Treatment of En Coup de Sabre Deformity with Fat Grafting and Demineralized Bone Matrix: A Case Series


MENKÜ ÖZDEMİR F. D. , ÜSTÜN G. G. , VARGEL İ., ÖZGÜR F. F.

JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY, vol.74, no.12, pp.3353-3360, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 74 Issue: 12
  • Publication Date: 2021
  • Doi Number: 10.1016/j.bjps.2021.05.038
  • Journal Name: JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Page Numbers: pp.3353-3360
  • Keywords: Bone, Defect, Demineralized bone matrix, Scleroderma, Stem cell, Subcutaneous tissue, ADULT STEM-CELLS, LOCALIZED SCLERODERMA, SYSTEMIC-SCLEROSIS, SKIN SCORE, ADIPOSE, RECONSTRUCTION
  • Hacettepe University Affiliated: Yes

Abstract

En coup de sabre deformity (ECDS) is a form of localized scleroderma in the frontoparietal region caused by progressive subcutaneous tissue atrophy and bony defect. Although ECDS involves two layers, skin/subcutaneous tissue and bone, the existing literature mainly focuses only on treating the skin/subcutaneous tissue layer. In this case series, we aimed to propose a novel approach that includes the combined use of fat grafting and demineralized bone matrix (DBM). Four patients with ECDS deformity, operated between February 2016 and October 2018, were retrospectively evaluated. All the patients were treated with the novel approach. Patients were evaluated with localized scleroderma scale and computed tomography (CT) scan in the preoperative period and at the annual follow-up. We observed remarkable improvement in the localized scleroderma scale including appearance, palpation, and size scores in all patients at the annual follow-up. CT scans at the annual follow-up revealed new callus formation at the bony defect area in all patients. Reinforcing fat grafting with DBM could promote healing of the bony and skin/subcutaneous tissue defects associated with ECDS. (C) 2021 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.