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Fibula graft

Eyituoyo Okoturo
INTRODUCTION: Mandibular defect reconstruction is extremely important to achieving an improved quality of life of patients as this bony defect influences facial harmony and aesthetics. Reconstruction of mandibular defects at our centre comprises use of reconstruction plate, non-vascularised anterior iliac crest graft and vascularised fibula flap. Despite the large mandibular defect recorded in our developing environment, non-vascularised iliac crest graft continues to play a role in its exclusive use for lateral mandibular defects...
October 10, 2016: Oral and Maxillofacial Surgery
Andreas Fuchs, Stefan Hartmann, Karen Ernestus, Grit Mutzbauer, Christian Linz, Roman C Brands, Alexander C Kübler, Urs D A Müller-Richter
BACKGROUND: Mandibular pseudocarcinomatous hyperplasia is a rare and generally benign pathology. We report on one of these rare cases. CASE PRESENTATION: The case history of a 73-year-old white man stated that he had a carcinoma of the oropharynx, which was primarily treated with radiotherapy and chemotherapy 4 years prior. As a result of radiotherapy he developed an osteoradionecrosis of his mandible and a consecutive pathological fracture of his left mandibular angle...
September 29, 2016: Journal of Medical Case Reports
Michael H Weber, Maryse Fortin, Jian Shen, Bobby Tay, Serena S Hu, Sigurd Berven, Shane Burch, Dean Chou, Christopher Ames, Vedat Deviren
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To assess the subsidence and revision rates associated with different interbody cages following anterior cervical corpectomy and reconstruction. SUMMARY OF BACKGROUND DATA: Different interbody cages are currently used for surgical reconstruction of the anterior and middle columns of the spine following anterior cervical corpectomy. However, subsidence and delayed union/nonunion associated with allograft and cage reconstruction are common complications, which may require revision with instrumentation...
September 10, 2016: Clinical Spine Surgery
Naohiro Ishii, Yusuke Shimizu, Jyun Ihara, Kazuo Kishi
BACKGROUND: High-quality mandibular reconstruction using vascularized free fibular graft is necessary to provide an osseointegrated dental implant and fixed denture. An appropriate crown-implant ratio is needed, and a good match between bones is extremely important. There are no articles describing the analysis and evaluation of both the fibula and mandible in the same patients. METHODS: Computed tomography images of both mandible and fibula of 80 patients were selected in a random manner...
August 2016: Plastic and Reconstructive Surgery. Global Open
Graham T Fedorak, Anna V Cuomo, Hugh G Watts, Anthony A Scaduto
BACKGROUND: Osseous overgrowth is a common complication in children after humeral transcortical amputation. Capping tibial overgrowth with the proximal fibula has been shown to be the most effective treatment. However, best treatment practices are not clear for the humerus. We compared patients treated surgically for humeral osseous overgrowth with simple resection or autologous osteocartilaginous graft to determine if this treatment were as effective in the humerus as it has been in the tibia...
August 19, 2016: Journal of Pediatric Orthopedics
Tristan Pollon, Nicolas Reina, Stéphanie Delclaux, Paul Bonnevialle, Pierre Mansat, Nicolas Bonnevialle
INTRODUCTION: Surgical treatment of persistent non-union of the humeral shaft is a complex situation because of the risk of failure and surgery-related complications. The primary objective of this study was to evaluate clinical and radiological results of a continuous series of persistent non-union treated with plating and bone grafting. The secondary objective was to expose factors contributing to the failure of prior bone union attempts. MATERIAL AND METHODS: Sixteen patients (average age of 52 years) were treated for persistent non-union of the humeral shaft in our department; six of these patients had predisposing comorbidities or addictions...
August 10, 2016: International Orthopaedics
Raju Vaishya, Chirag Kapoor, Paresh Golwala, Amit Kumar Agarwal, Vipul Vijay
Giant Cell Tumour (GCT) of the distal fibula is extremely rare and poses challenges in the surgical management. Wide excision or intralesional curettage, along with adjuvant chemical cauterisation can prevent the recurrence of GCT. The excised bone gap needs reconstruction using tricortical iliac autograft and supportive plate fixation. In addition to wide excision, preservation of ankle mortise is advisable in locally aggressive and large lesions of the distal fibula. We report a GCT of the distal fibula in a young female patient...
