Functional donor site morbidity longer than one year after fibula free flap: A prospective biomechanical analysis

Rendenbach, Carsten; Rashad, Ashkan; Hansen, Lara; Kohlmeier, Carsten; Dyck, Moritz L.; Suling, Anna; Assaf, Alexandre T; Amling, Michael; Heiland, Max; Wikner, Johannes; Riecke, Björn; Kreutzer, Kilian

doi:10.1002/micr.30205

Cited by 22 publications

(40 citation statements)

References 37 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is of crucial importance to consider potential adverse effects associated with surgical procedures. This is particularly important for reconstructions with autologous free flaps, that are very useful and reliable options for the restoration of form and function at the recipient site, but may cause surgical, functional, and aesthetical donor site morbidity at the same time (Rendenbach et al, 2018). Accordingly, impairments at the donor side are one important aspect to consider in the course of select the right flap for osseous reconstruction.…”

Section: Discussionmentioning

confidence: 99%

“…While certain limitations of simple and complex motions, strength and daily life routine have been reported for several soft tissue und composite tissue free flaps Riecke et al, 2016), the functional outcome after more than 1 year is usually more satisfying (Rendenbach et al, 2018;Riecke et al, 2015). For radial forerarm and fibula free flap, comprehensive analyses of functional long term results have recently been published, but no such investigation has been carried out among DCIA flap patients Rendenbach et al, 2018;Riecke et al, 2016). With the current study, we aimed to investigate the long-term functional outcome after DCIA flap harvesting, with special regards to maximum power and body sway.…”

Section: Discussionmentioning

confidence: 99%

“…Maximum peak power is an important parameter to analyze the relationship between muscle impairments, functional limitations and subsequently disability (Rendenbach et al, 2018;Suzuki, Bean, & Fielding, 2001). Harvesting myo-osseous free flaps is a direct intervention into the complex interplay of osseous integrity, muscular origin and insert and proprioception with a potential impact on complex biomechanical activities.…”

Section: Discussionmentioning

confidence: 99%

“…However, complex motions and parameters with high relevance for daily activities, have not been evaluated to date. In this regard, recent investigations took a closer look on maximum peak power, lower leg forces and body sway Rendenbach et al, 2018). With functional assessments on a ground force reaction plate, such complex motions and various musculoskeletal parameters can be measured (Matheson et al, 2013;Rittweger et al, 2004;Veilleux & Rauch, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Evaluation of long‐term functional donor‐site morbidity after deep circumflex iliac crest artery bone flap harvest

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evaluation of long‐term functional donor‐site morbidity after deep circumflex iliac crest artery bone flap harvest

et al. 2018

Self Cite

View full text Add to dashboard Cite

show abstract

“…The free fibula flap is ideal for reconstruction of the long bones of the arm, due to its characteristics and shape [91][92][93] . Its harvest presents low donor site morbidity, mostly represented by flexion contracture of the great toe and ankle pain [94][95][96] . The medial femoral condyle is a valuable option in smaller upper extremity bone defects, in particular in the carpal region.…”

Section: Bone Reconstructionmentioning

confidence: 99%

Advances in microsurgery for upper and lower extremity reconstruction and limb preservation

Bolletta¹,

Rubino²,

Chen³

2019

PAR

View full text Add to dashboard Cite

In the recent decades, microsurgical reconstruction has evolved from simple survival of the affected extremity to the improvement of functional and aesthetic outcome. This review retraces the main contributions to the advances of microsurgery for reconstruction of upper and lower extremities and limb preservation. In the upper extremity, it is important to restore fine motility, together with allowing prompt mobilization. In the lower limb, care must be taken in the reconstruction of weight-bearing areas and the aim must be proper ambulation and shoe wearing. Local perforator flaps can be considered for medium size defects. They provide thin coverage and can be performed in short operating time. Their use, though, is often limited by tissue availability. Free flaps allow to overcome this problem and, thanks to the recent development in the study of perforator vessels, the microsurgeon can choose the flap with the most appropriate characteristics. Chimeric flaps can accomplish simultaneous reconstruction of different tissue components and large bone defects often require vascularized bone reconstruction. When dealing with limb preservation it is very important to consider residual functionality. Functioning muscle transfer and targeted muscle re-innervation can be performed in these cases. A useful reconstructive tool in severely damaged limbs with limited blood supply is the use of cross-leg free flaps. In conclusion, extremity reconstruction and limb preservation are reaching new heights thanks, not only to the work of plastic surgeons, but also to the new developments in other fields of study such as oncology, traumatology, radiology and medical engineering.

show abstract

Advantages of the scapular system in mandibular reconstruction

et al. 2022

View full text Add to dashboard Cite

Background Fibula free flaps (FFF) are often considered the first choice for mandibular reconstruction, but scapular system free flaps (SFF) have increased in popularity due to versatility, donor site advantages, and patient factors. Methods Retrospective chart review of patients undergoing mandibulectomy with FFF or SFF reconstruction from 2016 to 2021. Results Hundred and seventy‐six patients (FFF n = 145, SFF n = 31) underwent the aforementioned procedures. Mean FFF operative time was 9.47 h versus 9.88 for SFF (p = 0.40). Two‐flap reconstructions required 12.65 h versus 10.09 for SFF with soft tissue (p = 0.002). Donor site complications were identified in 65.6% of FFF with skin grafting. Conclusions These findings suggest that SFF requires similar operative time and results in reduced donor site morbidity as compared to FFF. Supine, concurrent harvesting of SFF allows for single‐flap harvest with significantly shorter operative time. SFF could be considered a primary option for mandible reconstruction for complex defects and in select patients.

show abstract

Functional donor site morbidity longer than one year after fibula free flap: A prospective biomechanical analysis

Abstract: Reduced peak power and balance ability seem to be reversible short-term effects after fibula harvesting. We recommend preoperative patient education and standardized protocols for physiotherapy.

Cited by 22 publications

References 37 publications

Evaluation of long‐term functional donor‐site morbidity after deep circumflex iliac crest artery bone flap harvest

Evaluation of long‐term functional donor‐site morbidity after deep circumflex iliac crest artery bone flap harvest

Advances in microsurgery for upper and lower extremity reconstruction and limb preservation

Advantages of the scapular system in mandibular reconstruction

Contact Info

Product

Resources

About