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https://www.readbyqxmd.com/read/28805958/large-orbital-defect-reconstruction-in-the-setting-of-globe-sparing-maxillectomy-the-titanium-hammock-and-layered-fibula-technique
#1
Samuel J Trosman, Timothy M Haffey, Rafael A Couto, Michael A Fritz
INTRODUCTION: The purpose of our study was to describe a novel technique for reconstruction of orbital defects after maxillectomy using a non-anatomic titanium mesh suspension of orbital contents for both support and volume correction. This construct is then articulated with a layered fibula osteocutaneous free flap that restores orbital rim, zygoma, and maxillary alveolus. We herein present our application of this technique, including refinements over time and long-term outcomes. METHODS: A retrospective review was performed on 12 patients who underwent reconstruction of Brown class III orbitopalatomaxillary defects with extensive orbital involvement (at minimum complete orbital floor and rim absent) with titanium mesh sling and a layered fibula free flap...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28796099/radiotherapy-and-smoking-history-are-significant-independent-predictors-for-osteosynthesis-associated-late-complications-in-vascular-free-fibula-reconstruction-of-mandible
#2
YiMing Chen, JiaLing Wu, Sandhya Gokavarapu, Qingcheng Shen, Tong Ji
BACKGROUND: The vascular fibula flap is an ideal choice for function and appearance reconstruction of mandible. Despite the high success rate, "late complications" such as Ti plate exposure and local infection related to osteosynthesis are not uncommon. PATIENTS AND METHOD: A retrospective cohort of patients who received vascular fibula reconstruction for mandible from January 2011 to December 2013 from the Department of Oral and Maxillofacial Oncology in a tertiary hospital were charted: clinical, pathological, and therapeutic factors were analyzed for late complications in univariate and multivariate analyses...
August 8, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28767568/three-dimensional-virtual-planning-in-precise-chimeric-fibula-free-flap-for-metacarpal-defects-a-case-report
#3
Hui Shen, Xiang-Qian Shen, Ying Lv, Hui Lu, Jing-Hong Xu, Shou-Cheng Wu
RATIONALE: Metacarpal and phalanx defects with soft tissue loss were suggested to be reconstructed by vascularized bone flap. The fibular osteocutaneous flap is a preferred method. Three-dimensional virtual planning has successfully applied in mandibular reconstruction with fibular free flap. We applied three-dimensional virtual planning in precise fibula flap harvest to maintain the continuity of the fibula and to achieve accurate metacarpal and phalanx reconstruction. PATIENT CONCERNS: A 35-year-old male presented with extensive soft tissue defects and first metacarpal defect involving the first metacarpophalangeal joint...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28764951/reconstruction-of-the-bony-chin-using-sagittal-split-osteotomies-of-the-remaining-mandible-a-new-technique-for-a-special-indication-case-report
#4
Berthold H Hell
There are several indications for resecting the bony chin, such as squamous cell carcinoma, sarcoma, or benign tumors of the jaw such as ameloblastoma. Several techniques for reconstruction of the bony chin, such as the use of metal plates and also revascularized free bone grafts of the iliac crest, fibula, or scapula, are common. In the case of poor vascular supply, however, alternative techniques may be necessary. In this report, a new technique is described using pedicled bone flaps from both sagittally split mandibular stumps following chin resection...
