Composite Extremity and Trunk Reconstruction with Vascularized Fibula Flap in Postoncologic Bone Defects

Clemens, Mark W.; Chang, Edward I.; Selber, Jesse C.; Lewis, Valerae O.; Oates, Scott; Chang, David W.

doi:10.1097/prs.0b013e3182362171

Cited by 25 publications

(15 citation statements)

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“…There were 2 cases of delayed flap fracture caused by external trauma, both of which presented with normal consolidation after orthopedic fixation. The mean time to ambulation was 14.2 months, similar to those of global reports 2,19,20 . The mean flap size in this study was 15.8 cm (range, 10-20 cm).…”

Section: Discussionsupporting

confidence: 74%

“…In this series, we used the allograft in one case, in which ambulation occurred 10 months after surgery. Clemens et al 20 recently demonstrated a higher rate of con solidation and therefore earlier rehabilitation when only the free flap was used compared to the allograft/free flap (100% vs. 82.4%) and recommended the use of this kind of reconstruction in cancer patients. In this series, 100% of the flaps were viable, there was excellent integration of the flap to the receptor site, and there were no cases of pseudoar throsis or nonconsolidation.…”

Section: Discussionmentioning

confidence: 99%

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Reconstrução de extremidades com retalho livre de fíbula após ressecções oncológicas

Machado¹,

Portinho²,

Vasconcelos³

et al. 2012

Rev. Bras. Cir. Plást.

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Rev Bras Cir Plást. 2012;27(3):461-5 461Extremity reconstruction using a free fibula flap after oncological resection Extremity reconstruction using a free fibula flap after oncological resection Reconstrução de extremidades com retalho livre de fíbula após ressecções oncológicas ABSTRACT Background: Primary tumors of the long bones are rare, accounting for 0.2-1% of malignant tumors. In the past, amputation was the standard treatment and had a large impact on patient morbidity and mortality. With advances in surgical techniques and multidisciplinary involvement, conservative surgery of the limbs has become the treatment of choice, and reconstruction using a microsurgical fibula flap is the most commonly used technique. In this study, we aimed to present the experience of the National Cancer Institute (INCA) with limb reconstruction using a microsurgical fibula flap following tumor resection from the long bones. Methods: We retrospectively analyzed 7 cases of free fibular flap surgery at the INCA from 1997 to 2009 for the reconstruction of defects of the extremities after bone tumor resection. We evaluated the following parameters: gender, age, diagnosis, tumor location, resection size and type, reconstruction size and type, vessels used for the anastomosis, postoperative complications, disease status at the last visit, follow-up, and time to ambulation. Results: Seven patients with a mean age of 11.8 years (range, 5-14 years) underwent extremity reconstruction with a free fibula flap with 100% bone viability. The lesions were located within the femur, tibia, or humerus. Osteosarcoma was the most common tumor type. The average return to ambulation was 14.7 months. Conclusions: The use of a free fibula flap is an excellent alternative for limb reconstruction and features a high bone healing rate, early ambulation, good functionality, and a low complication rate.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Reconstrução de extremidades com retalho livre de fíbula após ressecções oncológicas

Machado¹,

Portinho²,

Vasconcelos³

et al. 2012

Rev. Bras. Cir. Plást.

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show abstract

“…13 In addition, in most series looking at allografts compared with vascularized grafts, there are increased bony nonunion rates in patients with allograft-vascularized grafts (85.2 percent) compared with patients with vascularized grafts alone (100 percent). 11 Moreover, Moran et al showed in their series of pediatric patients that all nonunions occurred in patients who underwent postoperative chemotherapy. 12 In our series, 83.3 percent (n = 10) of patients underwent both preoperative induction chemotherapy and postoperative chemotherapy.…”

Section: Discussionmentioning

confidence: 98%

“…First, there are significant limitations associated with the large-segment allografts. [10][11][12] Large-segment allografts heal through osteoconduction.…”

Section: Discussionmentioning

confidence: 99%

Lower Extremity Osseous Oncologic Reconstruction with Composite Microsurgical Free Fibula Inside Massive Bony Allograft

Weichman

Dec

Morris

et al. 2015

Plastic and Reconstructive Surgery

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“…Whether because of trauma or resection secondary to tumors, this type of bone loss 2–4 can be reconstructed with free bone flaps. However, when there is also associated loss of tissue, such as muscle or skin, the repair requires greater tissue contribution.…”

mentioning

confidence: 99%

Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up

Olvera-Caballero

Ortiz-Dominguez²

2016

Plastic and Reconstructive Surgery - Global Open

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Composite Extremity and Trunk Reconstruction with Vascularized Fibula Flap in Postoncologic Bone Defects

Abstract: Therapeutic, IV.

Cited by 25 publications

References 0 publications

Reconstrução de extremidades com retalho livre de fíbula após ressecções oncológicas

Reconstrução de extremidades com retalho livre de fíbula após ressecções oncológicas

Lower Extremity Osseous Oncologic Reconstruction with Composite Microsurgical Free Fibula Inside Massive Bony Allograft

Pediatric Arm Reconstruction after Shot-gun Injury Using Peroneal Free-flap and Pedicled Latissimus Dorsi Muscle Flap: Late Follow-up

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