The free osteofasciocutaneous fibula flap: Clinical applications and surgical considerations

Pototschnig, Hanno; Schaff, J.; Kovâcs, László; Biemer, E.; Papadopulos, Nikolaos Α.

doi:10.1016/j.injury.2013.01.007

Cited by 26 publications

(18 citation statements)

References 31 publications

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“…One study reported high HRQoL after reconstruction of a radius with a free osteocutaneous fibula graft. 39 In the present series, the authors compared postoperative generic HRQoL to that of the general Finnish population. The study confirmed that the free vascularized fibula graft in upper extremity reconstruction yields good HRQoL outcomes, even in patients with significantly impaired upper extremity function.…”

Section: Discussionmentioning

confidence: 99%

Free Vascularized Fibular Graft is Reliable in Upper Extremity Long-Bone Reconstruction with Good Long-Term Outcomes

Repo

Sommarhem

Roine

et al. 2016

J reconstr Microsurg

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Background Free vascularized fibular graft is useful in upper extremity long-bone reconstruction. The authors studied the reliability and long-term outcomes of this technique. Methods The authors included 20 patients with a minimum follow-up of 24 months in this study, and retrospectively reviewed patients' hospital records and used a preinformation form, the Disabilities of the Arm, Shoulder and Hand (DASH), the Lower Extremity Functional Scale (LEFS), and the 15D health-related quality of life (HRQoL) instrument to perform a cross-sectional assessment. Results A total of 9 adults and 11 children underwent vascularized fibular transfer for radical tumor resection (n = 13), infection (n = 1), injury (n = 3), or secondary pseudoarthrosis (n = 3) in various locations of the upper extremity. The median follow-up period was 6 years. Six reoperations proved necessary: one early reanastomosis and five revisions with cancellous bone grafting to enhance union. Altogether, 19 of the 20 grafts survived: one graft failed due to infection. One arm was amputated due to tumor recurrence. The median duration of bone union was 12 months. One graft never achieved distal union, whereas another developed nonunion after a stress fracture. Ten patients completed the questionnaires, with a median of 15.3 years postoperatively. The results revealed functional capabilities ranging from no restrictions to significantly impaired, and an HRQoL comparable to that of an age-standardized general population. Conclusion The free vascularized fibular graft is viable in different age groups to reconstruct upper extremity long-bone defects in cases of radical bone resection, extensive injury, and diaphyseal pseudoarthrosis. The long-term outcomes support the use of this technique.

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Section: Discussionmentioning

confidence: 99%

Free Vascularized Fibular Graft is Reliable in Upper Extremity Long-Bone Reconstruction with Good Long-Term Outcomes

Repo

Sommarhem

Roine

et al. 2016

J reconstr Microsurg

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“…18 Thus, some authors recommend performing routine preoperative ultrasonic Doppler flowmeter and an angiography if there is any uncertainty. 20 However, the posterior approach obviates the need for such measures, given its provision of an excellent visualization of the vasculature. Once it has been visualized that the posterior tibialis artery is present, harvest of the fibula flap may proceed without any concern for devascularizing the leg.…”

Section: Discussionmentioning

confidence: 99%

Fibula Osteoseptocutaneous Flap

Chen

Qiu

Lin

et al. 2016

Annals of Plastic Surgery

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According to our experience, the posterior approach for the harvest of the osteoseptocutaneous fibula flap is a safe technique and offers many advantages, such as a better visualization of the perforators, beneficial for chimeric flap elevation, preservation of the muscular fascia in the donor site, and an earlier diagnosis of any anatomical variation. Both the reliable and the versatility of the skin paddle can substantially improve with this approach.

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“…[19][20][21][22][23][24] While the sensational advantages of the RFFF cannot be disputed, the bony component of the fibula flap adds durable rigidity for sexual intercourse that can eliminate the need for a prosthesis. 1,19 Typically, this flap has three stages: harvest (►Fig. 2) and prelamination of the neourethra with split-thickness skin graft for 6 months before flap inset; inset of the free sensate osteocutaneous fibular flap (►Fig.…”

Section: Fibular Osteocutaneous Flapmentioning

confidence: 99%

“…1 Other complications included poor wound healing, infection, inflammation of the neoscrotum, neourethra stenosis, and prosthesis failure. [19][20][21][22][23] One study by Schaff and Papadopulos comparing the fibula flap to the RFFF found that patients who underwent the fibular flap interestingly experienced better sexual intercourse but had worse sensation. All patients reported the ability to void while standing, as well as satisfactory sexual intercourse, with minimal donor-site morbidity.…”

Section: Fibular Osteocutaneous Flapmentioning

confidence: 99%

Free Tissue Transfer Penile Reconstruction

Kropp

Cohn

Wang

et al. 2019

Seminars in Plastic Surgery

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Phalloplasty can be a challenging plastic surgery procedure associated with complications and unsatisfactory results. Phalloplasty has become an important procedure in the setting of trauma, partial or complete excision of the penis, and gender affirmation. Advances in microsurgery has expanded penile reconstruction through free tissue transfer techniques which include the radial forearm free flap, fibular osteocutaneous flap, anterolateral thigh flap, latissimus dorsi flap, scapular flap, and abdominal flaps. Each procedure has advantages and disadvantages; most of the procedures achieve adequate cosmetic results with high patient satisfaction. Most of the surgical complications are related to the reconstruction of the urethra or creating rigidity for intercourse. The main goals of reconstruction are to create a cosmetically appealing phallus with satisfactory sexual function.

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The free osteofasciocutaneous fibula flap: Clinical applications and surgical considerations

Cited by 26 publications

References 31 publications

Free Vascularized Fibular Graft is Reliable in Upper Extremity Long-Bone Reconstruction with Good Long-Term Outcomes

Free Vascularized Fibular Graft is Reliable in Upper Extremity Long-Bone Reconstruction with Good Long-Term Outcomes

Fibula Osteoseptocutaneous Flap

Free Tissue Transfer Penile Reconstruction

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