2016: Curēus
R Taraquois, A Joly, A Sallot, J-D Kün Darbois, B Laure, A Paré
INTRODUCTION: The sacrifice of inferior alveolar nerve (IAN) is usual in case of resection of mandibular tumors and is responsible for disabling sensory disorders, drooling and lip incompetence. We report the case of a reconstruction of the IAN by means of an autologous nerve graft after segmental resection of the mandible. OBSERVATION: A 27-year-old man presented with a recurrence of mandibular ameloblastoma. Treatment consisted in segmental mandibulectomy with resection of the IAN...
July 26, 2016: Revue de Stomatologie, de Chirurgie Maxillo-faciale et de Chirurgie Orale
Gilbert Moatshe, Erik L Slette, Lars Engebretsen, Robert F LaPrade
BACKGROUND: Knee dislocations are rare but potentially devastating injuries, often involving tears of multiple knee ligaments. Several studies have reported improved clinical and functional outcomes with surgical management of torn knee ligaments compared with nonsurgical management. Most multiple ligament reconstruction techniques involve creating several tunnels for various reconstruction grafts, posing a risk of tunnel convergence in the proximal tibia. PURPOSE: To assess the risk of tunnel convergence and determine the optimal tunnel placement for the reconstruction of multiple ligaments in the tibia...
July 28, 2016: American Journal of Sports Medicine
Brianna N Harris, Arnaud F Bewley
PURPOSE OF REVIEW: Fasciocutaneous and osteocutaneous free flap reconstruction has significantly changed the way surgeons reconstruct defects following ablation of head and neck tumors. Over time, success rates of free flaps have approached 98%, allowing surgeons to shift their focus to minimizing morbidities associated with the donor sites. The radial forearm, anterolateral thigh, and fibula free flaps are the three most commonly used flaps in head and neck reconstruction, and therefore each of their advantages and associated morbidities are of particular interest...
October 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Andre J Keenan, O J F Keenan, C Tubb, A M Wood, T Rowlands, S E Christensen
Large tibial defects present a challenging scenario for the orthopaedic surgeon, particularly in the paediatric patient. Most management options, such as the vascularised fibular graft or Ilizarov technique, require microsurgical techniques or specialist equipment. In an austere environment, acute shortening or limb amputation may be most appropriate. However, limb salvage may be achieved by ipsilateral fibular transfer. In a one-stage operation, the fibular graft is harvested and either placed in the tibial defect in an intramedullary position or secured to the tibia with screws...
July 22, 2016: Journal of the Royal Army Medical Corps
J D'Souza, V S Bedi, I K Indrajit, R Pant
BACKGROUND: The incidence of pseudoaneurysm has increased due to the large number of vascular procedures performed and the widespread use of anticoagulation therapy during procedures. Non-invasive methods for management of pseudoaneurysms comprise of ultrasound guided compression (USGC), thrombin therapy, arterial embolisation and endovascular stent graft insertion. We discuss our experience in the management of fourteen cases of pseudoaneurysms using non surgical techniques. METHODS: During a two year period, fourteen patients presenting with pseudoaneurysms of different regions were treated...
April 2007: Medical Journal, Armed Forces India
Yong Qi, Hong-Tao Sun, Yue-Guang Fan, Fei-Meng Li, Zhou-Sheng Lin
The presence of large segmental defects of the diaphyseal bone is challenging for orthopedic surgeons. Free vascularized fibular grafting (FVFG) is considered to be a reliable reconstructive procedure. Stress fractures are a common complication following this surgery, and hypertrophy is the main physiological change of the grafted fibula. The exact mechanism of hypertrophy is not completely known. To the best of our knowledge, no studies have examined the possible relationship between stress fractures and hypertrophy...