June 16, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28753219/the-retrograde-transverse-cervical-artery-as-a-recipient-vessel-for-free-tissue-transfer-in-complex-head-and-neck-reconstruction-with-a-vessel-depleted-neck
#5
Pedro Ciudad, Mouchammed Agko, Oscar J Manrique, Shivprasad Date, Kidakorn Kiranantawat, Wei Ling Chang, Fabio Nicoli, Federico Lo Torto, Michele Maruccia, Georgios Orfaniotis, Hung-Chi Chen
BACKGROUND: Reconstruction in a vessel-depleted neck is challenging. The success rates can be markedly decreased because of unavailability of suitable recipient vessels. In order to obtain a reliable flow, recipient vessels away from the zone of fibrosis, radiation, or infection need to be explored. The aim of this report is to present our experience and clinical outcomes using the retrograde flow coming from the distal transverse cervical artery (TCA) as a source for arterial inflow for complex head and neck reconstruction in patients with a vessel-depleted neck...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28749839/angle-to-angle-mandibular-defect-reconstruction-with-fibula-flap-by-using-a-mandibular-fixation-device-and-surgical-navigation
#6
Shi-Yue Shen, Yao Yu, Wen-Bo Zhang, Xiao-Jing Liu, Xin Peng
PURPOSE: Although free fibula flaps are widely used for mandibular reconstruction, 3-dimensional (3D) position is difficult to control in angle-to-angle mandibular defects. The present study describes a revised approach for angle-to-angle mandibular reconstruction with fibula flaps by using mandibular fixation device and surgical navigation. METHODS: Preoperative maxillofacial and fibular computed tomography (CT) scans were acquired, and CT data were imported into ProPlan CMF software...
July 26, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28749837/occlusion-guided-double-barreled-fibular-osteoseptocutaneous-free-flap-for-refined-mandibular-reconstruction-aided-by-virtual-surgical-planning
#7
Xingzhou Qu, Mingyi Wang, Liqun Xu, Jiannan Liu, Shizhu Bai, Chenping Zhang
BACKGROUND: There were many articles about double-barreled fibular flap for mandibular reconstruction. The upper layer bone was suit for implant placement as a new alveolar. The lower layer was necessary for contour. But the accurate relationship between the 2 layers bone was rarely reported. OBJECTIVES: The purpose of this study was twofold: to evaluate the feasibility of the novel design of the double-barreled fibular flap from virtual surgery to actual result; to evaluate the accuracy and results of occlusion-guided double-barreled fibular free flap in mandible reconstruction...
July 26, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28746288/using-a-second-free-fibula-osteocutaneous-flap-after-repeated-mandibulectomy-is-associated-with-a-low-complication-rate-and-acceptable-functional-outcomes
#8
Alexander F Mericli, Mark V Schaverien, Matthew M Hanasono, Peirong Yu, Rene D Largo, Mark T Villa, Greg Reece, Charles E Butler, Patrick B Garvey
BACKGROUND: A significant percentage of patients who undergo segmental mandibulectomy for head and neck cancer will develop a new or recurrent cancer or osteoradionecrosis, necessitating a second mandibulectomy and reconstruction. In this scenario, many surgeons are reluctant to perform a reconstruction with an osseous flap because of the presumed increased morbidity and complexity. The purpose of this study was to evaluate the safety and efficacy of performing a second free fibula flap reconstruction after repeated segmental mandibulectomy...
August 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28745438/functional-donor-site-morbidity-longer-than-one-year-after-fibula-free-flap-a-prospective-biomechanical-analysis
#9
Carsten Rendenbach, Ashkan Rashad, Lara Hansen, Carsten Kohlmeier, Moritz L Dyck, Anna Suling, Alexandre T Assaf, Michael Amling, Max Heiland, Johannes Wikner, Bjoern Riecke, Kilian Kreutzer
OBJECTIVES: The fibula free flap is the workhorse procedure for osseous reconstruction. The objective of this study was to investigate long-term functional outcomes of the harvesting site. PATIENTS AND METHODS: About 19 patients (10 male, 9 female, mean age 58.1 years) were available for the long-term analysis 13-51 months after surgery. Jumping mechanography and balance testing on a ground force reaction plate (Leonardo Mechanograph GFRP) were performed before and surgery...
