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https://www.readbyqxmd.com/read/28216818/limb-salvage-with-microvascular-free-fibula-following-primary-bone-sarcoma-resection
#1
Sahasrabudhe Parag, Panchwagh Yogesh, Jesal Rathod, Panse Nikhil, Jadhav Amit
BACKGROUND: Extremity sarcomas are challenging to manage. Total eradication of tumour has to be balanced with restoration of limb function to prevent mortality and morbidity. Disease-free survival with maximum limb function is the ultimate goal in these patients. MATERIALS AND METHODS: We present a series of ten cases of extremity malignancies, where limb salvage was attempted with microvascular free fibula for limb reconstruction from the period of 2008 to 2015...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28210412/reconstruction-of-a-combined-maxillectomy-and-segmental-mandibulectomy-defect-in-a-seven-year-old-with-a-single-free-fibula-osteocutaneous-flap
#2
Shawn T Joseph, Krishnakumar Thankappan, Subramania Iyer
Combined upper alveolectomy and segmental mandibulectomy are complex defects. Reconstruction of these defects is usually suboptimal. We describe the case of a pediatric patient with vessel-depleted neck with recurrent vascular malformation involving the ramus and coronoid process of mandible and a previous history of maxillectomy and a reconstruction with anterolateral thigh flap. The patient underwent wide resection. The defects involving the upper alveolus and mandible were simultaneously reconstructed with a single free fibula flap...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28202996/-surgical-reconstruction-of-maxillary-defects-using-a-computer-assisted-techniques
#3
W B Zhang, Y Yu, Y Wang, X J Liu, C Mao, C B Guo, G Y Yu, X Peng
The maxilla is the most important bony support of the mid-face skeleton and is critical for both esthetics and function. Maxillary defects, resulting from tumor resection, can cause severe functional and cosmetic deformities. Furthermore, maxillary reconstruction presents a great challenge for oral and maxillofacial surgeons. Nowadays, vascularized composite bone flap transfer has been widely used for functional maxillary reconstruction. In the last decade, we have performed a comprehensive research on functional maxillary reconstruction with free fibula flap and reported excellent functional and acceptable esthetic results...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28152218/tailored-approach-to-oromandibular-reconstruction-in-patients-with-compromised-lower-limb-vessels
#4
Conor P Barry, James Brown, Rebecca Hanlon, Richard Shaw
BACKGROUND: The purpose of this study was to compare outcomes for segmental reconstruction of the mandible between patients who underwent reconstruction with a fibula flap (group 1), and those with an alternative osseous free flap in which the fibula flap was unsuitable either for defect reasons (group 2) or in which the fibula flap could not safely be harvested because of compromised leg vessels (group 3). METHODS: One hundred fifty-two patients who underwent osseous free flap reconstruction of a mandibular segmental defect between January 2008 and June 2014 were identified from operating records...
February 2, 2017: Head & Neck
https://www.readbyqxmd.com/read/28150520/an-anatomical-study-on-the-availability-of-contralateral-recipient-vessels-in-hemi-mandibular-reconstruction-with-vascularised-free-fibula-transfer
#5
Shogo Kasai, Tomohisa Nagasao, Yoshiaki Sakamoto, Yusuke Shimizu, Nobuaki Imanishi, Kazuo Kishi
BACKGROUND: In mandibular reconstruction with vascularised free fibula transfer, there are situations where the neck on the operated site lacks recipient vessels for vascular anastomosis due to previous radiological/surgical interventions. METHODS: The present study aims to clarify the availability of neck vessels on the contralateral side in such situations. Experimental surgery was conducted on 20 fresh cadavers (six males and 14 females). After the left half of the mandible was removed, free vascularised fibula of equivalent length was transferred to fill the defect...
