Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report
Surgical management of femur osteomyelitis remains challenging. The burden of this chronic disease invariably results in composite bony and soft tissue defects that can interfere with bony stability. Therefore, reconstructive surgery is integral to functional limb salvage and limb preservatives. To...
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Malaysian Orthopaedic Association
2025-03-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | https://www.morthoj.org/2025/v19n1/osteomyelitis-femur-defect.pdf |
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| author | Lam HY Halim AS Wan-Sulaiman WA |
| author_facet | Lam HY Halim AS Wan-Sulaiman WA |
| author_sort | Lam HY |
| collection | DOAJ |
| description | Surgical management of femur osteomyelitis remains challenging. The burden of this chronic disease invariably results in composite bony and soft tissue defects that can interfere with bony stability. Therefore, reconstructive surgery is integral to functional limb salvage and limb preservatives. To the best of our knowledge, we are the first to report the limb salvaging method and important planning considerations for a case of chronic refractory osteomyelitis. We presented a case of a 31-year-old female with chronic post-traumatic osteomyelitis of the right femur. This intractable disease results in frequent remission of infection and non-union of the midshaft fracture. Surgical management with the implant, external fixation, and cement spacer failed due to infection. This rendered vascularised bone graft with massive allograft the only option. We described the anatomical aberrant during the harvest of free fibula flap and modified chimeric fibula flap to overcome the soft tissue defect complicated with severe fibrotic tissue with a background of an obese patient. She had undergone emergency hematoma evacuation 20 hours after the surgery. Otherwise, the flap survived well, and the patient started to have partial weight bearing. Chimeric fibula osteocutaneous free flap is a useful armament to provide a complex 3-dimensional spatial arrangement in a case of chronic osteomyelitis with huge bony and soft tissue defects. |
| format | Article |
| id | doaj-art-c247ad160526476aad18ce8e61d22190 |
| institution | OA Journals |
| issn | 1985-2533 2232-111X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj-art-c247ad160526476aad18ce8e61d221902025-08-20T02:08:43ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332232-111X2025-03-011911410.5704/MOJ.2503.017Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case ReportLam HY0Halim AS1Wan-Sulaiman WA2Department of Reconstruction Science Unit, Universiti Sains Malaysia, Kubang Kerian, MalaysiaDepartment of Reconstruction Science Unit, Universiti Sains Malaysia, Kubang Kerian, MalaysiaDepartment of Reconstruction Science Unit, Universiti Sains Malaysia, Kubang Kerian, MalaysiaSurgical management of femur osteomyelitis remains challenging. The burden of this chronic disease invariably results in composite bony and soft tissue defects that can interfere with bony stability. Therefore, reconstructive surgery is integral to functional limb salvage and limb preservatives. To the best of our knowledge, we are the first to report the limb salvaging method and important planning considerations for a case of chronic refractory osteomyelitis. We presented a case of a 31-year-old female with chronic post-traumatic osteomyelitis of the right femur. This intractable disease results in frequent remission of infection and non-union of the midshaft fracture. Surgical management with the implant, external fixation, and cement spacer failed due to infection. This rendered vascularised bone graft with massive allograft the only option. We described the anatomical aberrant during the harvest of free fibula flap and modified chimeric fibula flap to overcome the soft tissue defect complicated with severe fibrotic tissue with a background of an obese patient. She had undergone emergency hematoma evacuation 20 hours after the surgery. Otherwise, the flap survived well, and the patient started to have partial weight bearing. Chimeric fibula osteocutaneous free flap is a useful armament to provide a complex 3-dimensional spatial arrangement in a case of chronic osteomyelitis with huge bony and soft tissue defects.https://www.morthoj.org/2025/v19n1/osteomyelitis-femur-defect.pdfchimeric free fibula flapallograftrefractory osteomyelitisfemur |
| spellingShingle | Lam HY Halim AS Wan-Sulaiman WA Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report Malaysian Orthopaedic Journal chimeric free fibula flap allograft refractory osteomyelitis femur |
| title | Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report |
| title_full | Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report |
| title_fullStr | Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report |
| title_full_unstemmed | Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report |
| title_short | Chimeric Free Fibula Osteocutaneus Flap and Massive Allograft for Refractory Post-traumatic Osteomyelitis Femur Defect: A Case Report |
| title_sort | chimeric free fibula osteocutaneus flap and massive allograft for refractory post traumatic osteomyelitis femur defect a case report |
| topic | chimeric free fibula flap allograft refractory osteomyelitis femur |
| url | https://www.morthoj.org/2025/v19n1/osteomyelitis-femur-defect.pdf |
| work_keys_str_mv | AT lamhy chimericfreefibulaosteocutaneusflapandmassiveallograftforrefractoryposttraumaticosteomyelitisfemurdefectacasereport AT halimas chimericfreefibulaosteocutaneusflapandmassiveallograftforrefractoryposttraumaticosteomyelitisfemurdefectacasereport AT wansulaimanwa chimericfreefibulaosteocutaneusflapandmassiveallograftforrefractoryposttraumaticosteomyelitisfemurdefectacasereport |