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https://www.readbyqxmd.com/read/29344982/experience-with-pharmacologic-leeching-with-bivalirudin-for-adjunct-treatment-of-venous-congestion-of-head-and-neck-reconstructive-flaps
#1
Aisha Harun, Rachel M Kruer, Andrew Lee, Kofi Boahene, Patrick J Byrne, Jeremy D Richmon
OBJECTIVES: The goal of this study was to review the feasibility of local bivalirudin injection for adjunct treatment of venous congestion of head and neck reconstructive flaps. METHODS: A retrospective chart review of patients who underwent bivalirudin treatment for venous congestion of head and neck reconstructive flaps in a single institution from September 1, 2012 to September 1, 2015 was undertaken. Individuals were treated with variable number of intradermal injections directly into the flap followed by a small skin incision to allow extended passive bleeding...
January 18, 2018: Microsurgery
https://www.readbyqxmd.com/read/29343893/assessment-of-perfusion-of-free-flaps-used-in-head-and-neck-reconstruction-using-pulsatility-index
#2
Akshay Kapoor, Malay Karmakar, Collin Roy, Kaushal Priya Anand
Objective: To detect venous or arterial obstruction in the pedicle of a free flap we can monitor resistance in the flap bed which is reflected in Pulsatility Index (PI) Therefore if we detect change in the values of the PI in these flaps then we can detect complications in flap due to vascular insufficiency early. Materials and Methods: Seven patients of Free Fibular Flap Reconstruction and ten patients of Free Radial Forearm Flap reconstruction were evaluated over a period of 18 months...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29224810/utilization-of-a-pre-bent-plate-positioning-surgical-guide-system-in-precise-mandibular-reconstruction-with-a-free-fibula-flap
#3
Tingwei Bao, Jianfeng He, Changyang Yu, Wenquan Zhao, Yi Lin, Huiming Wang, Jianhua Liu, Huiyong Zhu
OBJECTIVES: We evaluated the effects of three-dimensional virtual planning and the use of a plate-embedded surgical guide in mandibular reconstruction with microvascular fibula flaps. MATERIALS AND METHODS: We retrospectively reviewed 35 patients who underwent primary mandibular reconstruction with a free fibula flap. They were divided into three groups according to the therapy they received. In group A, 12 patients underwent reconstruction using the modified surgical guide system, including virtual surgeries, pre-bent titanium plates, screw-predesignated cutting guides for mandibular and fibular osteotomies, and plate-embedded shaping guides...
December 2017: Oral Oncology
https://www.readbyqxmd.com/read/29222966/optimizing-functional-outcomes-in-mandibular-condyle-reconstruction-with-the-free-fibula-flap-using-computer-aided-design-and-manufacturing-technology
#4
Z-Hye Lee, Tomer Avraham, Casian Monaco, Ashish A Patel, David L Hirsch, Jamie P Levine
PURPOSE: Mandibular defects involving the condyle represent a complex reconstructive challenge for restoring proper function of the temporomandibular joint (TMJ) because it requires precise bone graft alignment for full restoration of joint function. The use of computer-aided design and manufacturing (CAD/CAM) technology can aid in accurate reconstruction of mandibular condyle defects with a vascularized free fibula flap without the need for additional adjuncts. The purpose of this study was to analyze clinical and functional outcomes after reconstruction of mandibular condyle defects using only a free fibula graft with the help of virtual surgery techniques...
