Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases
Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of t...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2013-09-01
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| Series: | Indian Journal of Plastic Surgery |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122013 |
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| author | Gurdayal Singh Kalra Pradeep Goel Pradeep Kumar Singh |
| author_facet | Gurdayal Singh Kalra Pradeep Goel Pradeep Kumar Singh |
| author_sort | Gurdayal Singh Kalra |
| collection | DOAJ |
| description | Introduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma. |
| format | Article |
| id | doaj-art-c8ebb4eb559748aeb6bcb160b9e7f418 |
| institution | OA Journals |
| issn | 0970-0358 1998-376X |
| language | English |
| publishDate | 2013-09-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Indian Journal of Plastic Surgery |
| spelling | doaj-art-c8ebb4eb559748aeb6bcb160b9e7f4182025-08-20T02:02:05ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2013-09-01460354354810.4103/0970-0358.122013Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 casesGurdayal Singh Kalra0Pradeep Goel1Pradeep Kumar Singh2Department of Burn and Plastic Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, IndiaDepartment of Burn and Plastic Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, IndiaDepartment of Burn and Plastic Surgery, Sawai Man Singh Medical College, Jaipur, Rajasthan, IndiaIntroduction: The severe long bone defects usually follow high-energy trauma and are often associated with a significant soft-tissue injury. The goal of management of these open long bone defects is to provide stable fixation with maintenance of limb length and soft-tissue coverage. The purpose of this article is to present the clinic-radiological outcome, complications and treatment of post-traumatic long bone defect with vascularised fibula transfer. Materials and Methods: Retrospective records of 28 patients were analysed who presented with post-traumatic long bone defects and in whom reconstruction with vascularised free fibula was done. Demographic data were recorded and clinical and radiological assessment was done. Results: Out of 28 patients in whom vascularised free fibula transfer was carried out three flaps were lost while non-union occur in three patients. Three patients developed a stress fracture of transferred free fibula in the post-operative period. Few of the patients experienced some problems in the donor leg; however, all of them improved in subsequent follow-up. Discussion: It is clearly evident from this study that timing of surgery plays an important role in the micro-vascular reconstruction in trauma cases. All the complication like flap loss, non-union or delayed union occur in patients in whom reconstruction was delayed. Conclusion: The free vascularised fibula graft is a viable method for the reconstruction of skeletal defects of more than 6 cm, especially in cases of scarred and avascular recipient sites or in patients with combined bone and soft-tissue defects. Results are best when the reconstruction is done within 1 week of trauma.http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122013long bone defectpost-traumaticvascularised free fibula |
| spellingShingle | Gurdayal Singh Kalra Pradeep Goel Pradeep Kumar Singh Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases Indian Journal of Plastic Surgery long bone defect post-traumatic vascularised free fibula |
| title | Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases |
| title_full | Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases |
| title_fullStr | Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases |
| title_full_unstemmed | Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases |
| title_short | Reconstruction of post-traumatic long bone defect with vascularised free fibula: A series of 28 cases |
| title_sort | reconstruction of post traumatic long bone defect with vascularised free fibula a series of 28 cases |
| topic | long bone defect post-traumatic vascularised free fibula |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0970-0358.122013 |
| work_keys_str_mv | AT gurdayalsinghkalra reconstructionofposttraumaticlongbonedefectwithvascularisedfreefibulaaseriesof28cases AT pradeepgoel reconstructionofposttraumaticlongbonedefectwithvascularisedfreefibulaaseriesof28cases AT pradeepkumarsingh reconstructionofposttraumaticlongbonedefectwithvascularisedfreefibulaaseriesof28cases |