February 2, 2017: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/28121893/complications-and-long-term-outcomes-of-free-fibula-reconstruction-following-resection-of-a-malignant-tumor-in-the-extremities
#6
Matthew T Houdek, Eric R Wagner, Allen T Bishop, Alexander Y Shin, Peter S Rose, Franklin H Sim, Steven L Moran
BACKGROUND: To achieve limb salvage and provide the patient with a functional extremity, vascularized free fibula transfer has become the workhorse for segmental bony reconstruction. Because of various host factors, there has been a high complication rate following oncologic reconstruction. The authors reviewed the experience of their institution with the use of free fibula reconstruction following an oncologic resection in the extremities. METHODS: The authors reviewed 56 cases of free fibula transfer performed for limb salvage following oncologic resection from 1994 through 2013...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28118198/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#7
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
January 23, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28092922/the-effectiveness-of-free-vascularized-fibular-flaps-in-osteonecrosis-of-the-femoral-head-and-neck-a-systematic-review
#8
Cassandra A Ligh, Jonas A Nelson, John P Fischer, Stephen J Kovach, L Scott Levin
Background Free vascularized fibular flaps (FVFFs) are accepted surgical options to treat osteonecrosis of the femoral head and neck (ONFHN) to prevent conversion to total hip replacement (THR), yet many studies are single institution cohorts, with little generalizability. Purpose The purpose of this study was to perform a systematic review examining the comparative effectiveness of FVFF to treat ONFHN, particularly preventing conversion to a THR and improving hip function/symptoms. Methods We searched PubMed and EMBASE databases using femoral head, free fibula, and femoral neck keywords...
January 16, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28045826/free-hand-perforator-concept-in-osteocutaneous-free-fibula-flap-through-posterior-approach
#9
Yigit Ozer Tiftikcioglu, Ersin Gur, Tahir Gurler
BACKGROUND: The fibula flap is a workhorse flap for bony reconstruction of oro-mandibular area and can be modified to include soft tissue for reconstruction of composite defects. However, the design of a reliable skin paddle that can be used for composite tissue reconstruction remains a challenge. The authors described the applicability of perforator concept for a more reliable free osteomusculocutaneous fibula flap. METHODS: Between 2013 and 2015, 29 patients underwent free fibula osteocutaneous flap reconstruction...
December 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#10
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28039007/pedicle-orientation-in-free-flap-microvascular-maxillofacial-reconstruction
#11
Daniel M Cummins, Beomjune Kim, Arshad Kaleem, Waleed Zaid
Oncologic and traumatic defects of the maxilla can pose a challenge to patients, reconstructive surgeons, and maxillofacial prosthodontists in an attempt to provide satisfactory treatment. Oral-nasal and oral-antral fistulas are frequently treated with soft tissue flaps, osteocutaneous flaps, or a maxillofacial obturator. Often, surgical reconstruction is preferred for patient quality of life and definitive restoration. Surgical reconstruction also avoids the difficulties encountered with fabricating an obturator in an irradiated field with the often-resultant microstomia...
December 10, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28027244/definitive-management-of-persistent-frontal-sinus-infections-and-mucocele-with-a-vascularized-free-fibula-flap
#12
Sammy Sinno, Eduardo D Rodriguez
Chronic frontal sinus infections in the setting of previous trauma or tumor removal are challenging clinical scenarios. To remove and débride all chronically infected tissue, obliterate dead space, and provide a stable reconstructive yet aesthetic contour are critical tasks in managing these patients. The vascularized free fibula is an ideal flap for this situation; in this article, the authors detail their technique in a patient with chronic frontal sinus infections complicated by mucocele formation.
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28007392/donor-site-morbidity-and-quality-of-life-after-microvascular-head-and-neck-reconstruction-with-free-fibula-and-deep-circumflex-iliac-artery-flaps
#13
Christopher Schardt, Angela Schmid, Jens Bodem, Johannes Krisam, Jürgen Hoffmann, Christian Mertens
PURPOSE: Bone defects after resective tumor surgeries often require the use of microvascular reanastomized bone grafts for reconstruction. The decision as to which specific flap is most suitable for the particular patient is dependent on various factors. The aspects donor site morbidity and quality of life are rarely taken into account in this connection. The aim of this study was to analyze whether these factors, in the future, should influence the choice of donor site. MATERIAL AND METHODS: In this study, the donor sites of 46 patients with respect to deep-circumflex iliac artery (DCIA) and fibula flaps were analyzed using subjective and objective parameters...
