Rekonstruktion des 1. Mittelhandknochens mittels freier Fibula-Transplantation und Suspensions-Arthroplastik nach extraläsionaler Resektion eines ossären Riesenzelltumors

Rau, Nena Vanessa; Fonseca, K. Da; Gazyakan, Emre; Lehner, Burkhard; Kneser, Ulrich; Panzram, Benjamin

doi:10.1055/a-1044-2229

Cited by 1 publication

(4 citation statements)

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“…Surgical angiogenesis is induced, a process that is characterized by an outgrowth of new vessels from the vascularized graft, promoting revascularization and neoangiogenesis, leading to a decreased risk of nonunion 41 . Bone healing was achieved after 3 months in our case, which is in line with the literature, reporting bone healing between 1.5 and 3.5 months after vascularized bone grafts in hand reconstruction 16,17,24 …”

Section: Discussionsupporting

confidence: 87%

“…41 Bone healing was achieved after 3 months in our case, which is in line with the literature, reporting bone healing between 1.5 and 3.5 months after vascularized bone grafts in hand reconstruction. 16,17,24 The vascularized diaphyseal fibula also promotes greater mechanical and chemical bone bonding between the prosthesis than nonvascularized bone grafts. In addition, dual coating of the prosthetic cup and stem surface with porous titanium and HA promotes osteointegration.…”

Section: Discussionmentioning

confidence: 99%

“…23 Combined defects of the carpometacarpal (CMC)-1 joint with loss of the trapezium and the first metacarpal have been reconstructed with medial femoral condyle flaps and arthrodesis 16 or suspension arthroplasty. 24 Combined defects of MCP joints and metacarpals were treated with nonvascularized iliac crest bone graft and Swanson prosthesis 25 or vascularized toe joint transfer. 26 Vascularized bone reconstruction achieves rapid bone union via osteogenesis, undergoes little resorption, and resists infection.…”

mentioning

confidence: 99%

“…Current options for the reconstruction of large metacarpal defects include the interposition of medial femoral condyle flaps with 14 or without 3-dimensional printed models, 15–17 nonvascularized fibular grafts, 18 fibular bone allografts, 19,20 nonvascularized metatarsal grafts, 21,22 and reverse radial artery bone flaps 23 . Combined defects of the carpometacarpal (CMC)-1 joint with loss of the trapezium and the first metacarpal have been reconstructed with medial femoral condyle flaps and arthrodesis 16 or suspension arthroplasty 24 . Combined defects of MCP joints and metacarpals were treated with nonvascularized iliac crest bone graft and Swanson prosthesis 25 or vascularized toe joint transfer 26 …”

mentioning

confidence: 99%

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Conjoined Free Fibula Transplantation and First Carpometacarpal Joint Prosthesis for Functional Thumb Reconstruction—A Case Report

Rein,

Geister,

Kremer

2023

Ann Plast Surg

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Background Giant cell tumors grow locally invasive with osseous and soft tissue destruction, requiring wide resection to avoid recurrence. Stable reconstruction of the first carpometacarpal (CMC-1) joint remains a challenge due to its high range of mobility. The latter is of paramount for the functionality of the hand. Purpose Therefore, the aim of this study was to report our approach for a combined reconstruction of the first metacarpal and the CMC-1 joint. Methods A 58-year-old woman underwent wide resection of a benign giant cell tumor at the base and shaft of the first metacarpal of the left thumb. Because of the loss of the CMC-1 joint and the instability of the thumb, an osseous reconstruction using a vascularized fibular graft combined with a TOUCH Dual Mobility CMC-1 prosthesis was performed to reconstruct the CMC-1 joint. Results Osseous healing was observed after 3 months. No tumor recurrence and good joint function were documented at the follow-up investigation after 1 year. The patient reported only minor restrictions during activities of daily living. Thumb opposition was possible with a Kapandji score of 8/10. A slight pain while walking remained as a donor-side morbidity at the right lower leg. Conclusion Metacarpal reconstruction with vascularized fibula bone grafts allowed a combined joint reconstruction with a commercially available prosthesis, which is an approach to restore the complex range of motion of the thumb.

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Section: Discussionsupporting

confidence: 87%