July 26, 2017: Microsurgery
https://www.readbyqxmd.com/read/28744609/-autologous-fibula-transplantation-for-reconstruction-of-bone-defects
#10
REVIEW
U Lenze, F Pohlig, C Knebel, F Lenze, N Harrasser, H Mühlhofer, A Toepfer, H Rechl, R von Eisenhart-Rothe
The reconstruction of large bone defects following tumor resection, trauma or infection is difficult and subject to individual preferences of each surgeon. Free autologous fibula grafts are a reliable biological treatment method, whereas both a vascularised and a non-vascularised transplantation is possible. The use of either treatment option - vascularised or non-vascularised - is accompanied by individual advantages and/or disadvantages that should be taken into consideration during the preoperative planning process...
August 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28718319/medical-modeling-for-precision-ulna-reconstruction-using-a-microvascular-fibula-free-flap
#11
Michael Alperovich, Jonathan M Bekisz, Vishal D Thanik
BACKGROUND: Despite the growing use of medical modeling in other surgical specialties, its utilization in extremity reconstruction has remained limited. METHODS: We present the application of medical modeling for ulna reconstruction using a microvascular fibula free flap. RESULTS: Following a motor vehicle accident, the patient suffered segmental loss of the right radius and ulna with concomitant forearm soft tissue and muscle loss. Using medical modeling, imaging from the unaffected contralateral forearm and lower extremity was used to plan a reconstruction that restored the anatomic length and orientation of the ulna...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28713713/reverse-peroneal-artery-flap-for-large-heel-and-sole-defects-a-reliable-coverage
#12
Yogesh C Bhatt, Sumer Singh, Piyush Doshi, Sanjay G Vaghani
BACKGROUND: Large soft tissue defects of ankle and foot always have been challenging to reconstruct. Reverse sural flaps, free flaps have been used for this problem with variable success. Reverse peroneal artery flap is an option to use with reliability without microvascular repair. Connections of peroneal artery around talus and ankle joint are deep and reliable with anterior tibial and posterior tibial artery. Arterial inflow and venous drainage improved with including short saphenous vein and reverse sural artery in the flap...
May 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28692450/advances-in-midface-reconstruction-beyond-the-reconstructive-ladder
#13
Antoine Eskander, Stephen Y Kang, Theodoros N Teknos, Matthew O Old
PURPOSE OF REVIEW: This article reviews the anatomy and function of the midface, defect classifications and the breadth of common and novel reconstructive techniques including medical modeling, dental splints, and dental rehabilitation. RECENT FINDINGS: Historically many classification systems for midface and maxillary defects exist but most defects are unique and an individualized approach is required. There has been an increased interest in using regional pedicled flaps with bone for reconstruction...
July 7, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28674752/-operative-access-for-treatment-of-pilon-fractures
#14
REVIEW
K Klaue
BACKGROUND: Under optimal conditions, fractures of the tibial pilon can be definitively managed operatively within 6 h after the trauma. Under suboptimal conditions, preoperative antiphlogistic treatment, possibly after approximate correction and external fixation of the alignment, is a reasonable option. Osteosynthesis implies reconstruction of good joint congruency in anatomical orientation. The soft tissue coverage of the distal lower leg is relatively poorly constructed and there is a high risk of devascularization, necrosis and ensuing infection...
July 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28671884/different-recipient-vessels-for-free-microsurgical-fibula-flaps-in-the-treatment-of-avascular-necrosis-of-the-femoral-head-a-systematic-review-and-meta-analysis
#15
Yiji Tu, Zenggan Chen, William Charles Lineaweaver, Feng Zhang
BACKGROUND: Several recipient vessels can be used in free microsurgical fibula flaps (MFFs) for the treatment of avascular necrosis of the femoral head (ANFH). Few articles investigate the influence of different recipient vessels on outcomes of MFF for ANFH. METHODS: A comprehensive literature search of databases including PubMed-Medline, Ovid-Embase, and Cochrane Library was performed to collect the related studies. The Medical Subject Headings used were "femur head necrosis" and "bone transplantation...
