Long-term donor-site morbidity after vascularized free fibula flap harvesting: Clinical and gait analysis

Feuvrier, D.; Sagawa, Yoshimasa; Béliard, Samuel; Pauchot, J.; Decavel, Pierre

doi:10.1016/j.bjps.2015.10.007

Cited by 53 publications

(55 citation statements)

References 43 publications

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Section: Discussionmentioning

confidence: 89%

“…However, the difference compared to the contralateral side was always below one standard deviation of the healthy control group, which might indicate a nonsignificant difference. In contrast,Feuvrier, Sagawa Jr., Beliard, Pauchot, and Decavel (2016) showed significant changes in gait analyses of 11 patients after free fibula bone grafting.The donor site morbidity of free iliac crest bone grafts is well documented Qi, Liu, Li, and Zhang (2014). performed a prospective study with a 10-year follow-up.…”

mentioning

confidence: 79%

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Donor site morbidity of vascularized bone grafts from the medial femoral condyle for osseous revascularization

et al. 2019

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Background Vascularized bone grafts from the medial femoral condyle (MFC) are used to gain surgical revascularization of osseous defects. To date objective data regarding the donor site morbidity are limited. This study aims to evaluate the donor site associated outcome after MFC flap harvest. Patients and Methods From 2008 to 2016, 22 patients who underwent MFC bone flap harvest for osseous revascularization of 9 talus, 8 scaphoids, 2 metacarpals, 1 phalanx, 1 pilon tibiale, and 1 distal femur were included. Outcome analysis was performed for the whole cohort as well as for two subgroups (recipient site upper [group A] and lower extremity [group B]) by the lower extremity functional scale (LEFS), the OAK‐score of the Swiss Orthopedic Society and the visual analog scale (VAS). Additionally, a 3D gait analysis was performed for four patients. Results The mean flap size was 1 × 1 × 3 cm. No flap loss was observed. One minor surgical revision was performed due to donor site hematoma. Mean follow‐up was 35.8 (12–98) months. Mean LEFS‐score was 74.9 ± 9.5 (A: 74.3 ± 7.9; B: 75.6 ± 11.2, p > .05) and OAK‐score was 92.8 ± 9.4 (A: 93.2 ± 5.8; B: 92.4 ± 12.3, p > .05). At follow‐up examination, pain at rest was stated with 0.1 ± 0.2 (A: 0.1 ± 0.3; B 0 ± 0, p > .05) and with activity 0.6 ± 1.4 (A: 1.2 ± 1.8; B: 0 ± 0, p > .05) on VAS. The 3‐D gait analysis showed normative walking patterns. Conclusion After MFC flap harvest knee function and gait pattern were almost unimpaired. Donor site morbidity can be considered as being of minor concern in the decision‐making for this microvascular procedure.

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Section: Discussionmentioning

confidence: 89%

mentioning

confidence: 79%

Donor site morbidity of vascularized bone grafts from the medial femoral condyle for osseous revascularization

et al. 2019

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“…This process involves a long surgical procedure and can increase the morbidity on the donor site. In addition, there is a demand for further information about the factors that lead to failure [25,26].…”

Section: Treatments For Bone Lesionsmentioning

confidence: 99%

Scaffolds and coatings for bone regeneration

Pereira

Cengiz

Silva

et al. 2020

J Mater Sci: Mater Med

110

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Bone tissue has an astonishing self-healing capacity yet only for non-critical size defects (<6 mm) and clinical intervention is needed for critical-size defects and beyond that along with non-union bone fractures and bone defects larger than critical size represent a major healthcare problem. Autografts are, still, being used as preferred to treat large bone defects. Mostly, due to the presence of living differentiated and progenitor cells, its osteogenic, osteoinductive and osteoconductive properties that allow osteogenesis, vascularization, and provide structural support. Bone tissue engineering strategies have been proposed to overcome the limited supply of grafts. Complete and successful bone regeneration can be influenced by several factors namely: the age of the patient, health, gender and is expected that the ideal scaffold for bone regeneration combines factors such as bioactivity and osteoinductivity. The commercially available products have as their main function the replacement of bone. Moreover, scaffolds still present limitations including poor osteointegration and limited vascularization. The introduction of pores in scaffolds are being used to promote the osteointegration as it allows cell and vessel infiltration. Moreover, combinations with growth factors or coatings have been explored as they can improve the osteoconductive and osteoinductive properties of the scaffold. This review focuses on the bone defects treatments and on the research of scaffolds for bone regeneration. Moreover, it summarizes the latest progress in the development of coatings used in bone tissue engineering. Despite the interesting advances which include the development of hybrid scaffolds, there are still important challenges that need to be addressed in order to fasten translation of scaffolds into the clinical scenario. Finally, we must reflect on the main challenges for bone tissue regeneration. There is a need to achieve a proper mechanical properties to bear the load of movements; have a scaffolds with a structure that fit the bone anatomy. Graphical Abstract* Helena Filipa Pereira

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“…The advantages of this flap in terms of reconstruction are well‐known; many papers on this topic have been published over the past 30 years (Aydin, Emekli, Erer, & Hafiz, ; Moubayed et al, ). Papers focusing on harvesting‐associated morbidities are relatively few in number, but nonetheless allow the assessment of long‐term, postoperative donor site outcomes—especially functionality (Baj et al, ; Feuvrier, Sagawa, Béliard, Pauchot, & Decavel, ; Li, Fang, Qi, Luo, & Sun, ; Ver Halen, ).…”

Section: Introductionmentioning

confidence: 99%

Perioperative pain management after fibular free flap harvesting for head‐and‐neck reconstruction using mini‐catheters to inject local anesthetic: A pilot study

et al. 2017

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Long-term donor-site morbidity after vascularized free fibula flap harvesting: Clinical and gait analysis

Cited by 53 publications

References 43 publications

Donor site morbidity of vascularized bone grafts from the medial femoral condyle for osseous revascularization

Donor site morbidity of vascularized bone grafts from the medial femoral condyle for osseous revascularization

Scaffolds and coatings for bone regeneration

Perioperative pain management after fibular free flap harvesting for head‐and‐neck reconstruction using mini‐catheters to inject local anesthetic: A pilot study

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