scholarly journals Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases

2013 ◽  
Vol 46 (03) ◽  
pp. 543-548 ◽  
Author(s):  
Gurdayal Singh Kalra ◽  
Pradeep Goel ◽  
Pradeep Kumar Singh
Keyword(s):  
Soft Tissue ◽  
Bone Defect ◽  
Bone Defects ◽  
High Energy ◽  
Long Bone ◽  
Non Union ◽  
Skeletal Defects ◽  
Free Fibula ◽  
Post Traumatic ◽  
Long Bone Defect

ABSTRACT Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.

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>

Reconstruction of post-traumatic long bone defect with vascularized bone graft

2000 ◽  
Vol 14 (2) ◽  
pp. 138 ◽  
Author(s):  
Yuan-Kun Tu ◽  
Steve Wen-Neng Ueng ◽  
Wen-Lin Yeh ◽  
Cheng-Yo Yen ◽  
Kun-Chang Wang
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Long Bone ◽  
Vascularized Bone Graft ◽  
Post Traumatic ◽  
Long Bone Defect ◽  
Vascularized Bone

Long-term outcome of free fibula osteocutaneous flap and massive allograft in the reconstruction of long bone defect

2015 ◽  
Vol 68 (12) ◽  
pp. 1755-1762 ◽  
Author(s):  
Ahmad Sukari Halim ◽  
Siew Cheng Chai ◽  
Wan Faisham Wan Ismail ◽  
Wan Sulaiman Wan Azman ◽  
Arman Zaharil Mat Saad ◽  
...  
Keyword(s):  
Bone Defect ◽  
Long Bone ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Free Fibula ◽  
Long Bone Defect ◽  
Osteocutaneous Flap

scholarly journals Salvage Secondary Reconstruction of the Mandible with Vascularized Fibula Flap

2019 ◽  
Vol 12 (4) ◽  
pp. 274-283
Author(s):  
Dinesh Kadam
Keyword(s):  
Soft Tissue ◽  
Tissue Loss ◽  
Successful Outcome ◽  
Primary Reconstruction ◽  
Reconstruction Plate ◽  
Secondary Reconstruction ◽  
Fibula Flap ◽  
Skeletal Defects ◽  
Vascularized Fibula ◽  
Free Fibula

Primary restoration of the mandibular continuity remains the standard of care for defects, and yet several constraints preclude this objective. Interim reconstructions with plate and nonvascular bone grafts have high failure rates. The secondary reconstruction, when becomes inevitable, remains a formidable task. This retrospective study evaluates various issues to address secondary reconstruction. Twenty-one patients following mandibulectomy presented with various complications between 2012 and 2016 were included in the study. The profile of primary reconstruction includes reconstruction plate ( n = 9), reconstruction plate with rib graft ( n = 3), soft tissue only reconstruction ( n = 4), free fibula ( n = 2), inadequate growth of reconstructed free fibula during adolescence ( n = 1), nonvascular bone graft alone ( n = 1), and no reconstruction ( n = 1). All had problems or complications related to unsatisfactory primary reconstruction such as plate fracture, recurrent infection, plate exposure, deformity, malocclusion, and failed fibula reconstruction. All were reconstructed with osteocutaneous free fibula flap with repair of soft-tissue loss. All flaps survived and had satisfactory outcome functionally and aesthetically. Dental rehabilitation was done in four patients. One flap was reexplored for thrombosis and salvaged. The challenges in secondary reconstruction include difficulty in recreating true defects, extensive fibrosis and loss of planes, unanticipated soft-tissue and skeletal defects, reestablishing the contour and occlusion, insufficient bone strength, dearth of suitable recipient vessels, nonpliable skin, tissue contraction to accommodate new mandible, need of additional flap for defect closure, and postirradiation effects. Notwithstanding them, the reasonable successful outcome can be attainable.

