No adverse affect after harvesting of free fibula osteoseptocutaneous flaps on gait function

Abstract

The aim of this study was to analyze gait function and muscular strength on donor site after harvesting of a vascularized fibula osteoseptocutaneous flap. Nine patients with a mean follow-up of 33 months (range, 7-59) and a mean resection length of the middle portion of the fibula of 18.0 cm (range, 14.0-23.0) underwent an instrumented three-dimensional gait analysis to evaluate gait function. Furthermore, CYBEX II extremity system was used for muscular strength measurements. Subjective muscle strength measurements were performed according to Kendall et al. and were classified according to the British Medical Research Council. Intraindividual comparison between the operated and the nonoperated leg revealed no significant differences for gait function parameters (cadence, velocity, and stride length, P > 1.00) and for muscular strength measurements for flexion (knee: P = 0.93, ankle: P = 0.54) and extension (knee: P = 0.97, ankle: P= 0.21), respectively. In conclusion, intraindividual comparison of the operated and nonoperated sides after harvesting of the middle portion of the fibula for gaining a free fibula osteoseptocutaneous flap has no adverse affect on gait function or muscular flexion and extension strength on donor site at a mean follow-up of 33 months.

Stair Ascent and Descent in Assessing Donor-Site Morbidity Following Osteocutaneous Free Fibula Transfer: A Preliminary Study

“…No significant differences were observed about the parameters listed above considering the comparison with the contra-lateral side 13 , the pre-intervention X-ray images 11 , a healthy control sample 10,12 , and after normalization with anthropometric values 4 . Additionally, no differences regarding the strength of the mediolateral compartment 10 , the force of the peroneus longus and of the extensor hallucis longus 15 , the moment of force and power in dorsal and plantar flexion 16 , and the power output in flexion-extension of the knee and ankle 13 were found.…”

“…Additionally, no differences regarding the strength of the mediolateral compartment 10 , the force of the peroneus longus and of the extensor hallucis longus 15 , the moment of force and power in dorsal and plantar flexion 16 , and the power output in flexion-extension of the knee and ankle 13 were found.…”

“…In particular, following the directions of the British Medical Research Council 17 , no decrease in performance was found by therapists in the muscles of the lower limbs 13 . Among the others, Agarwal et al 11 examined the walking on heels and on a slope (20°), together with hopping performance, but no studies have evaluated the morbidity of donor site in a typical action of daily life: stairs ascent and descent.…”

“…Other studies evaluated the kinematic parameters of gait (stride length, cadence, speed, single and double support time, ankle angle) in automated way or under cognitive and visual engagement to identify any differences 4,[10][11][12][13][14] .…”

Subtalar fusion with iliac bone free flap after a recalcitrant nonunion: Report of two cases

“…In recent microsurgical literature, the vascularized fibula free flap has been used for treatment of calcaneal defects due to infection after fracture . The fibula flap is useful for larger defect areas, but consequently can result in increased donor site morbidity including peroneal neuralgia, motor deficits of the great toe, persistent pain, and ankle instability . No studies have compared the mechanical properties of vascularized bone flaps; however, one can assume an advantage of multicortical structure in providing increased strength.…”