Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

Kalra, Gagan; Goel, Pradeep; Singh, Pradeep Kumar

doi:10.4103/0970-0358.122013

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Because the vascularised bone preserves the function of the osteoblasts and osteoclasts, consolidation and remodelling are incorporated faster and more efficiently. 20 , 21 …”

Section: Discussionmentioning

confidence: 99%

Fibula Musculo-Osteocutaneous Flap with Full Thickness of Flexor Hallucis Longus Muscle

Venkatesh

Kumaraswamy

Shivalingappa

et al. 2021

wjps

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BACKGROUND Fibula flap has been a gold standard method for reconstruction of the mandible. It has been used for reconstruction of maxilla as well as long bones, effectively. Fibula flap in selected cases has been used as a pedicled flap. The flexor hallucis longus muscle has been used to obliterate the dead space during the reconstruction. With a wide range of indications, the use of flexor hallucis muscle has studied for the reconstruction. METHODS In a retrospective case record analysis study, 38 subjects were enrolled, included 32 patients with reconstruction of mandible, 1 patient with reconstruction of maxilla, 4 patients with 3 free flaps and 1 pedicled flap with reconstruction of the tibia. RESULTS The success rate was 89%, with 4 flap failures. The muscle was used for reconstruction of the tongue, floor of the mouth, antrum, and to cover the fibula graft. CONCLUSION Flexor hallucis longus muscle harvested with the flap could decrease the operative time, ease the harvest, and fill the dead space during reconstruction.

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“…Because the vascularised bone preserves the function of the osteoblasts and osteoclasts, consolidation and remodelling are incorporated faster and more efficiently. 20 , 21 …”

Section: Discussionmentioning

confidence: 99%

Fibula Musculo-Osteocutaneous Flap with Full Thickness of Flexor Hallucis Longus Muscle

Venkatesh

Kumaraswamy

Shivalingappa

et al. 2021

wjps

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“…This procedure is technically demanding and needs excessive dissection [17]. A much lower rate of the union has been reported in those patients with complicated humeral non-unions as those with big bone defect, bad fibrotic soft tissue cover, or advance neuropathic limb [18]. Our patient's average age was 38.6 years and it was lower than the average age obtain in the study of Tzu-Liang et al 2005 [19] in which average age was 46.2, also female predominance in our study 60% and it against the study of Tzu-Liang et al 2005 [19].…”

Section: Discussionmentioning

confidence: 99%

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Hashmi

Al-Shara

Al-Edanni³

2021

Open Access Maced J Med Sci

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BACKGROUND: The humeral shaft fractures have a good rate of union, despite this fact, still there is a significant rate of nonunion after nonoperative treatment and more often after operative treatment. AIM: The aim of the study is to evaluate the autogenous onlay graft with compression plate for treatment of persistent humeral shaft non-union with failed previous surgery both radiological and functional outcome. MATERIALS AND METHODS: A prospective study on twenty patients having persistent aseptic non-union age between 20 and 60 years old, after failed surgical treatment of fractures humeral shaft in Al-Zahra teaching and Al-Kindy teaching hospitals, while infected nonunion, diabetes mellitus, secondary metastasis, smoking, alcoholism, and patients on long medication with corticosteroid were excluded from the study. All our patients were treated with corticocancellous onlay bone grafting harvesting from the ipsilateral upper tibia and compression plating (graft parallel to plate) and follow-up for at least 18 months post-operative to evaluate both radiology and functional using Mayo elbow performance index. RESULTS: All the patients ended with a solid union without hardware failure, and no one patient needs further surgery, even with significant resorption of the graft, there is a good chance of graft re-calcification and solid union with good to excellent functional outcome. CONCLUSION: Very successful solid union results achieve in those patients with established aseptic nonunion and pseudoarthrosis of the humerus.

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“…The most commonly used methods for reconstruction of large bone defects are vascularized fibular flap grafts and Ilizarov bone transfer techniques. 22,23 Bone resorption occurs with a high failure rate for defects of >5 cm when cancellous bone grafting is used alone. 24 The anterior tibial and posterior tibial vessels are both injured in Gustilo IIIC tibial fractures.…”

Section: Discussionmentioning

confidence: 99%

Masquelet technique combined with microsurgical technique for treatment of Gustilo IIIC open distal tibial fractures: a retrospective single-center cohort study

Wang

Tang

et al. 2020

J Int Med Res

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Objective: This study was performed to investigate the clinical effects of the Masquelet technique combined with a microsurgical technique for treatment of Gustilo IIIC open distal tibial fractures. Methods: Fifteen patients with a mean age of 39.3 AE 7.9 years (range, 21-43 years) with Gustilo IIIC open distal tibial fractures were treated by the Masquelet technique combined with a microsurgical technique from May 2013 to January 2017. The mean length of the bone defect was 6.9 AE 2.2 cm (range, 5.2-10.7 cm). The mean area of the wound defect was 129.3 AE 41.4 cm 2 (range, 83.7-180 cm 2 ). Complications and fracture healing were recorded. At the last follow-up, the functional outcome was measured using the Iowa ankle score. Results: All 15 patients achieved bone healing, and the median healing time was about 6.1 months (range, 5-8 months). No complications such as infection or nonunion occurred. At the last follow-up, the median Iowa ankle score was 82 (range, 68-88). The rate of an excellent and good Iowa ankle score was 86.6%. Conclusions: Application of the Masquelet technique combined with a microsurgical technique is an effective strategy for the treatment of Gustilo IIIC open distal tibial fractures.

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Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

Cited by 14 publications

References 16 publications

Fibula Musculo-Osteocutaneous Flap with Full Thickness of Flexor Hallucis Longus Muscle

Fibula Musculo-Osteocutaneous Flap with Full Thickness of Flexor Hallucis Longus Muscle

Autogenous Onlay Graft with Compression Plate for Treatment of Persistent Humeral Shaft Aseptic Non-union with Failed Previous Surgery

Masquelet technique combined with microsurgical technique for treatment of Gustilo IIIC open distal tibial fractures: a retrospective single-center cohort study

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