Outcomes of free vascularised fibular graft reconstruction in upper limb trauma—a systematic review

Liaw, Frank; Teoh, Say How; Stevens-Harris, Isabella; Maamoun, Wareth

doi:10.1007/s00590-021-03185-9

Cited by 11 publications

(16 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…27 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 The vascularized diaphyseal fibula also promotes greater mechanical and chemical bone bonding between the prosthesis than nonvascularized bone grafts.…”

Section: Discussionsupporting

confidence: 91%

“…The latter has greater bone healing capability than avascular bone grafts based on their osteogenic and osteoinductive properties 27 . 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: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Rein,

Geister,

Kremer

2023

Ann Plast Surg

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

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

Rein,

Geister,

Kremer

2023

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…These can be seen because of elderly age, previous surgeries, and disuse. Overlapping the bone erosions Vascularised fibular grafts are good choices, especially when the bony defect is wide and segmental (17,(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

Functional Outcomes of Patients Treated with Fibula Strut Graft and Double Plate in the Treatment of Recalcitrant Humerus Nonunions

Karadeniz

BÖLÜKBAŞI

2022

Middle Black Sea Journal of Health Science

View full text Add to dashboard Cite

Aim: Recalcitrant humerus nonunion is difficult to treat, and plate fixation is a common treatment choice. This study aimed to determine the efficiency of double plating combined with nonvascularized autologous fibular strut allograft in the treatment of atrophic and defective humerus nonunions. Methods: Fourteen patients were surgically treated for recalcitrant humerus malunions. Demographic data (age, gender, dominant side), clinical features, and previous surgical records of the patients were recorded preoperatively. Preoperative Visual Analogous Scale (VAS) and Constant-Murley scores of the patients were recorded before the surgery. Results: 10 (71.4%) of the patients were female and 4 (28.5%) were male. The mean age was 53.07±9 (range, 39-67). 9 (64.3%) of the patients had nonunions on the dominant side. Mean follow-up was 11.1±1.9 months. The complete union was observed in all patients and the mean union time was 5.1±0.63 months (range, 4.2-6.0). The mean preoperative VAS score was 7.29 ± 0.91 (range, 6-9), and the mean postoperative VAS score was 0.93 ± 0.92 (range, 0-3). VAS scores improved after the surgery (p

show abstract

“…Flap success rates for free fibula flap upper extremity reconstruction were reported to be 97% in a recent systematic review, which is in concordance with the flap viability rate of 97.5% in this study. 32 In our experience, there are two main keys to microsurgical success: choice of recipient vessels and optimal pedicle orientation. For humerus reconstruction, we first seek out a branch of the brachial artery or circumflex humeral artery for end-to-end anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of oncologic upper extremity defects with fibula free flaps has high union rates and excellent functional outcomes

Shahzad

Fazzalari

Zoghbi

et al. 2023

Journal of Surgical Oncology

View full text Add to dashboard Cite

BackgroundLimb salvage has better functional outcomes than amputation in the upper extremity. This can however be challenging after bony tumor resections.MethodsThis is a retrospective case series of patients who underwent humerus, ulna, or radius reconstruction with a fibula free flap. Data were collected on demographics, oncologic history, surgical details, and complications. Functional outcome measures included the patient's ability to perform activities of daily living (ADL), presence of pain, and musculoskeletal tumor society (MSTS) score.ResultsOver a 25‐year period, 38 reconstructions were performed. The flap success rate was 97.5%. Bony union was obtained in 19 of 19 (100%) forearm reconstructions and in 15 of 19 (79%) humerus reconstructions (p = 0.10). All 19 forearm reconstruction patients and 18/19 humerus reconstruction patients were able to perform ADLs with no pain or only occasional pain. The MSTS scores were not significantly different between the humerus and forearm cohorts (27.1 vs. 27.3, p = 0.68). Functional outcomes were significantly better in limbs that achieved union (p < 0.001). Recipient and donor site complications occurred in 10 (26.3%) and 5 (13%) patients, respectively.ConclusionsOncologic upper‐extremity reconstruction with fibula free flaps has excellent functional outcomes. Bone union is a predictor of superior limb function.

show abstract

Outcomes of free vascularised fibular graft reconstruction in upper limb trauma—a systematic review

Cited by 11 publications

References 48 publications

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

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

Functional Outcomes of Patients Treated with Fibula Strut Graft and Double Plate in the Treatment of Recalcitrant Humerus Nonunions

Reconstruction of oncologic upper extremity defects with fibula free flaps has high union rates and excellent functional outcomes

Contact Info

Product

Resources

About