Donor Leg Morbidity and Function after Fibula Free Flap Mandible Reconstruction

Anthony, James P.; Rawnsley, Jeffrey; Benhaim, Prosper; Ritter, Edmond F.; Sadowsky, Steven H.; Singer, Mark I.

doi:10.1097/00006534-199507000-00022

Cited by 147 publications

(94 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These data showed consistantency with previous studies. Anthony et al 16 stated all strengths (plantarflexion, dorsiflexion, inversion, and eversion) at the ankles revealed a significantly decreased strength in the donor leg compared with the unoperated control leg. Gore 22 also confirmed average ankle muscle torque was lower on the operated side compared with the nonoperated side.…”

Section: Discussionmentioning

confidence: 99%

“…In these studies, donor-site morbidity was considered low in most of patients. [7][8][9][10][11][12][13][14][15][16][17] However, the fibula functions as the origin and insertion points of various leg and foot muscles, the detachment and injury to these muscles during various fibula harvest will inevitably affect donor leg function. Patients may not always perceive significant functional losses because of compensatory mechanisms or because they use the donor leg only for activities of low functional demand.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of fibula osteoseptocutaneous flap donor‐site morbidity using balance and gait test

Chou

Liao

Yazar

et al. 2009

Journal Orthopaedic Research

View full text Add to dashboard Cite

To assess the functional deficits in gait and balance after fibular osteoseptocutaneous flap harvest, a case-control study in a hospital-based biomechanical laboratory was conducted. Eleven patients receiving fibula osteoseptocutaneous flaps were enrolled as study group and 10 age-matched and healthy subjects as a control group. The average postoperative period at the time of evaluation was 27.4 months (range: 10 to 68 months) and the average age at the time of evaluation was 52.1 years (range: 38 to 76 years). The balance test by Smart Balance Master and gait analysis were used for objective assessment of the donor leg function postoperatively. No statistical differences were observed in the kinetic and kinematic variables of gait analysis except double support time in both the groups. There were also no significant differences in simple static balance test (eyes open, eyes closed, swaying vision, eyes open with swaying surface, and sway-referenced vision and support). Significant differences were observed in more difficult task (eye closed with swaying support) and in the use of ankle strategy for maintaining maximum balance. In the dynamic balance test only specificity of the forward left direction determined significant difference in reaction time of movement control of gravity. The results of ankle strategy usage and dynamic balance indicated deficits of ankle muscle torque. Necessary postoperative physical training is required for ankle muscle torque and vestibular sense.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of fibula osteoseptocutaneous flap donor‐site morbidity using balance and gait test

Chou

Liao

Yazar

et al. 2009

Journal Orthopaedic Research

View full text Add to dashboard Cite

show abstract

“…Apart from this, the donor area morbidity to be expected is well documented. 27,28 We left a minimum of 8 cm of the distal part of the fibula, ensuring ankle stability (Fig. 8).…”

Section: Donor Area Functionmentioning

confidence: 99%

Fibula free flap phalloplasty: Modifications and recommendations

1996

View full text Add to dashboard Cite

Radial forearm flap phalloplasty should be regarded as the gold standard. The large forearm donor site scar, however, has led to the search for other donor areas. We present our modifications and recommendations for addressing the ideal goals of phalloplasty better when applying the fibula free flap. We recommend preconstruction and secondary anastomosis of the neo-urethra. Preoperative infiltration of the cutaneous nerve is recommended for planning of the sensate flap. The osseous part of the flap should be long enough to be fixed to the tunica albuginea. We recommend a longitudinal, rather than a transverse, design for the flap. For aesthetic reasons, the flap should include two triangular tongues. Even so, secondary surgery will be needed. The patient may be left with functional loss in the donor region. A case report illustrates all of these points. We conclude that the sensate fibula free flap has a place in phalloplasty in case the patient refuses a forearm scar.

show abstract

“…Despite the fact that several studies qualitatively described evolution of the donor-side leg after VFG [1,3,10,25,32,36], these did not quantitatively describe adaptation of the donor-side tibia. Questionnaire results [1,3,30,36], disability scales [1,10,25], or gait analyses [3,25] have been reported in some studies, and disabilities such as pain, ankle instability, and inability to run have been described [1,3,10,18,25,30,32,36].…”

Section: Introductionmentioning

confidence: 99%

“…Questionnaire results [1,3,30,36], disability scales [1,10,25], or gait analyses [3,25] have been reported in some studies, and disabilities such as pain, ankle instability, and inability to run have been described [1,3,10,18,25,30,32,36]. Other studies have attempted quantitative analyses of long-term side effects based on radiographs [2,10,14,28,30].…”

Section: Introductionmentioning

confidence: 99%

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Taddei

Balestri

Rimondi

et al. 2009

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Absence of the fibula after harvesting to reconstruct an upper-limb segment increases loads on the donor-side tibia and thereby provides a unique opportunity to analyze the bone adaptation process in humans. We therefore quantified densitometric and morphologic changes of the donor-side tibia in three young patients (ages 8, 13, 16 years), on the basis of computed tomography (CT) examinations of both legs (one preoperatively and two postoperatively). The range of final followup was 27-43 months. Three-dimensional models of shank bones were generated from CT data and used to measure crosssectional area, diaphyseal cortical thickness, and crosssectional moment of inertia. In addition, density of the newly formed bone was evaluated. The donor-side tibia showed morphologic and density adaptation with time.

show abstract

Donor Leg Morbidity and Function after Fibula Free Flap Mandible Reconstruction

Cited by 147 publications

References 0 publications

Assessment of fibula osteoseptocutaneous flap donor‐site morbidity using balance and gait test

Assessment of fibula osteoseptocutaneous flap donor‐site morbidity using balance and gait test

Fibula free flap phalloplasty: Modifications and recommendations

Tibia Adaptation after Fibula Harvesting: An in Vivo Quantitative Study

Contact Info

Product

Resources

About