Free vascularized fibular transplant. A new method for monitoring circulation of the grafted fibula.

Yoshimura, Mitsuo; Shimamura, Koji; Iwai, Yoshihiro; Yamauchi, Shigeki; Ueno, Takayoshi

doi:10.2106/00004623-198365090-00011

Cited by 145 publications

(57 citation statements)

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“…Osteotomies can also be performed along the graft (Hidalgo, 1989) and a simultaneous two team approach is possible, reducing operating time. Early on, the osteocutaneous fibular flap included a small skin paddle, used in order to monitor the postoperative circulation to the bone segment of the flap (Yoshimura et al, 1983;Carr et al, 1988). Further anatomical investigations regarding the skin-component of the free osteocutaneous fibular flap were performed aimed at safely enlarging the skin paddle, with the goal of restoring large composite oromandibular defects (Yoshimura et al, 1990;Schusterman et al, 1992;Wolff et al, 1996).…”

Section: Discussionmentioning

confidence: 99%

Cutaneous perforators of the peroneal artery: Cadaveric study with implications in the design of the osteocutaneous free fibular flap

2009

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Bilateral dissection of 15 formalin embalmed cadaver legs was performed in order to study the anatomic pattern of the peroneal artery (PA) and its cutaneous perforating vessels (CB). The total number of CB from the PA was 125 or an average of 4.17 branches per leg. CB were distributed in the superoinferior axis between 18.25 and 84.25% of the length of the fibula and their average length was 5 +/- 1.8 cm. 86/125 (68.8%) of the CB were classified as myocutaneous branches (MC) that penetrated muscle before reaching the skin, whereas 39/125 (31.2%) were septocutaneous branches (SC) that passed through the intermuscular septum. The mean distance between the posterior border of the fibula and the site where the perforators emerged was 1.88 +/- 0.79 cm for the SC and 1.21 +/- 0.87 cm for the MC. These anatomic findings should encourage the surgeon to design the skin paddle in the boundary between the middle and the distal third of the fibular length about 2 cm behind the posterior fibular border on the posterolateral leg, where the number of CB is maximal.

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Section: Discussionmentioning

confidence: 99%

Cutaneous perforators of the peroneal artery: Cadaveric study with implications in the design of the osteocutaneous free fibular flap

2009

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“…In 1983 Chen and Yan [1] incorporated a skin paddle with the free fibula as a composite graft for soft-tissue coverage. That same year, Yoshimura et al [24] expanded the indications for an osteocutaneous fibular graft with a skin island based on perforator vessels for postoperative monitoring of the free fibula bone graft. In 1989 Wei et al [23] published their successful results of an anatomical study and a clinical application of the vascularized free osteoseptocutaneous fibula flap.…”

Section: Discussionmentioning

confidence: 99%

“…Many reconstructive options exist due to the development of new techniques and the variety of flap donor sites [4,6,18,24]. However, the most common donor site remains to be the fibula [4,6,14,23].…”

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confidence: 99%

Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

et al. 2006

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The objective of this investigation was to evaluate the indications for and the functional and cosmetic results of mandible reconstruction using free vascularized fibular flaps. It was also designed to assess the patients' quality of life, daily activities, and self-esteem, with special emphasis on patient satisfaction. We conducted a retrospective chart review of all patients who underwent osseus or osteocutaneous free flap reconstruction of the mandible over a 10-year period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002). Those in whom a vascularized fibular flap was used were included in the study and invited for a follow-up comprehensive physical examination and x-ray evaluation. A questionnaire was also administered to evaluate patient satisfaction. Twenty-six patients were included in the study. Fourteen patients died after an average of 2 years and 9 months postoperatively due to their prognosis despite surgical intervention and adjuvant therapy. Of the remaining 12 patients, 6 appeared for the follow-up evaluation, 2 were unavailable for followup, and 4 denied participating. Of these 6 patients, all experienced a decrease in pain and were satisfied with their results. At the time of the latest follow-up, they experienced some difficulties swallowing, and in 3 patients, their articulation was impaired. All 6 patients would undergo the procedure again. Reconstruction of the mandible using a vascularized fibular graft produces satisfactory functional and cosmetic results. In benign lesions, the procedure is highly indicated. However, in the case of malignancy, most patients do not survive their primary tumor. Given the patients limited life expectancy, the improvement in their quality of life as a result of the improved appearance and function of the reconstructed mandible needs to be weighed against the potential morbidity of the operative intervention on an individual basis.

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“…Song et al (1982). Yoshimura et al (1983), Katsaros et al (1984), Swartz et al (1986) (Table 5). The graft vessels were sutured to the posterior tibial vessels in 2 transfers, to the peroneal vessels in 1 case and to the anterior tibial vessels in the remaining 19 transfers.…”

Section: Methodsmentioning

confidence: 99%

Free tissue transfer for Type III tibial fractures

Reigstad¹,

Hetland²,

Bye³

et al. 1992

Acta Orthopaedica Scandinavica

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Free vascularized fibular transplant. A new method for monitoring circulation of the grafted fibula.

Cited by 145 publications

References 0 publications

Cutaneous perforators of the peroneal artery: Cadaveric study with implications in the design of the osteocutaneous free fibular flap

Cutaneous perforators of the peroneal artery: Cadaveric study with implications in the design of the osteocutaneous free fibular flap

Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

Free tissue transfer for Type III tibial fractures

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