Orthoplastic Surgery最新文献

{"title":"Optimizing bone fixation in vascularized fibula graft in the upper extremity","authors":"Marco Innocenti ,&nbsp;Francesco Mori ,&nbsp;Luca Salmaso ,&nbsp;Francesca Alice Pedrini ,&nbsp;Paolo Sassu","doi":"10.1016/j.orthop.2024.04.001","DOIUrl":"10.1016/j.orthop.2024.04.001","url":null,"abstract":"<div><p>The free vascularized fibula transfer has become a widely utilized method in reconstructive surgery, with successful applications across various anatomical areas. The biological properties of the graft, including its ability to fuse with recipient bone, repair fractures, and remodel in new biomechanical environments, have been key to its efficacy. However, stable bone fixation is crucial for successful fusion and to prevent complications like non-union. While early approaches focused on minimally invasive techniques to preserve the fibula's vascular network, stable internal fixation has become favored in preventing complications. This article aims to systematically describe bone fixation options for vascularized fibula grafts in the upper limb based on extensive experience, recommending internal fixation over external methods, such as long plates for humerus reconstruction. Different osteotomy techniques are discussed, including intramedullary, transverse, and step cut, with considerations for biomechanics and patient demographics. The discussion emphasizes the importance of stable osteosynthesis for successful outcomes, particularly in early rehabilitation. Additionally, advancements in 3D printing offer personalized solutions in osteosynthesis device design, further enhancing surgical outcomes.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"16 ","pages":"Pages 12-19"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000071/pdfft?md5=8f29d31aa6a4c7835581b1f640e3d9a4&pid=1-s2.0-S2666769X24000071-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the success of fasciocutaneous flap techniques in treating distal leg injuries, a Sub-Saharan African experience from Sudan","authors":"Albra Kamal Ali Ahmed ,&nbsp;Osama Murtada Ahmed ,&nbsp;Talal Mohammed Geregandi ,&nbsp;Elbadwai Hassan-Mohamed HabibAlla ,&nbsp;Mohammed Yousof Bakhiet","doi":"10.1016/j.orthop.2024.04.002","DOIUrl":"https://doi.org/10.1016/j.orthop.2024.04.002","url":null,"abstract":"<div><h3>Background</h3><p>Soft tissue and bone injuries in the lower extremities associated with high-energy trauma remain a formidable challenge to treat. The timing of the operation, the most suitable type of tissue, and the decision between local or free flap coverage remain under discussion.</p></div><div><h3>Method</h3><p>This prospective, cohort, multi-center study was conducted in Khartoum, Sudan, from April 2021–September 2021. The study included 70 patients. Data was collected using a questionnaire filled with patients after getting informed consent.</p></div><div><h3>Results</h3><p>Males were 53(75.7 %) and females were 17(24.3 %). Male to female ratio was 3.1: 1. The mean age of the patients was 27.2 ± 3.4 years. The indications for the use of fascia-cutaneous flap in the management of traumatic soft tissue injuries of distal legs were distal substance loss areas of the leg 55(78.6 %), bone exposure 60(85.7 %), open fracture 29(41.4 %), and tendon exposure 31(44.3 %). The type of fasciocutaneous flap used for the patients in this study was perineal artery flap in 20(28.6 %), sural flap in 19(27.1 %), anterior tibial artery perforator flap in 18(25.7 %), and posterior tibial perforator flap in 13(18.6 %) of the patients in 42(60 %) of the patients, no complications were reported. The reported complications were infection 16(5.7 %), distal flap necrosis 8(11.4 %) and total loss 4(5.7 %).</p></div><div><h3>Conclusion</h3><p>Despite advances in microsurgery and free flap use, a fascia-cutaneous flap is still a valid option for distal leg soft tissue reconstruction in settings where this service is unavailable. fasciocutaneous flaps are an excellent option for distal leg defects to cover soft-tissue defects, exposed bones, and tendons.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"16 ","pages":"Pages 7-11"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000083/pdfft?md5=7d7a154aeb80d612109616905982f49b&pid=1-s2.0-S2666769X24000083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140894640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary and orthoplastic approach to diabetic foot reconstruction","authors":"Joon Pio Hong","doi":"10.1016/j.orthop.2024.01.001","DOIUrl":"https://doi.org/10.1016/j.orthop.2024.01.001","url":null,"abstract":"<div><p>The reconstructive surgeons are an important component in any multidisciplinary approach for the treatment of diabetic foot wounds. When technically feasible, the trend of management has shifted from major amputation to limb salvage. Furthermore, the reconstruction is not only providing adequate coverage but allowing the best possible function with minimum recurrence. By utilizing the orthoplastic approach, we can achieve these goals. The diabetic foot is one of the most difficult fields for reconstruction. With multidisciplinary and orthoplastic approach combined, the reconstructive surgeon can play a crucial part in avoiding amputation and providing an improved quality of life.