New Segmental Long Bone Defect Model in Sheep: Quantitative Analysis of Healing with Dual Energy X-Ray Absorptiometry

2000 ◽  
Vol 82 (12) ◽  
pp. 61
Author(s):  
Frank C. den Boer ◽  
Peter Patka ◽  
Fred C. Bakker ◽  
Burkhard W. Wippermann ◽  
Arthur van Lingen ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Bone Defect ◽  
Dual Energy ◽  
Long Bone ◽  
Defect Model ◽  
X Ray ◽  
Long Bone Defect

scholarly journals Effects of Calcium Sulfate Combined with Platelet-rich Plasma on Restoration of Long Bone Defect in Rabbits

2016 ◽  
Vol 129 (5) ◽  
pp. 557-561 ◽  
Author(s):  
Hua Chen ◽  
Xin-Ran Ji ◽  
Qun Zhang ◽  
Xue-Zhong Tian ◽  
Bo-Xun Zhang ◽  
...  
Keyword(s):  
Bone Defect ◽  
Calcium Sulfate ◽  
Platelet Rich Plasma ◽  
Long Bone ◽  
Long Bone Defect

scholarly journals Healing of a Large Long-Bone Defect through Serum-Free In Vitro Priming of Human Periosteum-Derived Cells

2017 ◽  
Vol 8 (3) ◽  
pp. 758-772 ◽  
Author(s):  
Johanna Bolander ◽  
Wei Ji ◽  
Jeroen Leijten ◽  
Liliana Moreira Teixeira ◽  
Veerle Bloemen ◽  
...  
Keyword(s):  
Bone Defect ◽  
Long Bone ◽  
Serum Free ◽  
Long Bone Defect

Critical Long Bone Defect Treated by Magnetic Scaffolds and Fixed by Permanent Magnets

2013 ◽  
Author(s):  
Alessandro Russo ◽  
Silvia Panseri ◽  
Tatiana Shelyakova ◽  
Monica Sandri ◽  
Chiara Dionigi ◽  
...  
Keyword(s):  
Finite Element ◽  
Magnetic Nanoparticles ◽  
Bone Tissue ◽  
Bone Defect ◽  
Long Bone ◽  
Bone Scaffold ◽  
Finite Element Software ◽  
Magnetic Forces ◽  
Long Bone Defect

Diaphyseal bone defect represents a significant problem for orthopaedic surgeons and patients. In order to improve and fasten bone regenerating process we implanted HA biodegradable magnetized scaffolds in a large animal model critical bone defect. A critical long bone defect was created in 6 sheep metatarsus diaphysis; then we implanted a novel porous ceramic composite scaffold (20.0 mm in length; 6.00 mm inner diameter and 17.00 mm outer diameter), made of Hydroxyapatite that incorporates magnetite (HA/Mgn 90/10), proximally fixated by two small cylindrical permanent parylene coated NdFeB magnets (one 6.00 mm diameter magnetic rod firmly incorporated into the scaffold and one 8.00 mm diameter magnetic rods fitted into proximal medullary canal, both 10.00 mm long); to give stability to the complex bone-scaffold-bone, screws and plate was used as a bridge. Scaffolds biocompatibility was previously assessed in vitro using human osteoblast-like cells. Magnetic forces through scaffold were calculated by finite element software (COMSOL Multiphysics, AC/DC Model). One week after surgery, magnetic nanoparticles functionalized with vascular endothelial growth factor (VEGF) were injected at the mid portion of the scaffold using a cutaneous marker positioned during surgery as reference point. After sixteen weeks, sheep were sacrificed to analyze metatarsi. Macroscopical, radiological and microCT examinations were performed. Macroscopical examination shows bone tissue formation inside scaffold pores and with complete coverage of scaffolds, in particular at magnetized bone-scaffold interface. X-rays show a good integration of the scaffold with a good healing process of critical bone defect, and without scaffolds mobilization. These datas were confirmed by the microCT that shown new formation of bone inside the scaffolds, in particular at magnetized bone-scaffold interface. These preliminary results lead our research to exploiting magnetic forces to stimulate bone formation, as attested in both in vitro and in vivo models and to improve fixation at bone scaffold interface, as calculated by finite element software, and moreover to guide targeted drug delivery without functionalized magnetic nanoparticles dissemination in all body. Histological analysis will be performed to confirm and quantify bone tissue regeneration at both interfaces.

Reconstruction of posttraumatic long bone defect with free vascularized bone graft: Good outcome in 48 patients with 6 years' follow-up

2001 ◽  
Vol 72 (4) ◽  
pp. 359-364 ◽  
Author(s):  
Yuan-Kun Tu ◽  
Cheng-Yo Yen ◽  
Wen-Lin Yeh ◽  
I-Chun Wang ◽  
Kun-Chang Wang ◽  
...  
Keyword(s):  
Bone Graft ◽  
Bone Defect ◽  
Long Bone ◽  
Vascularized Bone Graft ◽  
Good Outcome ◽  
Long Bone Defect ◽  
Vascularized Bone
Sign in / Sign up

Export Citation Format

Share Document