Long-term outcome of fibula flaps in complex limb reconstruction compared to alternative procedures, a median follow up of 41 months

IF 1.5 3区 医学 Q3 SURGERY
Microsurgery Pub Date : 2024-07-16 DOI:10.1002/micr.31213
Raymond Challita MD,MPH, Alexandra Forli MD, Jean-Philippe Giot MD,PhD, Denis Corcella MD
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引用次数: 0

Abstract

Introduction

Complex open long bone fractures present a multidisciplinary surgical challenge. Various treatment options are discussed with no consensus. Fibula flaps (FF) are frequently used in maxillofacial surgery, however their use in limb injuries is less common. With the tremendous improvement in microsurgery, orthoplastic surgery gained importance. Our retrospective study aims to assess the long-term results and the quality of life of the patients operated by FF for complex traumatic limb reconstruction.

Patients and Methods

We conducted an observational mono centric retrospective study from the year 2011 to the year 2021. Patients operated for complicated traumatic limb fractures using FF were included in the study. Not only long-term clinical results were evaluated, but also Patient-reported outcome measures (PROM). These included the Lower Extremity Functional Scale (LEFS), Quick Disabilities of the Arm, shoulder and hand (Qdash), and the Visual Analogue Scale (VAS). The statistical analysis was done using the R Software.

Results

Twenty patients were included in our study. 80% achieved complete union with no re fracture rate at a median follow-up of 41 months. All of the patients (n = 4) who underwent amputation were smokers (p = .09), were operated for lower limb fractures (p = .54), and were males (p = 1). The length of hospital stay was associated with an increased duration to complete bony union (p = .01, coefficient = 2.88). At the end of follow-up, the LEFS median score was 67 for the total population and 63.5 for the lower limb reconstructed sub group.

Conclusion

VFF is an important tool in the armamentarium of orthoplastic surgeons. Encouraging long term functional and clinical outcomes were obtained in patients with complex traumatic limb fractures.

Abstract Image

腓骨瓣在复杂肢体重建中的长期效果与其他手术相比,中位随访时间为 41 个月。
简介复杂的开放性长骨骨折是一项多学科手术挑战。人们对各种治疗方案进行了讨论,但尚未达成共识。腓骨瓣(FF)常用于颌面外科,但在四肢损伤中的应用却不常见。随着显微外科技术的巨大进步,整形外科也变得越来越重要。我们的回顾性研究旨在评估复杂创伤肢体重建中使用 FF 手术的患者的长期效果和生活质量:我们开展了一项观察性单中心回顾性研究,研究时间为 2011 年至 2021 年。研究对象包括使用 FF 进行复杂创伤性肢体骨折手术的患者。研究不仅评估了长期临床结果,还评估了患者报告结果指标(PROM)。这些指标包括下肢功能量表(LEFS)、手臂、肩部和手部快速残疾量表(Qdash)以及视觉模拟量表(VAS)。统计分析使用 R 软件进行:研究共纳入 20 名患者。中位随访时间为 41 个月,80% 的患者达到完全愈合,无再次骨折。所有接受截肢手术的患者(n = 4)均为吸烟者(p = .09)、下肢骨折手术者(p = .54)和男性(p = 1)。住院时间的长短与完全骨结合时间的延长有关(p = .01,系数 = 2.88)。随访结束时,总人数的 LEFS 中位数为 67 分,下肢重建亚组的 LEFS 中位数为 63.5 分:结论:VFF是整形外科医生的重要工具。结论:VFF是整形外科医生的重要工具,在复杂创伤性四肢骨折患者中取得了令人鼓舞的长期功能和临床效果。
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来源期刊
Microsurgery
Microsurgery 医学-外科
CiteScore
3.80
自引率
19.00%
发文量
128
审稿时长
4-8 weeks
期刊介绍: Microsurgery is an international and interdisciplinary publication of original contributions concerning surgery under microscopic magnification. Microsurgery publishes clinical studies, research papers, invited articles, relevant reviews, and other scholarly works from all related fields including orthopaedic surgery, otolaryngology, pediatric surgery, plastic surgery, urology, and vascular surgery.
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