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https://www.readbyqxmd.com/read/28328603/simultaneous-autologus-mandible-and-temporomandibular-joint-reconstruction
#1
Yigit Ozer Tiftikcioglu, Ersin Gur, Ufuk Bilkay
Ablative surgery of mandible often necessitates combined reconstruction of the mandible and the temporomandibular joint. Fibula-free flaps with gap arthroplasty or osseochondral grafts are common procedures in the authors' practice. In search for a better reconstructive option free fibula flap is used together with a metatarsal bone flap for the vascular reconstruction of the mandibular body and the condyle at the same time. The 2 osseous-free flaps have been fused and used as a combined flow through double-free flap...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28322117/effect-of-overlapping-operations-on-outcomes-in-microvascular-reconstructions-of-the-head-and-neck
#2
Larissa Sweeny, Eben L Rosenthal, Tyler Light, Jessica Grayson, Daniel Petrisor, Scott H Troob, Benjamin J Greene, William R Carroll, Mark K Wax
Objective To compare outcomes after microvascular reconstructions of head and neck defects between overlapping and nonoverlapping operations. Study Design Retrospective cohort study. Setting Tertiary care center. Subjects and Methods Patients undergoing microvascular free tissue transfer operations between January 2010 and February 2015 at 2 tertiary care institutions were included (n = 1315). Patients were divided into 2 cohorts by whether the senior authors performed a single or consecutive microvascular reconstruction (nonoverlapping; n = 773, 59%) vs performing overlapping microvascular reconstructions (overlapping; n = 542, 41%)...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28296984/implant-stability-and-bone-characteristics-in-free-fibula-flaps-used-for-jaw-reconstruction-a-prospective-cohort-study
#3
Vinay V Kumar, Ullash Kumar, Vijay Pillai, Vinotha Ponnusamy, Bilal Al-Nawas, Moni A Kuriakose
PURPOSE: The primary objective of this prospective cohort study was to evaluate primary and secondary implant stability values of implants placed into healed free fibula-reconstructed mandibles. The secondary objective was to investigate whether a correlation existed between primary implant stability and the quantity of cortical bone-implant contact and of cortical fibular bone in contact with the implants. MATERIALS AND METHODS: The study participants are patients enrolled in a registered trial (No...
March 17, 2017: International Journal of Oral & Maxillofacial Implants
https://www.readbyqxmd.com/read/28295569/simultaneous-vascularized-bony-reconstruction-of-the-maxilla-and-mandible-using-a-single-fibula-a-case-report
#4
Alexander F Mericli, Jonathan S Friedstat, Edward I Chang, Matthew M Hanasono
Simultaneous maxillary and mandibular reconstruction is exceedingly rare. These are complicated cases, requiring consideration of multiple variables: defect components, donor site morbidity, recipient vessels, and so forth. We describe a unique case of secondary maxillary/mandibular reconstruction in a 59-year-old male. The original defect was created after removal of a buccal squamous cell carcinoma, involving the external cheek skin, buccal mucosa, right mandibular body, and right inferior maxilla; a free vertical rectus abdominis musculocutaneous flap was used for the initial reconstruction...
March 2017: Microsurgery
https://www.readbyqxmd.com/read/28293503/near-complete-humerus-reconstruction-in-the-pediatric-patient-with-vascularized-free-fibula-transfer
#5
John Shuck, Benjamin C Wood, Christopher Zarella, Albert K Oh, Robert M Henshaw, Gary F Rogers
Vascularized free fibula transfer remains the gold standard for reconstruction of large segmental diaphyseal defects of the upper extremity. In the pediatric patient, before skeletal maturity, free fibula transfer with the fibular head provides an active physis for growth and an articular interface for glenohumeral joint reconstruction. Clinical and cadaveric studies have demonstrated that the vascular supply to the fibular head originates, in most cases, from the anterior tibial system. However, anatomical variation exists, and we report a case in which a vascularized fibula autograft including the physis was transferred on the peroneal artery in a 5-year-old patient with Ewing's sarcoma...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293492/a-rare-case-of-malignant-transformation-of-oral-lichen-planus-of-the-mandible
#6
Joanne Soo, George Kokosis, Michael Ogilvie, Xiaoyin Sara Jiang, David B Powers, Daniel J Rocke, Detlev Erdmann
Oral lichen planus (OLP) is an immune-mediated mucocutaneous disease associated with an increased risk in oral squamous cell carcinoma (OSCC). Nearly all cases of malignant transformation have been reported in patients >40 years old. We report the case of a 37-year-old woman with a 5-year history of erosive OLP who presented with malignant transformation to OSCC. Delineating the margins of the disease was impossible at presentation given her OLP, and she was initially treated with concurrent chemoradiation therapy...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28286393/versatility-of-fibula-free-flap-in-reconstruction-of-facial-defects-a-center-study
#7
Sunil S Shroff, Sanjiv C Nair, Anjan Shah, Balasubramanya Kumar
PURPOSE: To study a series of cases where vascularised fibula flap was used in various combinations of bone with muscle and skin along with its modifications for reconstruction of simple and composite defects of the facial region. PATIENTS AND METHODS: The investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of maxilla or mandible with vascularised fibula free flap from 2009 to 2013. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28280662/avoiding-facial-incisions-with-midface-free-tissue-transfer
#8
Mark W Stalder, Michael Sosin, Leo J Urbinelli, James L Mayo, Amir H Dorafshar, Hugo St Hilaire, Daniel E Borsuk, Eduardo D Rodriguez
BACKGROUND: We have adopted an intraoral microsurgical anastomosis to the facial vessels to eliminate the need for any visible facial incisions. METHODS: Cadaveric dissection was used to demonstrate accessibility of the facial artery and vein through an intraoral approach. Additionally, 5 patients underwent free tissue transfer for reconstruction of major defects of the midface through an intraoral, transmucosal approach, obviating the need for visible skin incisions...
February 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28259113/surgeon-based-3d-printing-for-microvascular-bone-flaps
#9
Erin M Taylor, Matthew L Iorio
Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models...
March 4, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28258918/evaluation-of-bone-resorption-in-fibula-and-deep-circumflex-iliac-artery-flaps-following-dental-implantation-a-three-year-follow-up-study
#10
Kristian Kniha, Stephan Christian Möhlhenrich, Ann Christina Foldenauer, Florian Peters, Nassim Ayoub, Evgeny Goloborodko, Frank Hölzle, Ali Modabber
Long-term results of dental implant treatment in fibula free and deep circumflex iliac artery (DCIA) free flaps are scarce. The purpose of this study was to assess and compare peri-implant bone resorption of vascularized bone flaps treated with dental implants. A total of 28 patients, 14 fibula and 14 DCIA flaps, respectively, underwent reconstruction of the lower and upper jaw by the use of vascularized bone flaps and were treated with dental implants. Peri-implant bone resorption was measured using digital panographs up to 3 years...
January 30, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28216818/limb-salvage-with-microvascular-free-fibula-following-primary-bone-sarcoma-resection
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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...
March 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28045826/free-hand-perforator-concept-in-osteocutaneous-free-fibula-flap-through-posterior-approach
#19
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...
March 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#20
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
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