Free non-vascularized fibular strut bone graft for treatment of post-traumatic lower extremity large bone loss

Lin, Kai-Cheng; Tarng, Yih-Wen; Hsu, Chien-Jen; Renn, Jenn-Huei

doi:10.1007/s00590-013-1342-7

Cited by 20 publications

(31 citation statements)

References 27 publications

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“…22 In 10 patients using free non-vascularised fibular graft for post-traumatic lower limb bone loss, the union rate was 100%. 26 conclusion Non-vascularised fibular grafts for reconstruction of the distal radius after resection of a GCT of bone achieved good cosmetic and functional outcomes.…”

Section: Discussionmentioning

confidence: 79%

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Reconstruction of the Distal Radius with Non-Vascularised Fibular Graft after Resection of Giant Cell Tumour of Bone

Ghulam

Zaidi

2014

J Orthop Surg (Hong Kong)

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Purpose. To evaluate outcomes of wide resection and reconstruction of the distal radius with nonvascularised autogenous fibular grafts for giant cell tumour (GCT) of bone. Methods. Medical records of 7 men and 5 women aged 22 to 47 (mean, 31) years who underwent wide resection of the distal radius and reconstruction with non-vascularised autogenous fibular grafts for GCT of bone were reviewed. The mean length of the resected radius was 9 (range, 7-11) cm. The ipsilateral proximal fibula with a small portion of attached ligament was harvested. The articular surface of the graft was fixed to the scapholunate articular surface by Kirschner wires, and the ligament of the fibular head was sutured to the carpal ligaments. The graft was fixed to the proximal radius with a small dynamic compression plate. Iliac cancellous bone graft was added. Pain, instability, and functional status were assessed. Wrist joint movements were measured using a goniometer. The grip strength was measured.Reconstruction of the distal radius with nonvascularised fibular graft after resection of giant cell tumour of bone Journal of Orthopaedic Surgery 2014;22(3):356-9The operated and contralateral sides were compared. Results. The mean follow-up was 24 (range, 20-27) months. All patients achieved radiological union after a mean of 16 (range, 14-20) weeks. The mean active range of movement in the operated wrists was 32º dorsiflexion, 38º palmar flexion, 15º radial deviations, 12º ulnar deviations, 50º supination, and 60º pronation. Compared with the contralateral wrists, the operated wrists regained 60% of the function, with satisfactory grip strength, and normal finger and thumb movements and hand sensation. No patient had recurrence after 2 years. Two patients had minor dorsal subluxation, which was resolved with a wrist brace. Three patients had superficial infection, which was resolved with intravenous antibiotics and dressings. Two patients had peroneal nerve palsy, which recovered completely in 12 weeks. Conclusion. Non-vascularised fibular grafts for reconstruction of the distal radius after resection of a GCT of bone achieved good cosmetic and functional outcomes.

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Section: Discussionmentioning

confidence: 79%

“…Results. The mean follow-up was 24 (range, [20][21][22][23][24][25][26][27] months. All patients achieved radiological union after a mean of 16 (range, [14][15][16][17][18][19][20] weeks.…”

mentioning

confidence: 99%

Reconstruction of the Distal Radius with Non-Vascularised Fibular Graft after Resection of Giant Cell Tumour of Bone

Ghulam

Zaidi

2014

J Orthop Surg (Hong Kong)

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“…In order to prevent intraoperative problems during fibular harvest, it is important to preserve at least 5 to 6 cm of the proximal and the distal parts of the fibula [12, 14]. Retaining the distal fibula can prevent adverse effects on the distal tibiofibular syndesmosis and the ankle joint [15]. In addition, we feel that the biological approach for harvesting long free nonvascularized fibular graft as proposed by Mukherjee et al reduces donor site morbidity and is safer than conventional approach [8].…”

Section: Discussionmentioning

confidence: 99%

“…The associated use of autograft has been proposed as an osteogenic stimulus with good results reported [4, 6, 7, 11, 13, 15]. Those authors describe the use of cancellous bone graft for augmentation of the fibular graft and speeding up the healing process.…”

Section: Discussionmentioning

confidence: 99%

Use of Nonvascularized Autologous Fibular Strut Graft in the Treatment of Major Bone Defect after Periprosthetic Knee Fracture

Giordano

Coutinho

Miyahira

et al. 2017

Case Reports in Orthopedics

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We present the case of a patient who suffered a comminuted supracondylar periprosthetic femur fracture. The patient was an 86-year-old lady who suffered a minor fall at home and presented at our hospital with a right comminuted distal femur fracture around a total knee arthroplasty. The patient was submitted to a cruciate-sacrificing total knee replacement 6 years before at the same institution. Despite severe metaphyseal fragmentation and short distal fragment, the prosthesis was stable; thus, open fracture reduction and stabilization with internal fixation were performed. The surgical technique included the use of a nonvascularized autologous fibular strut graft as an augmentation technique in conjunction with double plating fixation. Clinically, patient presented a painless aligned knee 12 months after femur fixation, although she was not able to return to an independent level of activity. No pain involving the donor graft site was reported at the time of the most recent follow-up examination. This case study demonstrates the use of free nonvascularized autogenous fibular strut bone graft as an option to bridge major bone defects. This proved to be a relatively simple, not expensive procedure that can be done percutaneously and does not need high-quality training.