June 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Hemant Prakash Parekh, Samir Chandrakant Dwidmuthe, Sampat Dumbre Patil, Satish Sonar
INTRODUCTION: The treatment of tibia bone loss can be challenging. The surgical options for the treatment of bone loss include bone transport, vascularized fibula graft, and induced membrane. CASE REPORT: We present a case of complex compound fracture of tibia with bone loss. Interestingly patient sustained this injury in spite of having intramedullary nail in tibia which was inserted to stabilize previous fracture 9 months prior to trauma. The proximal half of the nail was protruding out of the wound at the time of presentation in emergency department...
July 2014: Journal of Orthopaedic Case Reports
Amyn Rajani, C J Thakkar, Ravi Shah, Ashok Shyam
INTRODUCTION: Compound distal tibia fractures have high incidence of nonunions and have varied presentation as far as status of fibula is concerned. If fibula is sufficiently healthy we can use it for bridging the nonunion of tibia. CASE REPORT: We present a case of 20 year old female with compound and segmental tibia fracture. Primary stablisation by external fixation and later cast brace application achieved union at the proximal end of the segmental fragment with non union at the distal end...
January 2013: Journal of Orthopaedic Case Reports
Gaurav Gupta, Sohail Ahmad, Mohd Zahid, A H Khan, M K A Sherwani, Abdul Qayyum Khan
BACKGROUND: Gap nonunion of long bones is a challenging problem, due to the limitation of conventional reconstructive techniques more so if associated with infection and soft tissue defect. Treatment options such as autograft with non-vascularized fibula and cancellous bone graft, vascularized bone graft, and bone transportation are highly demanding on the part of surgeons and hospital setups and have many drawbacks. This study aims to analyze the outcome of patients with wide diaphyseal bone gap treated with induced-membrane technique (Masquelet technique)...
May 2016: Indian Journal of Orthopaedics
Anil Agarwal, Anubrat Kumar
BACKGROUND: A peculiarity of non-vascularized fibular harvest is that the donor site regenerates new bone provided periosteum is preserved. We prospectively investigated the regenerated fibula quantitatively and studied clinical implications of non-regeneration. MATERIAL AND METHODS: The fibula was harvested using a periosteum preserving technique. Only fibulae from healthy legs were harvested. X-rays were done pre- and post-operatively at three and six months...
June 8, 2016: International Orthopaedics
Hideya Ishigooka, Sean T Campbell, Ryan J Quigley, Michelle H McGarry, Yu Jen Chen, Akash Gupta, Christopher N H Bui, Thay Q Lee
PURPOSE: To compare the biomechanical properties of a fibula cross-tunnel technique for posterolateral corner (PLC) reconstruction with those of intact knees. METHODS: Seven fresh-frozen cadaveric knees were tested while intact, after PLC tear, and after reconstruction. Testing of the parameters listed above was performed at 0°, 30°, 60°, and 90° of knee flexion. Reconstruction was performed using 2 independent tendon autografts. Afterward, the fibula and graft were loaded to failure...
May 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Viju Daniel Varghese, Abel Livingston, P R Boopalan, Thilak S Jepegnanam
Nonunion neck of femur can be a difficult problem to treat, particularly in the young, and is associated with high complication rates of avascular necrosis due to the precarious blood supply and poor biomechanics. The various treatment options that have been described can be broadly divided according to the aim of improving either biology or biomechanics. Surgeries aimed at improving the biology, such as vascularized fibula grafting, have good success rates but require high levels of expertise and substantial resources...
May 18, 2016: World Journal of Orthopedics
Charles Scott Hultman
INTRODUCTION: Although plastic surgeons make important contributions to the clinical, educational, and research missions of academic medical centers (AMCs), determining the financial value of a plastic surgery service can be difficult, due to complex cost accounting systems. We analyzed the financial impact of plastic surgery on an AMC, by examining the contribution margins and operating income of surgical procedures. METHODS: We collaborated with hospital administrators to implement 3 types of strategic changes: (1) growth of areas with high contribution margin, (2) curtailment of high-risk procedures with negative contribution margin, (3) improved efficiency of mission-critical services with high resource consumption...
June 2016: Annals of Plastic Surgery
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