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Free fibula

Stephan Christian Möhlhenrich, Kristian Kniha, Dirk Elvers, Nassim Ayoub, Evgeny Goloborodko, Frank Hölzle, Ali Modabber
The aim of this study was to investigate the influence of two different microvascular reanastomized bone transplants on primary (PS) and secondary stability (SS) of dental implants. Totally 96 implants (Bone Level, Institut Straumann AG, Basel, Switzerland) were inserted in fibula (n = 50) and iliac crest (n = 46) in mean of 97.7 SD 75.6 weeks after performing reconstructive surgery. For measuring PS and SS the resonance frequency (RFA) analysis was used in mesiodistal and vestibulo-oral direction to quantify the implant stability quotient (ISQ)...
September 28, 2016: Journal of Cranio-maxillo-facial Surgery
Andreas Gravvanis, Despoina Kakagia, Nick Katsikeris, Dimosthenis Tsoutsos
BACKGROUND: This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT: A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering...
October 2016: Journal of Craniofacial Surgery
Nidal Farhan Al Deek, Donald H Lalonde
Fu-Chan Wei is a world-renowned plastic and reconstructive surgeon. He is clearly one of the most influential and innovative surgeons in the history of plastic surgery. The Taiwanese legend is the innovator of the osteoseptocutaneous fibula flap, which revolutionized the reconstruction of composite bone and soft tissue defects in the jaw and extremities. He has pioneered several perforator flaps, including the free style variety. He has taken toe-to-hand microsurgical transplantation to a whole new level. He is not only recognized for his surgical skills and clinical innovations, but also for his vision, leadership, and teaching...
September 2016: Plastic and Reconstructive Surgery. Global Open
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...
October 14, 2016: Journal of Craniofacial Surgery
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...
October 14, 2016: Journal of Craniofacial Surgery
Irene Degli Agosti, Elena Ginelli, Bruno Mazzacane, Gabriella Peroni, Sandra Bianco, Fabio Guerriero, Giovanni Ricevuti, Simone Perna, Mariangela Rondanelli
Introduction. A number of studies suggest that oxygen-ozone therapy may have a role in the treatment of chronic, nonhealing, or ischemic wounds for its disinfectant and antibacterial properties. Nonhealing wounds are a significant cause of morbidity. Here we present a case of subcutaneous oxygen-ozone therapy used to treat a nonhealing postoperative wound in a young man during a period of 5 weeks. Case Presentation. A 46-year-old man had a motorcycle accident and underwent amputation of the right tibia and fibula...
2016: Case Reports in Medicine
Jordan J Allensworth, Scott H Troob, Tyler S Weaver, Javier D Gonzalez, Daniel Petrisor, Mark K Wax
OBJECTIVE: Acute invasive fungal sinusitis (AIFS) is a frequently fatal infection for which extensive and debilitating surgical debridement is a mainstay of therapy. Resulting defects are often composite in nature, mandating free tissue-transfer reconstruction. Outcomes data for free flap reconstruction are limited. The purpose of this study was to examine surgical outcomes and survival in patients undergoing free flap transfer following invasive fungal sinusitis. STUDY DESIGN: Retrospective case series...
October 12, 2016: Laryngoscope
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
Tommy Wilkman, Satu Apajalahti, Erika Wilkman, Jyrki Törnwall, Patrik Lassus
PURPOSE: The aim of the present study was to compare the resorption of the bone in the free scapular, free iliac crest, and free fibular microvascular flaps in mandibular reconstruction over time. PATIENTS AND METHODS: In the present retrospective study, we analyzed 186 consecutive patients with scapular, fibular, or deep circumflex iliac artery (DCIA) osseous free microvascular flaps in mandibular reconstruction. We followed up the patients clinically and using multislice computed tomography (MSCT) with volume analyses of the bone...
September 15, 2016: Journal of Oral and Maxillofacial Surgery
Bharat Rekhi, Vivek Verma, Ashish Gulia, Nirmala A Jambhekar, Subhash Desai, Shashikant L Juvekar, Jyoti Bajpai, Ajay Puri
Giant cell tumor of bone (GCTB) is mostly a benign tumor, but associated with recurrences and metastasis. Lately, denosumab is being utilized in the treatment of certain GCTBs. Twenty-seven tumors, analyzed in the present study, occurred in 16 males and 11 females (M: F = 1.45:1), in the age-range of 16 to 47 years (mean = 29.5, median = 29). Most tumors were identified in the tibia(6) and femur(6), followed by the humerus(3), radius(3), pelvis(3), fibula(3), sacrum(1), metacarpal(1) and metatarsal(1) bones...
October 8, 2016: Pathology Oncology Research: POR
Vinay V Kumar, Supriya Ebenezer, Peer W Kämmerer, P C Jacob, Moni A Kuriakose, Naveen Hedne, Wilfried Wagner, Bilal Al-Nawas
OBJECTIVES: The objective of this study was to assess the difference in success rates of implants when using two or four implant-supported-overdentures following segmental mandibular reconstruction with fibula free flap. METHODS AND DESIGNS: This prospective, parallel designed, randomized clinical study was conducted with 1:1 ratio. At baseline, all participants already had segmental reconstruction of mandible with free fibula flap. The participants were randomized into two groups: Group-I received implant-supported-overdentures on two tissue-level implants and Group-II received implant-supported-overdentures on four tissue-level implants...
