Star excursion balance test for assessment of dynamic instability of the ankle in patients after harvest of a fibular free flap: a two-centre study

Shah, Kinnari; Peehal, J.P.; Shah, Anjan; Crank, Stephen; Flora, Harpaul S.

doi:10.1016/j.bjoms.2016.11.007

Cited by 9 publications

(14 citation statements)

References 7 publications

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“…The total post-operative surgical complication rate was 53% of all study subjects. This seems to be very high when compared to 1–19% of the comparative study by Ling et al [ 23 ], whereas individual studies also give high values of complications [ 34 , 65 , 70 ]. However, if the temporary complications, such as delayed wound healing and edema, were excluded, the long-term complication rate is 16%.…”

Section: Discussionmentioning

confidence: 76%

“…The number of 68 subjects included in this study corresponds to the values of comparable studies [ 31 ] or is significantly higher [ 34 , 38 , 39 ]. The average age of the subjects in this study was 55 years and 68% of the subjects were of male sex.…”

Section: Discussionmentioning

confidence: 99%

“…The main indication for fibula transplantation in this study subjects was tumor (95,6%, n = 65), most of them squamous cell carcinomas with 69% ( n = 47). In literature, the indication rates due to a tumor diagnosis are described at lower rates 62–89% [ 30 , 34 , 40 , 45 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

“…A comparable study by Ling and Peng calculated an average frequency of 6.95% for sensory deficits, but the values vary between 1.7–76% [ 23 ]. Other studies reported values up to 48% [ 26 ], Shah et al mentioned 23% ( n = 6) for numbness in the area of the fibular and Sural nerve [ 34 ]. For hypesthesia, the sharp-blunt discrimination test in this study resulted in a value of 38%, which is higher than the results in two comparable studies (11–20%) [ 39 , 72 ].…”

Section: Discussionmentioning

confidence: 99%

“…These range from simple sensomotoric examinations of the N. fibularis and walking tests, to complex optical and kinetic analyses of leg function [ 29 , 30 , 31 , 32 , 33 ]. However, data regarding donor site morbidity after lifting of the fibula flap in a split-leg design are rare in literature [ 34 ]. The here presented study mainly focuses on the stability and balance of the affected leg.…”

Section: Introductionmentioning

confidence: 99%

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Donor-Site Morbidity after Fibula Transplantation in Head and Neck Tumor Patients: A Split-Leg Retrospective Study with Focus on Leg Stability and Quality of Life

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The free fibula flap has been one of the most important microvascular grafts for orofacial reconstruction for more than 30 years. The complication rates at the donor-site reported in literature are considered to be low, but the published data vary greatly in some cases. In particular, restrictions in the stability and balance of the involved leg and their effects on the quality of life have been described very inconsistently to date. Therefore, this study mainly focuses on the stability and balance of the affected leg in a split-leg design. Between December 2014 and January 2018, out of 119 subjects who underwent mainly jaw ablative tumor surgery and reconstruction using a fibula flap, 68 subjects were examined for donor site morbidity. Besides reporting general types of complications, two specific test procedures were used. The Star Excursion Balance Test (SEBT) as a practical test for ankle function and the Foot and Ankle Disability Index (FADI) as a questionnaire in order to assess quality of life, depending on the lower leg function. SEBT revealed an average of 55.3 cm with the operated leg as the supporting leg, which corresponds to 95.5% of 57.9 cm achieved with the healthy leg as the supporting leg. An average FADI score of 89.4% was recorded. SEBT and FADI seem to be suitable methods of examination for subjects post fibular transplantation and pointed out minimal limitations of the involved legs in comparison to the unaffected legs. These limitations were clinically not relevant and they had minor influence on the subjects’ quality of life and their daily activities.

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