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"15 ","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000010/pdfft?md5=f128b6d1ec764ff0a75b0e1038769322&pid=1-s2.0-S2666769X24000010-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139548700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Cohort Study of the Anterolateral Thigh Flap in Lower Extremity Traumatic Reconstruction. Does the Muscle Matter?","authors":"Idean Roohani ,&nbsp;Katelyn Kondra ,&nbsp;Eloise Stanton ,&nbsp;Jacob A. Becerra ,&nbsp;Ishani D. Premaratne ,&nbsp;David A. Daar ,&nbsp;Joseph N. Carey","doi":"10.1016/j.orthop.2024.01.002","DOIUrl":"10.1016/j.orthop.2024.01.002","url":null,"abstract":"<div><h3>Background</h3><p>Anterolateral thigh (ALT) flaps has served as a workhorse in lower extremity reconstruction. Flap design showcases both fasciocutaneous (ALT-FC) and myocutaneous variants; the latter includes variable amounts of vastus lateralis muscle (ALT-VL). This study aims to evaluate outcomes of ALT flaps for lower extremity reconstruction at a Level 1 trauma center between ALT-FC and ALT-VL variants and assess if there is any added benefit of muscle in flap design.</p></div><div><h3>Methods</h3><p>A retrospective review was conducted at Los Angeles General Medical Center (2007–2022). Demographics, medical comorbidities, injury characteristics, and outcomes were collected. Outcomes included flap necrosis, postoperative infection, and ambulatory function.</p></div><div><h3>Results</h3><p>Among 413 flaps placed, 63 were ALT flaps, of which 43 (68.3 %) were ALT-FC and 20 (31.7 %) were ALT-VL. Patient comorbidities, defect size, and wound severity were not significantly different across cohorts. Infectious and flap outcomes were comparable between cohorts, yet significantly more patients with hypertension and diabetes mellitus had osteomyelitis overall and in the ALT-FC cohort; patients with diabetes mellitus had significantly more flap complications. Flap survival was 96.8 % with 58.7 % of patients being fully ambulatory, without significance across degrees of ambulation or time to full ambulation.</p></div><div><h3>Conclusions</h3><p>Our findings demonstrated good outcomes with low rates of infection and flap loss that were comparable between both ALT-FC and ALT-VL cohorts. ALT-FC has recently been favored given decreased donor site morbidity without impaired function or infectious/flap complications. Accordingly, our findings may suggest that the addition of muscle to flap design may not be necessary for successful reconstruction.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"15 ","pages":"Pages 8-14"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000022/pdfft?md5=bab2ac1640afc34a016617d8548772ad&pid=1-s2.0-S2666769X24000022-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139638601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial nerve palsy in patients presenting with fentanyl/xylazine wounds of the dorsal forearm: A case series","authors":"Ashley Sun,&nbsp;Mikayla Borusiewicz,&nbsp;T. Shane Johnson","doi":"10.1016/j.orthop.2024.01.004","DOIUrl":"10.1016/j.orthop.2024.01.004","url":null,"abstract":"<div><h3>Introduction</h3><p>The presence of synthetic compounds like xylazine in the illicit opioid supply of the United States has led to presentations of unique upper extremity wounds in persons who inject drugs. As an alpha-2 adrenergic receptor agonist, xylazine causes local vasoconstriction of blood vessels as well as central nervous system depression. With increased vasoconstriction, patients experience more issues with adequate perfusion which is hypothesized to cause nerve deficiencies near injection sites.</p></div><div><h3>Methods</h3><p>Three patients presenting with a history of deep upper extremity forearm wounds secondary to injection with xylazine and fentanyl had clinically significant radial nerve palsies. Each patient's presentation and clinical course was observed and reported.</p></div><div><h3>Results</h3><p>In all three cases, patients presented with chronic necrotic forearm wounds that required repeated surgical debridement and wound care. There was evidence of weakness in the radial nerve distribution, with patients exhibiting dysfunction of the extrinsic digital and wrist extensors.