One‐stage treatment of infected bone defects of the tibia with skin loss by free vascularized osteocutaneous grafts

Doi, Kazuteru; Kawakami, Fujio; Hiura, Yasuhiro; Oda, Tatsuya; Sakai, Kazuhiro; Kawai, Shinya

doi:10.1002/micr.1920161009

Cited by 69 publications

(69 citation statements)

References 39 publications

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“…24,25,39,58,59,[63][64][65] Reported delayed union rates are ranging between 14 and 45%. 59,65 In cases of CPT, nonunion is usually observed at the distal end of the graft.…”

Section: Complicationsmentioning

confidence: 99%

Vascularized fibula transfer for lower limb reconstruction

et al. 2011

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Massive bony defects of the lower extremity are usually the result of high-energy trauma, tumor resection, or severe sepsis. Vascularized fibular grafts are useful in the reconstruction of large skeletal defects, especially in cases of scarred and avascular recipient sites, or in patients with combined bone and soft-tissue defects. Microvascular free fibula transfer is considered the most suitable autograft for reconstruction of the middle tibia because of its long cylindrical straight shape, mechanical strength, predictable vascular pedicle, and hypertrophy potential. The ability to fold the free fibula into two segments or to combine it with massive allografts is a useful technique for reconstruction of massive bone defects of the femur or proximal tibia. It can also be transferred with skin, fascia, or muscle as a composite flap. Proximal epiphyseal fibula transfer has the potential for longitudinal growth and can be used in the hip joint remodeling procedures. Complications can be minimized by careful preoperative planning of the procedure, meticulous intraoperative microsurgical techniques, and strict postoperative rehabilitation protocols. This literature review highlights the different surgical techniques, indications, results, factors influencing the outcome, and major complications of free vascularized fibular graft for management of skeletal or composite defects of the lower limb.

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“…24,25,39,58,59,[63][64][65] Reported delayed union rates are ranging between 14 and 45%. 59,65 In cases of CPT, nonunion is usually observed at the distal end of the graft.…”

Section: Complicationsmentioning

confidence: 99%

Vascularized fibula transfer for lower limb reconstruction

et al. 2011

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“…Bone defects of an infectious aetiology constitute a particularly challenging and important subgroup; however, only a few studies in the literature have focussed on the application of the free vascularised bone graft for the treatment of infected bone defects [4,16,18]. To investigate this question, we evaluated the use of a vascularised fibular graft to treat such a defect due to osteomyelitis.…”

Section: Introductionmentioning

confidence: 99%

Free vascularised fibular grafting in the treatment of large skeletal defects due to osteomyelitis

Sun

Zhang

Jin

et al. 2009

International Orthopaedics (SICOT)

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Treatment of skeletal defects secondary to osteomyelitis is a challenging problem. The purpose of this study was to present our experience of the use of free vascularised fibular grafts to treat such defects. Ten patients with a mean age of 31 years (range 16-50 years) and a skeletal defect with a mean length of 9.5 cm (range 6-17 cm) were managed with a protocol which included radical debridement of the lesion and a vascularised fibular graft. The mean follow-up time was 26 months. Union of the graft occurred in all patients, at a mean of 4.5 months. No recurrence of osteomyelitis was observed. The mean time to full weight bearing was ten months, and all patients were pain-free and able to walk without supportive devices. A free vascularised fibular graft is a viable option for the management of large skeletal defects resulting from osteomyelitis.

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“…It also requires special surgical skills and instruments and a long operating time. This method may be suitable for cases of non-union with a bone defect in the presence of infection or a soft tissue problem [7]. The Ilizarov technique enables simultaneous correction of deformity and of any limb-length discrepancy through the formation of new osseous tissue without the use of a bone graft.…”

Section: Discussionmentioning

confidence: 99%

Tibial reconstruction using a non-vascularised fibular transfer

Morsi

2002

International Orthopaedics

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A non-vascularised contralateral fibular transfer was performed on seven patients with non-union of the tibia and a sclerosed segmental bone defect following injury. The average follow-up was 2.7 years with a minimum of 2 years. The operation was successful in achieving fracture union in six patients, with an average time to union of 4.5 months (range: 3-6). Shortening of up to 2.4 cm was found in two patients and mild residual ankle stiffness in one. This procedure is successful and simple when compared to microvascular and Ilizarov techniques.Résumé Une transposition fibulaire non -vascularisée a été exécuté sur sept malades avec une non-consolidation tibiale et un défaut osseux segmentaire après un traumatisme. Le suivi moyen était 2.7 années avec un minimum de 2 années. L'opération a permis la consolidation dans six cas, en un temps moyen de 4,5 mois ( 3 à 6 mois). Un raccourcissement jusqu'à 2.4 centimètres a été noté chez deux malades et une discrète raideur résiduelle de la cheville chez un autre. Cette méthode est efficace et simple comparée aux techniques microvasculaires ou d' Ilizarov.

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One‐stage treatment of infected bone defects of the tibia with skin loss by free vascularized osteocutaneous grafts

Cited by 69 publications

References 39 publications

Vascularized fibula transfer for lower limb reconstruction

Vascularized fibula transfer for lower limb reconstruction

Free vascularised fibular grafting in the treatment of large skeletal defects due to osteomyelitis

Tibial reconstruction using a non-vascularised fibular transfer

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