September 9, 2016: Journal of Cranio-maxillo-facial Surgery
Nawale Hadouiri, Pierre Decavel, Damien Feuvrier, Bernard Parratte, Julien Pauchot, Yoshimasa Sagawa
OBJECTIVE: Fibula and leg muscles play an important role during gait. The vascularized free fibula flap (VFFF) harvesting procedure could have an impact during short walking distance [1]. However, little is know about the VFFF effect during prolonged walk conditions [2]. The aim of this study was to determine the effect after VFFF harvesting on the evolution of spatiotemporal gait parameters during a 6-Minutes Walk Test (6MWT) and to compare results with those found in healthy persons...
September 2016: Annals of Physical and Rehabilitation Medicine
Carlos Olvera-Caballero, Abel Ortiz-Dominguez
A 15-year-old patient harmed himself upon firing a shotgun that he was carrying when he slipped and fell, causing a destructive wound in the right arm with a medial entry hole and a posterolateral exit hole. The biceps, coracobrachialis, triceps, deltoids, skin cover, and humerus were injured; however, the blood vessels and major nerves of the area were surprisingly not affected. The residual skin muscle defect after debridements was 16 × 5 cm medially and posteriorly, and the bone loss was 7 cm. The wound was reconstructed during a single surgery with a free fibula flap and a pedicled flap of latissimus dorsi...
August 2016: Plastic and Reconstructive Surgery. Global Open
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
James E McCarthy, Venkat K Rao
BACKGROUND: The purpose of this article is to describe the indications, operative technique, outcomes, and systematic review of the literature on the reconstruction of patients with end-stage pressure ulcers using a fillet flap technique. In this technique, the femur, tibia, and fibula are removed from the thigh and leg, and the soft tissue is used as a pedicled, or free, myocutaneous flap for reconstruction. Long-term outcomes, salient surgical technique of flap elevation, and design are detailed for patients who had a fillet of leg flap for reconstruction of extensive pressure ulcers...
August 2016: Plastic and Reconstructive Surgery. Global Open
Zhong-Fei Xu, Shuang Bai, Zhi-Qiang Zhang, Wei-Yi Duan, Zhi-Qiang Wang, Chang-Fu Sun
BACKGROUND: The free fibula flap has become popular for mandibular reconstruction. The purpose of this study was to propose comprehensive functional assessments of the donor site. METHODS: Thirty free fibula flaps for mandible reconstruction were prospectively enrolled in the study. Objective assessments included isokinetic testing of the ankle joint, electromyographic examination of the superficial peroneal nerve (SPN), and preoperative and postoperative foot scans...
September 12, 2016: Head & Neck
Joshua J DeSerres, Brittany R Barber, Hadi Seikaly, Jeffrey R Harris, Daniel A O'Connell
Free tissue transfer has become the mainstay of head and neck cancer (HNC) reconstructive surgery. The objective of the study is to examine the efficacy of the Harmonic Scalpel (HS) Shears on free flap elevation time and complication rates after HNC reconstruction compared with traditional electrocautery. A retrospective review of 215 HNC patients undergoing surgical ablation and free flap reconstruction from January 2010 to April 2013 at the University of Alberta Hospital was undertaken. All patients requiring free flap reconstruction with radial forearm free flap or fibula free flap were included...
May 2016: Plastic and Reconstructive Surgery. Global Open
Evan Kalin-Hajdu, M Reza Vagefi, Robert C Kersten
A 49-year-old female with advanced left maxillary squamous cell carcinoma underwent total maxillectomy. The orbital floor was reconstructed using a titanium mesh implant and the midface reformed with a free fibula flap. Following reconstruction, the patient developed progressive left-sided proptosis. Review of postoperative imaging prompted extraction of the titanium implant, rapidly normalizing globe position. This unique case highlights the clinical relevance of orbital venous anatomy.
August 23, 2016: Ophthalmic Plastic and Reconstructive Surgery
Toshiaki Numajiri, Hiroko Nakamura, Yoshihiro Sowa, Kenichi Nishino
BACKGROUND: Surgical cutting guides are used in mandibular reconstruction involving osteotomy of the mandible and fibula. Cutting guides produced using computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies have been reported recently. These guides aim to increase the benefits to patients by improving the accuracy, shortening the operating time, and correcting occlusion. However, the availability of these advanced technologies is limited in some regions of the world...
July 2016: Plastic and Reconstructive Surgery. Global Open
Saif Al-Bustani, Grace Kim Austin, Emily Cohn Ambrose, Justin Miller, Trevor G Hackman, Eric G Halvorson
PURPOSE: The free fibula is the flap of choice for reconstructing most segmental mandibular defects resulting from head and neck resections. The use of miniplates or reconstruction bars for fixation has been described in the literature. We wanted to compare outcomes between the 2 methods of fixation in head and neck cancer patients. PATIENTS AND METHODS: An IRB approved retrospective review of 25 consecutive patients undergoing free fibula flap reconstruction of the mandible for head and neck cancer over a period of 5 years was performed...
September 2016: Annals of Plastic Surgery
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