti-brachial flap can be either perforator-based, thus saving the radial artery or raised as an adipo-fascial flap, to spare the skin. Patients and Methods A case of post-traumatic highly contaminated dorsal cutaneotendinous defect of the second ray of the hand was reported. An original surgical reconstructive technique with a Revers Radial Teno-Adipo-Fascial Flap (RRTAFF) plus vascularized Palmaris Longus was described, preserving the radial artery. A simple partial thickness skin graft was performed a second time to complete dorsal cutaneous coverage. A subsequent infection was managed by trusting the complete vascularizati...

Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der Peripheren Nerven und Gefässe : Organ der Vereinigung der Deutschen Plastischen Chirurgen, 2015

Replacement of osseous defect, restoration of joint function, and restoration of longitudinal gro... more Replacement of osseous defect, restoration of joint function, and restoration of longitudinal growth are the 3 main reconstructive issues that need to be addressed when the physis and epiphysis are damaged in a skeletally immature individual. Failure in achieving these objectives leads to severe deformity and functional impairment, which significantly compromises the quality of life of young patients. Because of its biological and morphological characteristics, the proximal fibula epiphyseal transfer has proven to be an excellent option in limb salvage surgery in pediatric oncologic cases meeting all the reconstructive requirements. Between 1992-2006, 8 children with a mean age of 7.3 years (range 4-11 years old) diagnosed with malignant bone tumor of the distal radius underwent tumor resection and immediate microsurgical reconstruction of the distal part of the radius with vascularized proximal fibular transfer, which included the physis and a variable length of the diaphysis. The ...

Handchirurgie · Mikrochirurgie · Plastische Chirurgie, 2009

The quality of reconstruction of soft tissue defects in the upper extremity, resulting either fro... more The quality of reconstruction of soft tissue defects in the upper extremity, resulting either from traumatic injury or tumor excision, has relevant implications both from functional and aesthetic standpoints. Various local and free flaps with more or less consistent donor-site morbidity have been described in the past. The recent introduction of the perforator-based flap concept, has led to an evolution in upper extremity reconstruction, optimizing results at the recipient site whilst minimizing damage to the donor site and, performing this in the simplest way possible. In this study between 2001 and 2008, 31 patients having post-traumatic or post-tumor excision soft tissue defects of the upper limb, were treated using local perforator flaps raised according to two different modalities: "pedicled fasciocutaneous" and "transposition fasciocutaneous/cutaneous". Complete and stable coverage of the soft tissue losses was obtained in all cases with an inconspicuous, only aesthetic, donor-site defect. Superficial or partial necrosis of the tip of the flap, due to venous congestion, was observed in 2 cases of "pedicled fasciocutaneous flap". An additional surgical procedure was required in only one of these cases. In our series all 9 patients who had a transposition flap, underwent routinely a preoperative echo color Doppler investigation to identify the main perforators. In only one case did the Doppler investigation fail to accurately locate the perforator. Local perforator flaps allow the coverage of medium size defects in the upper extremity, can be raised with a relatively simple surgical technique, have a high success rate and good aesthetic results without functional impairment. In the light of this they can be considered among the surgical choices to resurface complex soft tissue defects of the upper extremity. Preoperative identification of the perforators in case of "transposition flaps" greatly facilitates the operation. In our experience echo color Doppler investigations provided reliable results.