Free Vacularized Fibula Flap for Septic Bone Defects of the Lower Limb

2021 ◽  
pp. 153473462110498
Author(s):  
Iván Copete González ◽  
Nieves Vanaclocha ◽  
Alberto Sánchez-García ◽  
Alessandro Thione ◽  
Alberto Pérez-García
Keyword(s):  
Lower Limb ◽  
Weight Bearing ◽  
Major Complication ◽  
Bone Defects ◽  
Full Weight Bearing ◽  
Free Fibula Flap ◽  
Fibula Flap ◽  
Walking Aids ◽  
Free Fibula ◽  
Reconstructive Techniques

Free fibula flap (FFF) is one of the reconstructive techniques to treat bone defects, although in septic conditions there are some limitations that have made it less popular. We present our experience with FFF for the reconstruction of lower limb infectious bone defects. From September 2015 to January 2020, 10 patients underwent reconstruction with FFF without rigid internal fixation of septic bone defects of the lower extremities. Demographic, clinical, and operative data were retrospectively collected. All the flaps survived and consolidated. The only major complication was a stress fracture of a fibula that required osteosynthesis. Median time to consolidation and full weight-bearing was 2.5 and 9.8 months, respectively. Bipedal gating was achieved in all the patients, 7 of them without walking aids. Despite it has some limitations and technical difficulties, in our experience FFF is an effective and reliable option in the reconstruction of septic bone defects of the lower limb.

scholarly journals Biological reconstruction of bone defects: the role of the free fibula flap

2011 ◽  
Vol 5 (4) ◽  
pp. 241-249 ◽  
Author(s):  
Arik Zaretski ◽  
Eyal Gur ◽  
Yehuda Kollander ◽  
Isaac Meller ◽  
Shlomo Dadia
Keyword(s):  
Bone Defects ◽  
Free Fibula Flap ◽  
Biological Reconstruction ◽  
Fibula Flap ◽  
Free Fibula ◽  
Reconstruction Of Bone Defects

scholarly journals Efficacy of free fibula flap for reconstruction of post traumatic long bone defect: retrospective study of eighteen cases

2019 ◽  
Vol 5 (6) ◽  
pp. 1171
Author(s):  
Shobhit Sharma ◽  
Sudipta Bera
Keyword(s):  
Success Rate ◽  
Bone Defect ◽  
Bone Healing ◽  
Weight Bearing ◽  
Long Bone ◽  
Free Fibula Flap ◽  
Fibula Flap ◽  
Free Fibula ◽  
Post Traumatic ◽  
Long Bone Defect

<p class="abstract"><strong>Background: </strong>Complex and segmental bone defects are common after resection of tumors and trauma involving long bones of the extremities. Free fibula flap is commonly practiced for complex oromandibular defects and bone reconstruction after sarcoma and bone tumor excision. But post traumatic bone reconstruction of extremities with free fubula is less commonly practiced and only reserved for long segmental reconstruction or as an alternative to distraction osteogenesis. We are presenting a retrospective analysis of surgical details and outcome of 18 cases with post traumatic long bone defect reconstructed with free fibula osteocutaneous flap.</p><p class="abstract"><strong>Methods:</strong> 18 patients with post traumatic composite or segmental long bone defect which were reconstructed with free fibula osteocutaneous flap (FFOCF) between 2014 to 2018 are included in this study. Operative details, success rate, bone healing, functional outcome and complications are reviewed retrospectively.<strong></strong></p><p class="abstract"><strong>Results:</strong> Success rate of flap surgery was 17/18 (94.44%). Bone gap was 6-17 cm and Skin paddle ranged from 10 cm × 8 cm to 15 cm × 10 cm. Bone healing, weight bearing outside cast and return to daily activity period were 8-16 weeks, 10-15 months and 12-18 months respectively. Non-union, malunion and stress fracture were noted in one,one and three patients respectively.</p><p class="abstract"><strong>Conclusions:</strong> Free fibula flap is a reliable method for reconstruction of post traumatic complex and segmental long bone defects. Quality of bone healing is good enabling resuming to early weight bearing and daily activities and high success rate. Free fibula flap may be procedure of choice for reconstruction of such bony injuries with the microvascular surgical facilities.</p>

Long-Term Follow-Up of Total Penile Reconstruction with the Sensate Osteocutaneous Free Fibula Flap

2006 ◽  
Vol 22 (03) ◽  
Author(s):  
Mustafa Şengezer ◽  
Serdar Ozturk ◽  
Mustafa Deveci ◽  
Mustafa Nisanci
Keyword(s):  
Free Fibula Flap ◽  
Fibula Flap ◽  
Long Term Follow Up ◽  
Free Fibula

Osteomyocutaneous Free Fibula Flap Prevents Osteoradionecrosis and Osteomyelitis in Head and Neck Cancer Reconstruction

2021 ◽  
Author(s):  
Kuan-Ying Wang ◽  
Wen-Chung Liu ◽  
Chun-Feng Chen ◽  
Lee-Wei Chen ◽  
Hung-Chi Chen ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Muscle Flap ◽  
Flexor Hallucis Longus ◽  
Free Fibula Flap ◽  
Chi Square ◽  
Fibula Flap ◽  
Free Fibula ◽  
Chi Square Test

Abstract Background Osteoradionecrosis (ORN) is one of the most severe complications of free fibula reconstruction after radiotherapy. The gold standard treatment of osteomyelitis involves extensive debridement, antibiotics, and sufficiently vascularized muscle flap coverage for better circulation. Therefore, we hypothesized that free fibula flap with muscle could decrease the risk of ORN. Methods This study consisted of 85 patients who underwent reconstruction with free fibula flap in head and neck cancer by a single reconstructive surgeon at Kaohsiung Veterans General Hospital over a period of 19 years (1998–2016). Patients with postoperative adjuvant radiotherapy were included in the study and were grouped by either free fibula osteocutaneous flap or free fibula osteomyocutaneous flap (with flexor hallucis longus muscle), and the incidence of ORN was compared. Results Of the 85 patients, 15 were reconstructed with osteocutaneous fibula flap and 70 were with osteomyocutaneous fibula flap. The rate of ORN or osteomyelitis was significantly lower in the muscle group (18.6%, n = 13/70 vs. 46.7%, n = 7/15, p = 0.020, Chi-square test). Conclusion Vascularized muscle transfer increases perfusion of surrounding tissues and the bone flap, thereby decreasing the incidence of osteomyelitis or osteonecrosis.

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