Free Fibula Flap for Extremity Oncologic Defects: Factors Influencing Union and Functional Outcomes

Mericli, Alexander F.; Asaad, Malke; Lewis, Valerae O.; Lin, Patrick P.; Goodenough, Christopher J.; Adelman, David M.; Oates, Scott; Hanasono, Matthew M.

doi:10.1097/prs.0000000000010014

Cited by 3 publications

(1 citation statement)

References 41 publications

(179 reference statements)

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“…21 Since then, this vascularized bone transfer has been widely described in the literature, providing adequate radius reconstruction in selected patients. 22 23 24 Recently, Mericli et al 25 evaluated the outcomes after vascularized fibula flap reconstruction of oncologic bony extremity defects. The authors conducted a retrospective review in which they included two patients who had undergone DR reconstruction with an intercalary osteocutaneous fibula flap.…”

Section: Discussionmentioning

confidence: 99%

Cuboid Bone for Distal Radius Reconstruction: An Anatomical Cadaver Study

Alvedro-Ruiz,

Trapero-Ovejero,

Ferràs-Tarragó

et al. 2024

J Wrist Surg

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Background The cuboid bone (CB) of the foot has been suggested as a potential source of autologous reconstruction of the distal radius (DR). This study sought to examine the feasibility of harvesting the CB as a vascularized bone transfer for DR reconstruction. Purposes We evaluated the feasibility of a vascularized bone transfer of the CB by performing the flap dissection, analyzing its pedicle and demonstrating its perfusion using indocyanine green (ICG) fluorescence angiography. Methods Ten feet from five fresh-frozen cadaver specimens were dissected. The lateral tarsal artery (LTA) mean diameter, length, and emerging point were described. The CB mean length and the mean length of the bone segment harvested were reported. ICG injection was used to demonstrate its blood supply. Results The average length of the pedicle was 68.26 ± 3.12 mm. The mean diameter was 1.43 ± 0.15 mm. The CB had a mean anterior–posterior length of 40.81 ± 5.05 mm. The harvested bone had a mean length of 15.05 ± 2.03 mm. All CBs showed enhancement after ICG injection. Conclusion The CB presented reasonable anatomical similarities with the DR and a long and consistent pedicle with an adequate blood supply observed during ICG injection. Clinical Relevance This study supports the possibility of using the CB as a vascularized bone transfer for autologous reconstruction of the articular surface of the DR. Further study is warranted.

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Section: Discussionmentioning

confidence: 99%

Cuboid Bone for Distal Radius Reconstruction: An Anatomical Cadaver Study

Alvedro-Ruiz,

Trapero-Ovejero,

Ferràs-Tarragó

et al. 2024

J Wrist Surg

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Immunomodulation Using BMP‐7 and IL‐10 to Enhance the Mineralization Capacity of Bone Progenitor Cells in a Fracture Hematoma‐Like Environment

Wiesli,

Huber,

Weisse

et al. 2024

Adv Healthcare Materials

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Following biomaterial implantation, a failure to resolve inflammation during the formation of a fracture hematoma can significantly limit the biomaterial's ability to facilitate bone regeneration. This study aimed to combine the immunomodulatory and osteogenic effects of BMP‐7 and IL‐10 with the regenerative capacity of collagen‐hydroxyapatite (CHA) scaffolds to enhance in vitro mineralization in a hematoma‐like environment. Incubation of CHA scaffolds with human whole blood led to rapid adsorption of fibrinogen, significant stiffening of the scaffold, and the formation of a hematoma‐like environment characterized by a limited capacity to support the infiltration of human bone progenitor cells, a significant upregulation of inflammatory cytokines and acute phase proteins, and significantly reduced osteoconductivity. CHA scaffolds functionalized with BMP‐7 and IL‐10 significantly downregulated the production of key inflammatory cytokines, including IL‐6, IL‐8, and leptin, creating a more permissive environment for mineralization, ultimately enhancing the biomaterial's osteoconductivity. In conclusion, targeting the onset of inflammation in the early phase of bone healing using BMP‐7 and IL‐10 functionalized CHA scaffolds is a promising approach to effectively downregulate inflammatory processes while fostering a more permissive environment for bone regeneration.This article is protected by copyright. All rights reserved

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Clinical Efficacy Evaluation and Complication Analysis of 3D-Printed Porous Titanium Implants Combined with Flap Reconstruction for the Treatment of Open Bone Defects in Lower Extremities: A Retrospective Study

cai,

wang,

et al. 2024

Preprint

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Objective To retrospectively analyze the clinical efficacy and complications of flap combined with 3D-printed microporous titanium prosthesis in treating open lower limb bone defects, and to evaluate the feasibility and safety of this innovative method. Methods This study is a retrospective, single-center, non-randomized controlled clinical study. Thirty patients with open lower limb bone defects treated with flap combined with 3D-printed microporous titanium prosthesis were included. Patient demographics, bone defect location and length, follow-up time, radiographic evaluation, Lower Extremity Functional Scale (LEFS) scores, complications, prosthesis failure, and patient satisfaction were recorded. Kaplan-Meier survival analysis was used to assess the cumulative survival rate of the prostheses. Results A total of 30 patients were included, comprising 21 males and 9 females, with a mean age of 45.5 years (range: 13–67 years). Bone defects were located in the tibia (n = 17), femur (n = 11), and metatarsal bones (n = 2). The defect length ranged from 41 to 211 mm, with a mean of 101.9 mm. The follow-up period ranged from 1.23 to 61.7 months, with a mean of 13.95 months. The mean LEFS score at the final follow-up was 47.4. Seven patients (23.3%) developed infectious complications, all leading to prosthesis failure requiring revision. The mean patient satisfaction score was 3.8 out of 5. Kaplan-Meier survival analysis showed a 2-year cumulative prosthesis survival rate of 76.67%. Conclusion Flap combined with 3D-printed microporous titanium prosthesis for treating open lower limb bone defects can achieve satisfactory bone healing, functional recovery, and patient satisfaction. However, the complication rate is relatively high. Further optimization of surgical protocols and prosthesis design is needed to reduce infection risk and improve prosthesis survival. Prospective, large-sample, long-term follow-up studies are recommended for a more comprehensive evaluation of the efficacy and safety of this method.

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Free Fibula Flap for Extremity Oncologic Defects: Factors Influencing Union and Functional Outcomes

Cited by 3 publications

References 41 publications

Cuboid Bone for Distal Radius Reconstruction: An Anatomical Cadaver Study

Cuboid Bone for Distal Radius Reconstruction: An Anatomical Cadaver Study

Immunomodulation Using BMP‐7 and IL‐10 to Enhance the Mineralization Capacity of Bone Progenitor Cells in a Fracture Hematoma‐Like Environment

Clinical Efficacy Evaluation and Complication Analysis of 3D-Printed Porous Titanium Implants Combined with Flap Reconstruction for the Treatment of Open Bone Defects in Lower Extremities: A Retrospective Study

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