November 15, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29209690/prosthetic-rehabilitation-involving-the-use-of-implants-following-a-fibula-free-flap-reconstruction-in-the-treatment-of-osteosarcoma-of-the-maxilla-a-case-report
#5
E Brauner, A Quarato, F De Angelis, G Pompa, S Jamshir, V Valentini, S Di Carlo
INTRODUCTION: Osteosarcoma is an aggressive primary bone tumor composed of connective tissue cells directly producing osteoid and bone. Prosthetic rehabilitations in post-oncological patients after bone reconstruction are not substantially different than those of patients affected by severe atrophy of upper or lower jaw after bone reconstruction. The treatment for patients with a malignant neoplasia of the oral cavity requires multidisciplinary approach by a team of different specialists that follow the patient through the phases of diagnosis, therapy and oral rehabilitation...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29153233/temporomandibular-joint-reconstruction-in-the-growing-child
#6
REVIEW
Cory M Resnick
Indications and considerations for reconstruction of the temporomandibular joint (TMJ) differ between growing and skeletally mature patients. Osteoarthritis, which is the most common cause of TMJ destruction in adults, is comparatively rare in children. The most common indications in young patients are congenital deformities, pathology, ankylosis and progressive resorptive processes. Options for reconstruction include distraction osteogenesis, autologous reconstruction (ie, costochondral graft, free fibula flap), and total alloplastic joint replacement...
February 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29117845/restoration-of-the-active-forearm-rotation-using-vascularized-free-fibular-graft-and-radial-head-arthroplasty-for-a-wide-defect-of-the-proximal-radius
#7
Ryosuke Sato, Yoshitaka Hamada, Naohito Hibino, Toshihiko Nishisho, Ichiro Tonogai, Kenji Endo, Koichi Sairyo
In this report we present a case of re-stabilization of the proximal radius using vascularized free fibular graft combined with anconeus arthroplasty to stabilize the transplanted fibula in a patient with large loss of the proximal radius due to Ewing's sarcoma. A 20-year-old woman had Ewing's sarcoma in the proximal three-fourths of the radius. The resection of large part of the radius containing radial head were necessary for removal of the sarcoma. Reconstruction of the proximal radius was performed using vascularized free fibular graft and the transplanted fibula was stabilized by attaching the anconeus to the proximal edge of the fibula...
December 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29109844/porcine-urinary-bladder-extracellular-matrix-for-the-salvage-of-fibula-free-flap-skin-paddle-technical-note-and-description-of-a-case
#8
REVIEW
Rabie M Shanti, Ryan J Smart, Andrew Meram, David Kim
This report establishes a novel application of a commercially available porcine urinary bladder extracellular matrix, MatriStem (ACell, Inc., Columbia, MD), in the salvage of partial loss of the skin paddle of a fibula osteoseptocutaneous free flap that was utilized for mandibular reconstruction.
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29105820/the-radial-forearm-free-flap-as-a-vascular-bridge-for-secondary-microsurgical-head-and-neck-reconstruction-in-a-vessel-depleted-neck
#9
Pedro Ciudad, Mouchammed Agko, Shivprasad Date, Wei-Ling Chang, Oscar J Manrique, Tony C T Huang, Federico Lo Torto, Emilio Triganano, Hung-Chi Chen
BACKGROUND: In a vessel-depleted neck, distant recipient sites may be the only option for secondary free flap reconstruction. While interposition vein grafts and arteriovenous loops can bridge the gap between the recipient and donor pedicle, they are not without risks. In these scenarios, we examinate the reliablity of a radial forearm free flap (RFFF) as an alternative vascular conduit. PATIENTS AND METHODS: A retrospective review of cases between March 2005 and May 2016 was performed...
November 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/29100719/contribution-of-3d-printing-to-mandibular-reconstruction-after-cancer
#10
A Dupret-Bories, S Vergez, T Meresse, F Brouillet, G Bertrand
Three-dimensional (3D) printing is booming in the medical field. This technology increases the possibilities of personalized treatment for patients, while lowering manufacturing costs. To facilitate mandibular reconstruction with fibula free flap, some companies propose cutting guides obtained by CT-guided moulding. However, these guides are prohibitively expensive (€2,000 to €6,000). Based on a partnership with the CNRS, engineering students and a biomedical company, the authors have developed cutting guides and 3D-printed mandible templates, deliverable in 7days and at a lower cost...
