Reem A Karami1, Fadi M Ghieh1, Rawad S Chalhoub1, Said S Saghieh2, Suhail A Lakkis2, Amir E Ibrahim3. 1. Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon. 2. Department of Surgery, Division of Orthopedic Surgery, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon. 3. Department of Surgery, Division of Plastic and Reconstructive Surgery, American University of Beirut Medical Center, Cairo Street, Beirut, Lebanon. amir.ibrahim78@gmail.com.
Abstract
BACKGROUND: In a high conflict region, war injuries to the distal lower extremity are a major source of large composite defects involving bone and soft tissues. These defects are at the edge between using a single free flap [osteo-(+/-myo) cutaneous] vs double free flap reconstruction (bone and soft tissue). In this paper, we present our experience and outcomes in treating patients with leg war injury reconstructed using a single free fibula flap. METHODS: Fifteen patients with distal leg composite defects secondary to war injuries were treated between January 2015 and March 2016. All patients were reconstructed using single barrel free fibula osteo-(+/-myo)cutaneous flap where single or double skin paddles were used according to the soft tissue defect requiring coverage. RESULTS: There were no cases of total or partial flap loss. Complications were limited to three cases including traumatic fibula fracture, venous congestion with negative findings, and residual soft tissue defect requiring coverage. There were no cases of wound dehiscence or infection. Mean follow-up time was 418.8 days. Mean bone healing time was nine months after which patients were allowed full weight bearing. CONCLUSION: A single barrel free fibula osteo-(+/-myo)cutaneous flap is a valid and reliable tool for reconstruction composite lower extremity defects post-war injury. Adequate planning of fibula flap soft tissue components (skin, muscle) rearrangement is essential for success in such challenging reconstructions.
BACKGROUND: In a high conflict region, war injuries to the distal lower extremity are a major source of large composite defects involving bone and soft tissues. These defects are at the edge between using a single free flap [osteo-(+/-myo) cutaneous] vs double free flap reconstruction (bone and soft tissue). In this paper, we present our experience and outcomes in treating patients with leg war injury reconstructed using a single free fibula flap. METHODS: Fifteen patients with distal leg composite defects secondary to war injuries were treated between January 2015 and March 2016. All patients were reconstructed using single barrel free fibula osteo-(+/-myo)cutaneous flap where single or double skin paddles were used according to the soft tissue defect requiring coverage. RESULTS: There were no cases of total or partial flap loss. Complications were limited to three cases including traumatic fibula fracture, venous congestion with negative findings, and residual soft tissue defect requiring coverage. There were no cases of wound dehiscence or infection. Mean follow-up time was 418.8 days. Mean bone healing time was nine months after which patients were allowed full weight bearing. CONCLUSION: A single barrel free fibula osteo-(+/-myo)cutaneous flap is a valid and reliable tool for reconstruction composite lower extremity defects post-war injury. Adequate planning of fibula flap soft tissue components (skin, muscle) rearrangement is essential for success in such challenging reconstructions.
Authors: E García-Cimbrelo; B Olsen; M Ruiz-Yagüe; N Fernandez-Baíllo; L Munuera-Martínez Journal: Clin Orthop Relat Res Date: 1992-10 Impact factor: 4.176
Authors: Jennifer Sabino; Elizabeth Polfer; Scott Tintle; Elliot Jessie; Mark Fleming; Barry Martin; Mark Shashikant; Ian L Valerio Journal: Plast Reconstr Surg Date: 2015-03 Impact factor: 4.730