</p></div><div><h3>Conclusion</h3><p>Providers should be aware of a common manifestation of radial nerve deficiency in upper extremity wounds in patients with a history of fentanyl-xylazine injections. While surgical management of nerve palsies such as tendon transfers are options for treatment, successful long-term treatment must also rely on multidisciplinary care for addiction and psychosocial support for ideal functional outcomes.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"15 ","pages":"Pages 15-20"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000046/pdfft?md5=6f319980b1c2a8700cff95e9bde7c65a&pid=1-s2.0-S2666769X24000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139876356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Review of contemporary non-surgical management techniques for metacarpal fractures: Anatomy and rehabilitation strategies”","authors":"Paolo Boccolari,&nbsp;Roberto Tedeschi,&nbsp;Daniela Platano,&nbsp;Danilo Donati","doi":"10.1016/j.orthop.2024.02.001","DOIUrl":"https://doi.org/10.1016/j.orthop.2024.02.001","url":null,"abstract":"<div><p>This comprehensive study explores the various aspects of metacarpal fractures, a prevalent condition in hand injuries. We delve into the anatomy of the metacarpals, elucidating how their structural characteristics influence fracture mechanics and treatment options. Special attention is given to the diverse types of fractures, particularly the differing tolerances for angular, shortening, and rotational deformities. The manuscript extensively reviews conservative treatment approaches, emphasizing the efficacy of non-surgical methods like modified braces and active mobilization techniques. Additionally, we provide a nuanced understanding of specific fracture types, such as neck fractures, highlighting their unique healing dynamics. This research offers valuable insights for orthopedic and plastic surgery practitioners, advancing the understanding and management of metacarpal fractures.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"15 ","pages":"Pages 21-23"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X24000058/pdfft?md5=8b009c499cedb9af638c378c91f6c249&pid=1-s2.0-S2666769X24000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasonic bone scalpel for long bone resections in limb reconstruction: Device description and case series","authors":"Stephanie V. Kaszuba . ,&nbsp;Michael Amick ,&nbsp;David L. Colen ,&nbsp;David B. Frumberg .","doi":"10.1016/j.orthop.2023.08.001","DOIUrl":"10.1016/j.orthop.2023.08.001","url":null,"abstract":"<div><h3>Introduction</h3><p>While the ultrasonic bone scalpel (UBS) has shown benefits, including decreased surgical duration, blood loss, and local tissue thermal injury, its implementation has been limited to skull base and spinal surgery. This case series sought to determine the safety and advantages of the UBS for bony resections in limb reconstructive procedures.</p></div><div><h3>Methods</h3><p>A retrospective review of four patients with a median age of 42 ± 13.38 at the time of resection and bone segment transport (BST) surgery was performed with UBS. Patients with prior history of lower extremity trauma with sequelae including non-union (2), osteomyelitis (1), or both (1). Intraoperative and post-operative courses and complications were documented.</p></div><div><h3>Results</h3><p>Each patient underwent tibial resection with UBS with a median bone resection size of 6.6 ± 2.85. Three patients underwent BST using cables and external fixator and one underwent plate-assisted BST with an intramedullary device. All patients had proximal corticotomies and antegrade transport, with a formal docking procedure at the end of transport. Complications included fixator cable tensioning device failure, frame readjustment, and pin tract infections. Two patients required subsequent grafting for docking site nonunion. One patient terminated bone transport early. No neurovascular injuries, hematomas, or dead space infections were reported.</p></div><div><h3>Conclusion</h3><p>The UBS offers a safe mechanism for long bone resections in lower extremity limb reconstruction. Neurovascular structures within the resection zone were preserved and uninjured, demonstrating major advantages in using this technology. Further study is needed to assess the risk for docking site nonunion with UBS.