Utility of the Free Vascularized Fibula Flap to Reconstruct Oncologic Defects in the Upper Extremity

Claxton, Matthew R; Shirley, Matthew; Bakri, Karim; Rose, Peter S.; Moran, Steven L.; Houdek, Matthew T.

doi:10.21873/anticanres.14246

Cited by 16 publications

(17 citation statements)

References 32 publications

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“…12,13 Surgeons have utilized the free fibula transfer to reconstruct a myriad of humeral defects when nonvascularized bone graft or prosthesis would not be sufficient. [14][15][16] However, there conceivably exist circumstances where a free fibula flap is not an option, as in our shoulder arthrodesis case. Patients with multiple previous surgeries and attempts at wound coverage may have significant disruption of the regional vasculature.…”

Section: Discussionmentioning

confidence: 87%

Free Your Mind, Not Your Flap

Neusner

Pribaz

Guo

2022

Plastic and Reconstructive Surgery - Global Open

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Summary: The pedicled flap has been a mainstay of soft tissue reconstruction since the earliest days of plastic surgery. Advances in surgical technology and skill have led to an erosion in the use of pedicled flaps in favor of increasingly popular free tissue transfers. Still, regional flaps without microvascular anastomosis remain a valuable reconstructive tool. Although still requiring microsurgical skills, these flaps are of particular benefit in patients with few or poor quality recipient vessels, in those who cannot tolerate antiplatelet therapy, and in those who cannot tolerate the often-extended anesthesia time necessitated by microvascular anastomosis. Furthermore, pedicled flaps may significantly reduce total cost of a reconstruction procedure with similar outcomes. In this case series, we report challenging scenarios where microsurgical approaches may have been typical choices but were instead reconstructed by pedicled options with desired outcomes. Difficult soft tissue defects were successfully reconstructed with a variety of pedicled flaps. Soft tissue transfers to the abdomen, flank, shoulder, and back are presented. None of the reconstructions required microvascular anastomosis.

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Section: Discussionmentioning

confidence: 87%

Free Your Mind, Not Your Flap

Neusner

Pribaz

Guo

2022

Plastic and Reconstructive Surgery - Global Open

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“…However, the proximal fibula-ulnar coaptation failed to unite and the patient developed non-union. In a series of 28 VFF grafts for oncological reconstruction of the upper limb, primary union was achieved in 71% of cases, increasing to 96% following supplemental bone-grafting [4] .…”

Section: Discussionmentioning

confidence: 99%

Combination of a free vascularised fibula and the Masquelet technique for long bone ulna defect reconstruction: A case report

Wright¹,

Bourke

Giannoudis³

2022

Trauma Case Reports

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“…It has been reported that the incidence of stress fracture for one-barrel bula grafts ranging from 20-40% within 1 year, especially for the bone defect of lower extremity [15,16] . One-barrel bula graft provides su cient biomechanical and bone support for long bone defects including humerus, radius and ulna [17] . Double or folded bula grafts were chosen when intermediate stress loads were applied to the resection site [18] .…”

Section: Discussionmentioning

confidence: 99%

Folded Free Vascularized Fibular Bone Graft for Segmental Femoral Bone Defect: a Retrospective Report

Jian

et al. 2021

Preprint

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ObjectiveVascularized fibular bone graft is an efficient method for various segmental bone defects. The objective of this report is to introduce our experience of folded free vascularized fibular bone graft for segmental femoral bone defect.Patients and methodsClinical data collected by surgeons and Hospital Information System (HIS) system were screened respectively. Cases with segmental femoral bone defect repaired by folded free vascularized fibular bone graft were collected. Clinical data including demographic characteristics, defect size, coinfection, perioperative treatment and imaging data during follow up were all collected for analysis.ResultsTwelve patients (10 males and 2 females), aged from 6 to 58, were included in this report. The defect range was 3 to 10 cm, with an average of 6.2 cm. Three cases were complicated with infection, the others were not. Folded free vascularized fibular bone graft were harvested for the reconstruction of segmental femoral bone defect. The grafts were fixed with plates in 9 cases and external fixators in 3 cases. All grafts healed uneventfully with an average healing time of 5.2 months (range 4~8 months). Internal fixation failure occurred in one case. The follow up time ranged from 15 to 130 months (average 58.3 months).ConclusionFolded free fibula graft is one of the optional methods for segmental bone defect of femur. Through this method, patients can achieve one-time operation to reconstruct the bone defect of the affected limb.

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Utility of the Free Vascularized Fibula Flap to Reconstruct Oncologic Defects in the Upper Extremity

Cited by 16 publications

References 32 publications

Free Your Mind, Not Your Flap

Free Your Mind, Not Your Flap

Combination of a free vascularised fibula and the Masquelet technique for long bone ulna defect reconstruction: A case report

Folded Free Vascularized Fibular Bone Graft for Segmental Femoral Bone Defect: a Retrospective Report

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