Reconstruction fonctionnelle de l’avant-bras par lambeau libre composite de fibula et de soléaire ré-innervé. À propos d’un cas

Blanc, Christelle; Kerfant, N.; Robert, M; Gasnier, P.; Hu, Weiguo

doi:10.1016/j.anplas.2014.07.019

Cited by 3 publications

(1 citation statement)

References 18 publications

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“… 12 In 2015, Blanc et al used a 15-cm-long fibula to bridge the proximal ulna to distal radius to achieve one-bone forearm reconstruction for the segmental loss of both the radius and ulna. 15 The reinnervated soleus muscle was used for wrist and finger extension. However, none of these performed simultaneous reconstruction of the radius and ulna with a double-barrel fibula like we did.…”

Section: Discussionmentioning

confidence: 99%

Functional Chimeric Double-barrel Fibula and Reinnervated Peroneus Brevis Osteomyocutaneous Flap for One-stage Forearm Reconstruction

Lai

Lee

2023

Plastic and Reconstructive Surgery - Global Open

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Summary: Reconstructing a mangled limb is complex and requires expertise in both bone and soft-tissue reconstruction, particularly when there is significant muscle loss. Typically, multistage surgery is necessary, starting with soft-tissue coverage, followed by bone grafting and tendon transfers. Sometimes, microsurgical techniques such as vascularized bone grafts and free functional muscle transfers are necessary, especially when there is a bone defect of over 6 cm; the soft-tissue environment is infected, scarred, or poorly vascularized; or there are extensive musculotendinous injuries. We treated a 34-year-old man who had a crushed left forearm resulting in an 18 × 8 cm open wound, 5-cm radius and 7-cm ulna bone defects, loss of the extensor pollicis longus and brevis muscles, and extensive injuries to the other musculotendinous structures of the forearm. To accomplish a one-stage reconstruction, we used a chimeric fibula osteomyocutaneous flap that included a 20 × 10 cm skin flap, peroneus brevis muscle with its motor nerve, and two segments of fibula. The proximal and distal fibula segments were used for ulnar and radial bone reconstruction, respectively, preserving forearm supination and pronation. The peroneus brevis tendon was sutured to the extensor pollicis longus tendon, and its motor nerve was coaptated with the posterior interosseous nerve to restore thumb extension. The skin flap provided complete coverage of all exposed bone and tendon structures. At the 12-month follow-up, the patient regained full extension of the thumb, and there were no difficulties with forearm supination and pronation or with foot eversion and plantar flexion at the donor leg.

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Section: Discussionmentioning

confidence: 99%