The Fibula-Flexor Hallucis Longus Osteomuscular Flap

Ruch, D. S.; Koman, L. Andrew

doi:10.1302/0301-620x.79b6.0790964

Cited by 14 publications

(8 citation statements)

References 26 publications

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“…These usually traverse the flexor hallucis longus muscle before arborising on bone. 2 Tibialisation of the fibula was first described by Albert in 1877 to achieve fusion between the femur and distal tibia in a patient with congenital absence of the proximal tibia. 3 Since then, four methods with a number of varia- of the graft and of infection are higher.…”

Section: Discussionmentioning

confidence: 99%

“…11,12 In methods 3 and 4 it is recommended that an angiogram be done before the graft is harvested. 2,13 In some cases the harvested vessel was found to be the sole feeder to the foot, the fibula had no demonstrable nutrient vessels, or the nutrient artery entered the fibula away from its usual position. The use of a circular external fixator with fine wires after methods 3 and 4 can cause irreparable damage to the vessels of the graft.…”

Section: Discussionmentioning

confidence: 99%

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Ipsilateral vascularised fibular transport for massive defects of the tibia

Atkins

Madhavan

Sudhakar

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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T he ipsilateral and contralateral fibulae have been used as a vascularised bone graft for loss of tibial bone usually by methods which have involved specialised microvascular techniques to preserve or re-establish the blood supply.We have developed a method of tibialisation of the fibula using the Ilizarov fixator system, ipsilateral vascularised fibular transport (IVFT), and have used it in five patients with massive loss of tibial bone after treatment of an open fracture, infected nonunion or chronic osteomyelitis. All had successful transport, proximal and distal union, and hypertrophy of the graft without fracture. One developed a squamous-cell carcinoma which ultimately required amputation of the limb.The advantage of IVFT is that the fibular segment retains its vascularity without the need for microvascular dissection or anastomoses. Superiosteal formation of new bone occurs if the tibial periosteal bed is retained. Other procedures such as corticotomy and lengthening can be carried out concurrently.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Ipsilateral vascularised fibular transport for massive defects of the tibia

Atkins

Madhavan

Sudhakar

et al. 1999

The Journal of Bone and Joint Surgery. British volume

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“…Free vascularized fibula Rush and Koman [38] 1997 Tibia Fibula-flexor halluces longus osteomuscular flap…”

Section: Kneementioning

confidence: 99%

“…The fibula can also be harvested as a combined osteocutaneous flap for composite defects of the lower extremity [6,10] . An additional osteomuscular flap that has been reported to have good outcomes for coverage after distal tibial osteosarcoma resection is the fibula-flexor hallucis longus osteomuscular flap [38] . Saito et al [24] also describe adequate aesthetic and functional outcomes with the use of a free composite graft of latissimus dorsi and scapular bone as well as a free osteocutaneous scapular-parascapular flap.…”

Section: Bone Involvementmentioning

confidence: 99%

Complex reconstruction of the lower extremity following sarcoma resection: a literature review

Azadgoli¹,

Carre²,

Perrault³

et al. 2018

PAR

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While amputation was traditionally the only option available for patients with sarcomas of the extremities, chemotherapy, radiation, and advances in microsurgical technique have allowed many patients to undergo limb-salvaging procedures. Given the low incidence and heterogeneity of these tumors, there is currently no standard treatment algorithm for limb reconstruction after large sarcoma resection. Thus, we systematically reviewed the various types of free tissue transfer used for the reconstruction of lower limbs after sarcoma resection. Techniques were described based on anatomic location. This literature review supports free tissue transfer as a safe and acceptable modality for reconstruction after sarcoma resection of the lower limb. It allows for the application of healthy vascularized tissue to the defect while also providing freedom of flap positioning. Flap choice is dependent on tumor and defect size, tissue type and function, as well as donor site availability.

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“…Various modifications of the free fibula flap have been described. [2][3][4][5][6][7] Osseous defects requiring vascularized bone transfer using the free fibula flap typically include the craniofacial skeleton including the maxilla and mandible, 8 -14 and the upper and the lower extremities. [15][16][17][18][19][20][21][22][23][24] Additional indications have been reported.…”

mentioning

confidence: 99%