October 31, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29100670/donor-site-morbidity-after-vascularized-fibula-free-flap-gait-analysis-during-prolonged-walk-conditions
#11
N Hadouiri, D Feuvrier, J Pauchot, P Decavel, Y Sagawa
The aim of this study was to determine the effect of vascularized fibula free flap (VFFF) harvest on gait variables during the six-minute walk test (6MWT). Eleven patients who had undergone VFFF harvest and 11 healthy peers participated in this case-control study. The main evaluation consisted of the collection of gait variables using the GAITRite system during three periods of the 6MWT: beginning (0-1min), middle (2:30-3:30min), and end (5-6min). The 6MWT was significantly shorter in the VFFF group than in the reference group (-31%, P<0...
October 31, 2017: International Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29079242/fibulocalcaneal-impingement-in-a-growing-child-with-otherwise-asymptomatic-talocalcaneal-coalition
#12
G Ulrich Exner, Hilaire A C Jacob, Gerardo J Maquieira
Subfibular impingement has been described in patients with flatfoot. It possibly occurs with valgus deformity associated with talocalcaneal coalition. We observed symptomatic unilateral fibular impingement initially on the left foot of an 11-year-old female with an otherwise asymptomatic bilateral talocalcaneal coalition. From the age of 8 years, she had complained of pain around the left fibular tip. Magnetic resonance imaging showed a partial talocalcaneal coalition. At 10 years of age, it was questioned whether the pain was related to the coalition...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29076982/reconstruction-of-traumatic-open-supracondylar-femoral-fractures-by-autologous-fibular-strut-grafting-and-cortico-cancellous-bone-grafting-a-single-centre-observational-study
#13
Raju Iyengar, Nagesh Cherukuri, Chandrasekar Patnala
OBJECTIVES: To study the safety and efficacy of staged reconstruction of distal femoral (supracondylar) bone loss using autologous fibular strut, cortico-cancellous bone grafting. DESIGN: Single Centre, Observational study, with review of literature. SETTING: Urban Level I Trauma Centre,Patients/Participants. 18 consecutive patients (mean age: 35± 8.5 years, all males) with open supracondylar fracture and intercondylar extension (Type C3), (AO type) operated between January 2010 and February 2014 with severe bone loss in 11 patients and moderate loss in 7...
September 25, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29017734/anatomy-of-the-vasculature-of-the-lower-leg-and-harvest-of-a-fibular-flap-a-systematic-review
#14
REVIEW
A K Abou-Foul, A Fasanmade, S Prabhu, F Borumandi
The fibular free flap (FFF) is based on the peroneal artery, which has a consistent anatomy and makes a minimal contribution to the pedal circulation. However, certain anatomical variations in the vasculature of the leg might leave the peroneal artery with a major role in the perfusion of the foot, and to raise a FFF could lead to ischaemic complications. Our aim was to review the implications of anatomical variants on planning and harvest of a FFF. We systematically reviewed all relevant publications, and included 28 cases that described a dominant peroneal artery and FFF...
November 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29016574/microvascular-free-flaps-in-oral-and-maxillofacial-reconstruction-following-cancer-ablation
#15
Santosh Kumar Yadav, Suraksha Shrestha
Microsurgical free flaps have become the first choice for reconstruction of oral and maxillofacial (OMF) defects after tumor resection. Till recently the pectoralis major myocutaneous flap (PMMC) was considered to be the benchmark for OMF reconstruction. This philosophy is changing fast with rapid advancement in reconstructive microsurgery. Years of innovation in reconstructive microsurgery has given us a reasonably good number of excellent flaps. Tremendous work has been put into producing some exceptionally brilliant research articles, sometimes contradicting each other...
