Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

2021 ◽  
pp. 107110072110252
Author(s):  
Mohamad Aizat Rosli ◽  
Wan Faisham Wan Ismail ◽  
Wan Azman Wan Sulaiman ◽  
Nor Azman Mat Zin ◽  
Syurahbil Abdul Halim ◽  
...  
Keyword(s):  
Iliac Artery ◽  
Donor Site ◽  
Tumor Resection ◽  
Case Series ◽  
Benign Tumors ◽  
Reconstruction Method ◽  
Short Term ◽  
Deep Circumflex Iliac Artery ◽  
First Case ◽  
Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

scholarly journals Restoration of Trigeminal Cutaneous Sensation with Cross-Face Sural Nerve Grafts: Case Report and Literature Review

2020 ◽  
Vol 10 (5) ◽  
Author(s):  
Trung Trực Vũ ◽  
Keyword(s):  
Trigeminal Nerve ◽  
Facial Palsy ◽  
Sural Nerve ◽  
Donor Site ◽  
Tumor Resection ◽  
Contralateral Side ◽  
Nerve Graft ◽  
Cutaneous Sensation ◽  
Nerve Tumor ◽  
First Case

Abstract Complete anesthesia leaves patients susceptible to occult injury, and facial sensation is an important component of interaction and activities of daily living. Although treating facial palsy is considered debilitating for patients, trigeminal nerve palsy and sensory deficits of the face are overlooked components of disability. The authors reported the first case in Vietnam: 38 year-old man who lost the sensation on his right face follow by V cranial nerve tumor resection one year before. The sensation of the trigeminal cutaneous nerve was restored with cross-face sural nerve graft from contralateral side in 2018. The patient demonstrated improved sensation in the reconstructed dermatomes without donor-site aNBormalities at the time of 18 months post operation. Keywords: Facial palsy, facial sensation, trigeminal nerve tumor, cross-face nerve graft.

scholarly journals Image-guided resection of aggressive sacral tumors

2017 ◽  
Vol 42 (1) ◽  
pp. E15 ◽  
Author(s):  
Doniel Drazin ◽  
Neil Bhamb ◽  
Lutfi T. Al-Khouja ◽  
Ari D. Kappel ◽  
Terrence T. Kim ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Case Series ◽  
Benign Tumors ◽  
Image Guided Surgery ◽  
Tumor Type ◽  
Retrospective Case ◽  
Giant Cell Tumors ◽  
Guided Surgery ◽  
Image Guided ◽  
Sacral Tumors

OBJECTIVE The aim of this study was to identify and discuss operative nuances utilizing image guidance in the surgical management of aggressive sacral tumors. METHODS The authors report on their single-institution, multi-surgeon, retrospective case series involving patients with pathology-proven aggressive sacral tumors treated between 2009 and 2016. They also reviewed the literature to identify articles related to aggressive sacral tumors, their diagnosis, and their surgical treatment and discuss the results together with their own experience. Information, including background, imaging, treatment, and surgical pearls, is organized by tumor type. RESULTS Review of the institutional records identified 6 patients with sacral tumors who underwent surgery between 2009 and 2016. All 6 patients were treated with image-guided surgery using cone-beam CT technology (O-arm). The surgical technique used is described in detail, and 2 illustrative cases are presented. From the literature, the authors compiled information about chordomas, chondrosarcomas, giant cell tumors, and osteosarcomas and organized it by tumor type, providing a detailed discussion of background, imaging, and treatment as well as surgical pearls for each tumor type. CONCLUSIONS Aggressive sacral tumors can be an extremely difficult challenge for both the patient and the treating physician. The selected surgical intervention varies depending on the type of tumor, size, and location. Surgery can have profound risks including neural compression, lumbopelvic instability, and suboptimal oncological resection. Focusing on the operative nuances for each type can help prevent many of these complications. Anecdotal evidence is provided that utilization of image-guided surgery to aid in tumor resection at our institution has helped reduce blood loss and the local recurrence rate while preserving function in both malignant and aggressive benign tumors affecting the sacrum.

scholarly journals The Deep Circumflex Iliac Artery Perforator Flap for Breast Reconstruction: Un lambeau perforateur de l’artère iliaque circonflexe profonde pour la reconstruction mammaire

2018 ◽  
Vol 26 (4) ◽  
pp. 229-237 ◽  
Author(s):  
Kate Elzinga ◽  
Edward Buchel
Keyword(s):  
Breast Reconstruction ◽  
Iliac Artery ◽  
Donor Site ◽  
Perforator Flap ◽  
Donor Site Morbidity ◽  
Diep Flap ◽  
Deep Circumflex Iliac Artery ◽  
Epigastric Artery ◽  
Early Results ◽  
Aesthetic Results

Autologous breast reconstruction using abdominal-based perforator flaps produces excellent aesthetic results with minimal donor site morbidity. The superficial inferior epigastric artery and deep inferior epigastric perforator (DIEP) flaps reliably perfuse a hemi-abdomen, up to the anterior axillary line. Beyond this line laterally, the flank or “love handle” tissue is primarily perfused by the deep circumflex iliac artery (DCIA) or secondarily by the superficial circumflex iliac artery. The flank tissue is a valuable addition to increase flap size when harvested with a DIEP flap or to provide vascularized tissue when the abdomen has been previously harvested. Harvesting the flank tissue in combination with the anterior abdominal tissue improves the contour of the trunk, accentuates the waist, and minimizes secondary revisions to excise prominent “dogears.” The DCIA flap is a novel technique for breast reconstruction. In this article, we describe our technique, pearls and pitfalls, and early results.

scholarly journals Clinical Comparison of Scapular, Fibular, and Iliac Crest Osseal Free Flaps in Maxillofacial Reconstructions

2018 ◽  
Vol 108 (1) ◽  
pp. 76-82 ◽  
Author(s):  
T. Wilkman ◽  
A. Husso ◽  
P. Lassus
Keyword(s):  
Iliac Artery ◽  
Iliac Crest ◽  
Donor Site ◽  
Maxillofacial Surgery ◽  
Free Flaps ◽  
Late Complications ◽  
University Hospital ◽  
Patient Demographics ◽  
Advantages And Disadvantages ◽  
Deep Circumflex Iliac Artery

Background and Aims: This study compared the three most used composite flaps in maxillofacial reconstructions in our institute. Patients and Methods: Between 2000 and 2012, a total of 163 patients with mandibular, maxillary, and orbital defects received either scapular, fibular, or iliac crest osseal reconstructions in Helsinki University Hospital, Departments of Plastic Surgery and Maxillofacial Surgery. Data regarding the patient demographics, complications, and outcomes were analyzed. Results: There were 92 deep circumflex iliac artery flaps (56%), followed by 42 scapular (26%) and 29 fibular flaps (18%). The rate of flap loss was the highest in the deep circumflex iliac artery group (p = 0.001). Reconstructions using fibula were fastest (p = 0.001) and had lowest perioperative blood loss (p = 0.013). There were no significant differences in the number of early or late complications between the flaps, but donor site complications were more severe in deep circumflex iliac artery. Osteotomies as well as dental implants were safely performed in all flaps with equal results. Conclusion: All three flaps of this study can be performed with awareness of the deep circumflex iliac artery flap being the least reliable alternative. The knowledge of the advantages and disadvantages of several osseal-free flap alternatives is beneficial in selecting the best suitable method for each individual patient requiring maxillofacial osseal reconstruction.

Sign in / Sign up

Export Citation Format

Share Document