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“…Sebuah studi terbaru tentang kejadian ameloblastoma menunjukkan angka kejadian ameloblastoma secara global 0,92 per juta orang/ tahun. 10,11 Terapi mandibulektomi segmental, yang seringkali digunakan untuk reseksi tumor memiliki dampak buruk pada kualitas hidup pasien. Reseksi mandibula menciptakan dampak yang signifikan pada kehidupan pasien, baik secara estetika maupun fungsional.…”

Section: Pendahuluanunclassified

<p>Mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi pada pasien ameloblastoma tipe folikuler</p><p>Segmental mandibulectomy with non-vascularised fibular bone graft reconstruction in follicular ameloblastoma patient</p>

2021

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Pendahuluan: Ameloblastoma adalah tumor invasif lokal dengan insidensi kekambuhan yang tinggi jika tidak dieksisi sepenuhnya. Mandibulektomi segmental sebagai pilihan tatalaksana yang dapat menyebabkan deformitas dan asimetri pada wajah, serta masalah pengunyahan. Pemulihan defek setelah reseksi mandibula menimbulkan masalah yang cukup berat. Tujuan laporan kasus ini untuk melaporkan hasil rekontruksi menggunakan cangkok tulang non-vaskularisasi mandibulektomi segmental pada pasien dengan ameloblastoma mandibula. Laporan kasus: Pria berusia 33 tahun datang ke Poliklinik Rawat Jalan Bagian Bedah Mulut dan Maksilofasial RS Persahabatan dengan keluhan utama pembengkakan mandibula yang perlahan bertambah dan tidak nyeri sejak enam tahun lalu. Pemeriksaan ekstra oral tampak asimetri wajah, bukaan mulut tidak ada limitasi, tidak teraba pembesaran kelenjar getah bening regio leher. Pemeriksaan intraoral didapatkan adanya benjolan regio mandibula kiri dengan batas tegas, konsistensi padat, permukaan tampak trauma oklusi gigi antagonis, immobile, dan terdapat nyeri tekan. Gambaran radiologis menunjukan lesi radiolusen multilokuler menyerupai honeycomb pada corpus mandibula kiri meluas ke regio ramus mandibula kiri. Pemeriksaan biopsi menunjukkan hasil ameloblastoma tipe folikuler pada mandibula kiri dan dilakukan mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi. Sembilan bulan setelah operasi, cangkok tulang non-vaskularisasi tidak menunjukkan komplikasi intraoral dengan bekas luka submandibular ekstraoral baik. Simpulan: Cangkok tulang fibula non-vaskular dapat dipertimbangkan sebagai salah satu pilihan untuk rekonstruksi setelah mandibulektomi segmental pada pasien ameloblastoma.Kata kunci: Mandibulektomi segmental, cangkok fibula non-vaskularisasi, ameloblastoma folikuler. ABSTRACTIntroduction: Ameloblastoma is a locally invasive tumour with a high incidence of recurrence if not completely excised. Segmental mandibulectomy as a treatment option that can cause facial deformities and asymmetry and mastication problem. Recovery of the defect after mandibular resection presents a severe problem. This case report was aimed to report the results of reconstruction using a segmental non-vascularised mandibulectomy bone graft in a patient with mandibular ameloblastoma. Case report: A 33-year-old male came to the Outpatient Polyclinic of the Oral and Maxillofacial Surgery Division of Persahabatan General Hospital with the chief complaint of mandibular inflammation, which was slowly increasing yet painless since six years prior. Extraoral examination showed facial asymmetry, no limitation in mouth opening, no palpable enlargement of lymph nodes in the neck region. Intraoral examination revealed a lump in the left mandibular region with firm borders, solid consistency. The surface appears to be traumatic occlusion of the antagonist tooth, immobile, and tenderness was found. Radiological features showed a multilocular, honeycomb-like radiolucent lesion on the left mandibular body extending into the left mandibular ramus region. A biopsy showed follicular ameloblastoma in the left mandible, and a segmental mandibulectomy was performed with non-vascular fibular bone graft reconstruction. Nine months after surgery, non-vascular bone grafts showed no intraoral complications with either extraoral submandibular scar. Conclusion: Non-vascular fibular bone graft can be considered an option for reconstruction after segmental mandibulectomy in ameloblastoma patients. Keywords: Segmental mandibulectomy, non-vascularised fibula graft, follicular ameloblastoma.

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Free non-vascularized fibular strut bone graft for treatment of post-traumatic lower extremity large bone loss

Cited by 20 publications

References 27 publications

Reconstruction of the Distal Radius with Non-Vascularised Fibular Graft after Resection of Giant Cell Tumour of Bone

Reconstruction of the Distal Radius with Non-Vascularised Fibular Graft after Resection of Giant Cell Tumour of Bone

Use of Nonvascularized Autologous Fibular Strut Graft in the Treatment of Major Bone Defect after Periprosthetic Knee Fracture

<p>Mandibulektomi segmental dengan rekonstruksi cangkok tulang fibula non-vaskularisasi pada pasien ameloblastoma tipe folikuler</p><p>Segmental mandibulectomy with non-vascularised fibular bone graft reconstruction in follicular ameloblastoma patient</p>

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