November 30, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28005769/aberrant-lower-extremity-arterial-anatomy-in-microvascular-free-fibula-flap-candidates-management-algorithm-and-case-presentations
#14
Alyssa R Golas, Jamie P Levine, Justin Ream, Eduardo D Rodriguez
An accurate and comprehensive understanding of lower extremity arterial anatomy is essential for the successful harvest and transfer of a free fibula osteoseptocutaneous flap (FFF). Minimum preoperative evaluation includes detailed history and physical including lower extremity pulse examination. Controversy exists regarding whether preoperative angiographic imaging should be performed for all patients. Elevation of an FFF necessitates division of the peroneal artery in the proximal lower leg and eradicates its downstream flow...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005762/jaw-in-a-day-state-of-the-art-in-maxillary-reconstruction
#15
Christopher M Runyan, Vishal Sharma, David A Staffenberg, Jamie P Levine, Lawrence E Brecht, Leonard H Wexler, David L Hirsch
BACKGROUND: Reconstruction of maxillary defects following tumor extirpation is challenging because of combined aesthetic and functional roles of the maxilla. One-stage reconstruction combining osseous free flaps with immediate osseointegrated implants are becoming the standard for mandibular defects, and have similar potential for maxillary reconstruction. METHODS: A woman with maxillary Ewing sarcoma successfully treated at age 9 with neoadjuvant chemotherapy, right hemimaxillectomy, and obturator prosthetic reconstruction presented for definitive reconstruction, complaining of poor obturator fit, and hypernasality...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005744/a-new-procedure-assisted-by-digital-techniques-for-secondary-mandibular-reconstruction-with-free-fibula-flap
#16
Yao Yu, Wen-Bo Zhang, Xiao-Jing Liu, Chuan-Bin Guo, Guang-Yan Yu, Xin Peng
PURPOSE: To describe a new procedure assisted by digital techniques for secondary mandibular reconstruction with free fibula flap. METHODS: The 3-dimensional (3D) reconstruction images for vessels were used to demonstrate the vascular diameter and location, which help select the most suitable vein and artery for anastomosis. Maxillary and mandibular stone models of the patient were fabricated and a stable occlusal relationship was determined on an articulator. The 3D tooth model data were scanned using a 3D-optical measuring system, and the obtained stereolithographic (STL) data were imported to Geomagic software...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27995558/is-there-benefit-to-free-over-pedicled-vascularized-grafts-in-augmenting-tibial-intercalary-allograft-constructs
#17
Marco Manfrini, Srimanth Bindiganavile, Ferhat Say, Marco Colangeli, Laura Campanacci, Massimiliano Depaolis, Massimo Ceruso, Davide Donati
BACKGROUND: Intercalary reconstruction of tibial sarcomas with vascularized fibula autografts and massive bone allografts is reliable with predictable long-term results. However, inadequate data exist comparing free and pedicled vascularized fibula autografts in combination with a massive bone allograft in patients undergoing intercalary tibia reconstructions. QUESTIONS/PURPOSES: Among patients undergoing large-segment intercalary allografting, we sought to compare supplemental free vascularized fibular autografts with supplemental pedicled vascularized fibular autografts, in terms of (1) oncologic results, (2) complications associated with surgery, (3) Musculoskeletal Tumor Society (MSTS) scores, and (4) surgical time...
December 19, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27995119/fibular-flap-for-mandible-reconstruction-in-osteoradionecrosis-of-the-jaw-selection-criteria-of-fibula-flap
#18
Ji-Wan Kim, Jong-Hyun Hwang, Kang-Min Ahn
BACKGROUND: Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better reconstruction...
December 2016: Maxillofacial Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27991024/-cooperation-between-the-plastic-surgery-and-the-head-neck-surgery-departments-in-the-treatment-of-unusual-cases-veszpr%C3%A3-m-hungary-2010-2015
#19
Zoltán Lóderer, József Piffkó, Károly Somlai, Gábor Bognár, Gábor Sándor
INTRODUCTION: Handling problems in the head and neck region often requires a close cooperation between allied professions, just as in the challenging cases presented by us. Cases and methodology: With the first patient, we performed a radical surgery on the left side of the face due to recidivious basal cell carcinoma, followed by reconstruction using a Type I chimeric anterolateral thigh flap (ALT), while in the case of the second patient, we carried out a radical surgery on the right side of the face due to epithelial carcinoma and reconstruction with a Type I chimeric thoracodorsal flap...
December 2016: Magyar Sebészet
https://www.readbyqxmd.com/read/27987018/-osteosynthesis-of-distal-fibular-fractures-with-illuminoss-video-article
#20
M Zyskowski, M Crönlein, E Heidt, P Biberthaler, C Kirchhoff
OBJECTIVE: The aim was minimally invasive osteosynthesis of a distal fibular fracture under the premises of poor soft tissue conditions and existing chronic comorbidities to enable rapid recovery and to reduce soft tissue stress in order to avoid postoperative infections and achieve early weight bearing. INDICATIONS: This involved a distal fibula fracture, classified as 44 B1.1, B1.2, B1.3 according to the working group for osteosynthesis (AO) or a B fracture after Danis and Weber with indications for surgery (cortical disruption and shaft offset > 5 mm), age > 65 years, poor soft tissue conditions and a Charlson score ≥ 1...
January 2017: Der Unfallchirurg
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