June 1, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28646587/perioperative-pain-management-after-fibular-free-flap-harvesting-for-head-and-neck-reconstruction-using-mini-catheters-to-inject-local-anesthetic-a-pilot-study
#16
Andrea Ferri, Andrea Varazzani, Adriana Valente, Giuseppe Pedrazzi, Bernardo Bianchi, Silvano Ferrari, Enrico Sesenna
BACKGROUND: Fibular donor site pain management in the early postoperative period can help minimize complications, patient discomfort, and agitation. Traditional management of postoperative pain consists of systemic administration of opioids and NSAIDS. The use of local anesthetics in addition to systemic analgesics has the potential to improve pain control. Purpose of the study is to evaluate the efficacy of mini-catheters used to inject local anesthetic into the fibular donor site after flap harvesting for reconstruction of the head-and-neck area...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28627358/long-term-changes-in-bone-height-after-mandibular-reconstruction-using-a-free-fibula-graft-in-an-elderly-population
#17
Kosuke Ishikawa, Yuhei Yamamoto, Hiroshi Furukawa, Yoichi Ohiro, Akira Satoh, Toshihiko Hayashi
PURPOSE: This study evaluated short-term and long-term changes in bone height after mandibular reconstruction using an osteotomized fibula graft, with the aim of identifying factors associated with atrophy of the graft in an elderly population. PATIENTS AND METHODS: This retrospective study involved patients who underwent mandibular reconstruction using a free vascularized fibula graft from 2005 through 2015 and had at least 12 months of follow-up. Postoperative panoramic radiographs were used to measure bone height at standardized locations on each segment of the graft at 1 year postoperatively and at later follow-up...
May 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28609493/vestibuloplasty-with-retroauricular-skin-grafts-for-dental-implant-rehabilitation-in-vascularized-fibula-grafts-two-case-reports
#18
Metin Sencimen, Aydin Gulses, Altan Varol, Mustafa Ayna, Jölide Ozen, Necdet Dogan, Yahya Açil
The aim of this study was to present the use of retroauricular full-thickness skin grafts in vestibuloplasty surgeries for dental implant rehabilitation in vascularized fibula grafts. Two patients underwent mandibular reconstruction with vascularized fibula grafts due to mandibular gunshot injuries. Inadequate sulcus gaps secondary to mandibular soft tissue deficiencies were managed by full-thickness autologous skin grafts harvested from the retroauricular region. Dental rehabilitation was achieved by implants placed in free fibula grafts...
July 2017: International Journal of Periodontics & Restorative Dentistry
https://www.readbyqxmd.com/read/28607872/vascularized-fibula-based-physis-transfer-a-follow-up-study-of-longitudinal-bone-growth-and-complications
#19
Ronnie L Shammas, Yash J Avashia, Alfredo E Farjat, Anthony A Catanzano, L Scott Levin, William C Eward, Brian E Brigman, Detlev Erdmann
BACKGROUND: The vascularized free fibula epiphyseal transfer provides an option for the preservation of limb lengthening after resection of the proximal humerus in pediatric sarcoma patients. The purpose of this study was to provide a long-term follow-up of longitudinal growth patterns and outcomes after free fibula epiphyseal transfer in upper extremity reconstruction. METHODS: A retrospective review of 4 patients who underwent free fibula epiphyseal transfer after oncologic resection of the proximal humerus for osteosarcoma was performed...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28606440/mandible-reconstruction-with-free-fibula-flaps-outcome-of-a-cost-effective-individual-planning-concept-compared-with-virtual-surgical-planning
#20
Niklas Rommel, Marco Rainer Kesting, Nils Hagen Rohleder, Florian Martin Josef Bauer, Klaus-Dietrich Wolff, Jochen Weitz
PURPOSE: The free osteomyocutaneous fibular flap has become one of the primary options for mandibular reconstruction, because of the later introduction and development of virtual surgical planning (VSP). However, VSP is associated with high additional pre-operative effort and costs. Therefore, the purpose of the study was to develop a new individual cost-effective pre-operative planning concept for free fibula mandible reconstruction and to compare it with VSP regarding clinical parameters and post-operative outcome...
May 9, 2017: Journal of Cranio-maxillo-facial Surgery
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