September 8, 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28969965/axial-four-dimensional-computed-tomographic-images-to-analyze-crosswise-differences-in-protrusive-condylar-movement-in-patients-who-underwent-mandibulectomy-and-free-flap-reconstruction
#16
Masaya Akashi, Toshinori Sekitani, Yumi Ohtsuki, Yasumasa Kakei, Junya Kusumoto, Takumi Hasegawa, Michinori Maeda, Noriyuki Negi, Kazunobu Hashikawa, Yasuyuki Shibuya, Satoru Takahashi, Takahide Komori
OBJECTIVE: Few studies evaluate condylar movement following mandibular reconstruction. The main objective of this study was to show that axial four-dimensional computed tomography (4DCT) could visualize bilateral protrusive condylar movement directly. We used axial 4DCT images to assess condylar protrusion in patients who underwent mandibular reconstruction. METHODS: We enrolled seven healthy volunteers (median age 30 years, range 27-38 years) and seven patients (median age 65 years, range 52-80 years), who underwent mandibulectomy (segmental in five, hemi in one, marginal in one) and free flap reconstruction (using the fibula in six and the radial forearm in one)...
September 1, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28968321/postradiotherapy-prosthetic-management-of-mandible-reconstructed-with-fibular-graft
#17
Pankaj Kharade, Kanchan Dholam, Pravin Bhirangi
Intraoral defects secondary to resection of mandible leading to mandibular discontinuity are very complicated to treat as the muscles exert forces on the residual portion of the mandible. Primarily this leads to disfigurement of the face. These forces also make mastication difficult due to imbalance. Ultimately it leads to poor quality of life for the patient. Apart from that the clinical outcome and prognosis of prosthetic rehabilitation of such patients is very poor. The composite fibular flap is the preferred donor site for reconstruction of most complex orofacial-mandibular defects...
September 29, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28967393/treatment-of-a-mandibular-discontinuity-defect-by-using-a-fibula-free-flap-and-an-implant-supported-fixed-complete-denture-fabricated-with-a-pekk-framework-a-clinical-report
#18
Kyung Chul Oh, Ji-Hyun Park, Joon-Hee Lee, Hong Seok Moon
This clinical report describes the rehabilitation of a patient with a history of mandibulectomy that involved the use of a fibula free flap and an implant-supported fixed complete denture. A recently introduced material, polyetherketoneketone, was used as the framework material for the prosthesis, and the treatment produced favorable esthetic and functional results.
September 27, 2017: Journal of Prosthetic Dentistry
https://www.readbyqxmd.com/read/28961429/synchronous-reconstruction-of-a-total-mandibulectomy-defect-with-a-single-fibula-osteocutaneous-free-flap
#19
Ramzey Tursun, J Marshall Green, Daniel Winokur, Andre Ledoux
Osteoradionecrosis (ORN) is a well-known and usually late complication of radiation therapy in the treatment of head and neck cancer. Although the therapy can be life extending, it also produces tissue toxicity in ipsilateral and contralateral tissues in an acute and chronic fashion. In the most severe cases of ORN, such as the one presented in this report, bilateral disease results in the need for total mandibulectomy and creates a tremendous reconstructive challenge. The advent of microvascular surgery and free tissue transfer has caused an evolution of the management protocol for severe ORN cases...
January 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28951870/heterogeneity-of-necrotic-changes-between-cortical-and-cancellous-bone-in-mandibular-osteoradionecrosis-a-histopathological-analysis-of-resection-margin-after-segmental-mandibulectomy
#20
Masaya Akashi, Kazunobu Hashikawa, Satoshi Wanifuchi, Junya Kusumoto, Manabu Shigeoka, Shungo Furudoi, Hiroto Terashi, Takahide Komori
BACKGROUND: This study aimed to analyze differences in necrotic changes between cortical and cancellous bone in resection margins after segmental mandibulectomy for advanced mandibular osteoradionecrosis. METHODS: Anteroposterior bone specimens from eleven patients who underwent segmental mandibulectomy with simultaneous free fibula flap reconstruction for advanced osteoradionecrosis were analyzed histopathologically for the presence of necrotic bone based on the presence of blood vessels within Haversian canals...
2017: BioMed Research International
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