Gait Analysis: A New Perspective on Sural Nerve Graft Donor Site Morbidity Assessment

Background: Proximal radial nerve lesions located between the brachial plexus and its division into the superficial and deep branches are rare but severe injuries. The majority of these lesions occur in association with humerus fractures, directly during trauma or later during osteosynthesis for fracture treatment. Diagnostics and surgical interventions are often delayed. The best type of surgical treatment and the outcome to be expected often is uncertain. Methods: Twelve patients with proximal radial nerve lesions due to trauma or prior surgery were included in this study and underwent neurolysis (n = 6) and sural nerve graft interposition (n = 6). Retrospective analysis of the collected patient data was performed and the postoperative course was systematically evaluated. The Disabilities of the Arm, Shoulder, and Hand (DASH) and the LSUHS (Louisiana State University Health Sciences) scores were used to determine regeneration after surgery. Comparison between the patients’ and calculated normative DASH scores was performed. Results: All patients had a traumatically or iatrogenically induced proximal radial nerve lesion and underwent secondary treatments. The average time from radial nerve lesion occurrence to surgical intervention was approximately four months (1.5–10 months). Eight patients (66.67%) had a humeral fracture. During follow up, no statistically significant difference between the calculated normative and the patients’ DASH scores was observed. The LSUHS scores were at least satisfactory. Conclusions: Neurolysis or sural nerve graft interposition performed within a specific period of time are the primary treatment options for radial nerve lesions. They should be performed depending on the lesion type. Regeneration to a satisfactory degree was observed in all patients, and the majority achieved full recovery of sensory and motor functions. This was the first study to highlight the efficiency of neurolysis and sural nerve graft interposition as secondary treatment interventions, especially for radial nerve lesions.

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Long-term donor-site morbidity after vascularized free fibula flap harvesting: Clinical and gait analysis

Journal of Plastic Reconstructive & Aesthetic Surgery ◽

10.1016/j.bjps.2015.10.007 ◽

2016 ◽

Vol 69 (2) ◽

pp. 262-269 ◽

Cited By ~ 27

Author(s):

Damien Feuvrier ◽

Yoshimasa Sagawa ◽

Samuel Béliard ◽

Julien Pauchot ◽

Pierre Decavel

Keyword(s):

Gait Analysis ◽

Donor Site ◽

Donor Site Morbidity ◽

Free Fibula Flap ◽

Fibula Flap ◽

Free Fibula

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Repair of nasal septal perforations using local mucosal flaps and a composite cartilage graft

The Journal of Laryngology & Otology ◽

10.1258/0022215011906939 ◽

2001 ◽

Vol 115 (1) ◽

pp. 22-25 ◽

Cited By ~ 33

Author(s):

T. J. Woolford ◽

N. S. Jones

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Observation Time ◽

Cartilage Graft ◽

Septal Perforation ◽

Surgical Closure ◽

Nasal Septal Perforation ◽

Graft Donor ◽

Conchal Cartilage Graft ◽

Suitable Technique

The surgical closure of a nasal septal perforation is recognized as being particularly challenging. A series of 11 consecutive patients who underwent closure of a septal perforation using a mucosal flap/composite conchal cartilage graft technique are reviewed, and the surgical technique described. The size of the perforation repaired varied, with eight cases being 2 cm or more in diameter. There was no significant graft donor site morbidity and complete perforation closure was achieved in eight cases after a mean observation time of 19.8 months. These results suggest that this is a suitable technique for closing nasal septal perforation.

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Cartilage Graft Donor Site Morbidity following Rhinoplasty and Nasal Reconstruction

Craniomaxillofacial Trauma & Reconstruction ◽

10.1055/s-0037-1607065 ◽

2018 ◽

Vol 11 (4) ◽

pp. 278-284 ◽

Cited By ~ 1

Author(s):

Thuy-Van Tina Ho ◽

Kevin Sykes ◽

J.David Kriet ◽

Clinton Humphrey

Keyword(s):

Donor Site ◽

Donor Site Morbidity ◽

Nasal Reconstruction ◽

Cartilage Graft ◽

Nasal Surgery ◽

Auricular Cartilage ◽

Donor Site Pain ◽

Graft Donor ◽

Ear Cartilage ◽

Site Pain

Although surgical techniques for rhinoplasty and nasal reconstruction are well established, prospective research on postoperative morbidity remains limited. The aim of this pilot study was to assess costal and auricular cartilage donor site pain and morbidity in patients undergoing rhinoplasty and nasal reconstruction. In this prospective cohort study, we enrolled 55 patients undergoing nasal surgery that required costal or auricular cartilage harvest from February 2015 through May 2016. Each patient was given a symptom-specific patient survey that assessed general pain, nasal pain, graft donor site pain, graft donor site itching, color variation, skin stiffness and thickness, and graft donor site appearance at 1, 4, and 12 weeks after surgery. Our patient group was 55% female ( n = 30); the mean age was 47 years. Rib cartilage graft patients had significantly greater nasal pain than cartilage donor site pain. There was no significant difference in rib versus ear cartilage donor site pain. Nearly all patients reported that they were not at all concerned about their scar appearance or ear shape and appearance. No prior studies compare cartilage donor site morbidity in patients undergoing nasal surgery. Our findings challenge the conventional wisdom that utilizing auricular and costal cartilage results in high levels of donor site pain. Surgeons should have a low threshold to harvest rib or ear cartilage when it can improve surgical outcome.

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