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"14 ","pages":"Pages 23-28"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000167/pdfft?md5=98012f254aad9b4a2a0e959c7fbad13b&pid=1-s2.0-S2666769X23000167-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75446618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between number of debridements and clinical outcomes in open tibia fractures requiring free flap coverage: A retrospective cohort study","authors":"Hayley Sacks ,&nbsp;Jesse Hu ,&nbsp;Agraharam Devendra ,&nbsp;Shengnan Huang ,&nbsp;Jamie Levine ,&nbsp;S. Raja Sabapathy ,&nbsp;Hari Venkatramani ,&nbsp;David Brogan ,&nbsp;Martin Boyer ,&nbsp;Jacques Hacquebord","doi":"10.1016/j.orthop.2023.08.002","DOIUrl":"10.1016/j.orthop.2023.08.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Open fractures with degloving injuries are commonly managed by serial debridements prior to definitive flap coverage in the United States (US). Some international institutions minimize the number of debridements prior to coverage. The purpose of this study was to compare clinical outcomes in patients with open tibia fractures requiring free flap coverage from institutions with differing debridement philosophies.</p></div><div><h3>Methods</h3><p>This was a multi-site retrospective cohort study of patients treated at two US tertiary care facilities (serial debridement cohort) and one in India (early total debridement cohort) with Type IIIB or IIIC open tibia fractures requiring free tissue transfer. The number of debridements prior to flap coverage were recorded and primary outcomes were rates of infection, non-union, and flap failure. Fischer's exact tests were used to compare outcomes between the cohorts.</p></div><div><h3>Results</h3><p>80 patients were included, 44 from India and 36 from the US. Patients in the serial debridement cohort underwent more debridements prior to flap coverage (mean 3.64 vs 1.84, p &lt; 0.001) and had significantly higher rates of infection and non-union compared to patients in the early total debridement cohort (p &lt; 0.05). There were no differences in rates of flap failure between the cohorts.</p></div><div><h3>Conclusions</h3><p>Patients with open tibia fractures treated at institutions favoring serial debridements underwent more debridements and had higher rates of infection and non-union compared to patients treated at a center favoring early total debridement. Serial debridements may not be necessary prior to flap coverage for open tibia fractures and the current practice should be further investigated.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"14 ","pages":"Pages 9-14"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000179/pdfft?md5=1e02e2a3bd8670ca2de8dc175f8a7623&pid=1-s2.0-S2666769X23000179-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80308515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience to date with elective transfemoral amputations incorporating agonist-antagonist myoneural interface (AMI) design","authors":"Corey L. Sullivan ,&nbsp;Lori Berger ,&nbsp;Rachael Chiao ,&nbsp;Kendall Clites ,&nbsp;Tracy Landry ,&nbsp;Tawnee L. Sparling ,&nbsp;Matthew J. Carty","doi":"10.1016/j.orthop.2023.09.001","DOIUrl":"10.1016/j.orthop.2023.09.001","url":null,"abstract":"<div><h3>Introduction</h3><p>The agonist-antagonist myoneural interface (AMI) is a surgical construct that, when incorporated into limb amputation, offers to potential to preserve or restore proprioception, augment functionality, reduce neuropathic pain and enhance overall limb stability. We here present our experience to date with AMI construction in the context of transfemoral amputation (TFA).</p></div><div><h3>Methods</h3><p>Patients were recruited for TFA with AMI construction at Brigham &amp; Women’s and Brigham &amp; Women’s Faulkner Hospital between June 2018 and June 2023. Data collection included demographic information, intraoperative parameters, clinical recovery metrics and complications. All data was then collated and analyzed.</p></div><div><h3>Results</h3><p>Seven TFA procedures were performed on seven patients during the study period. The operative technique employed evolved significantly over time, and included the development of both native and regenerative AMI models. Four patients were biological males (57%), and mean patient age was 42.0 ± 14.6 years. The etiology of conditions necessitating amputation included traumatic (43%), oncologic (29%), iatrogenic (14%) and congenital (14%). Mean operative time was 566 ± 97 min and average length of stay was 11.7 ± 8.4 days. Average postoperative follow-up was 2.19 ± 1.57 years (range 0.81–4.30 years). Postoperative imaging of AMI constructs demonstrated average muscle excursions of 6±3 mm, and total average limb volume preservation over time was 102 ± 14%. All patients demonstrated a complete wean from narcotic pain medications, with a mean time to wean of 86 ± 79 days. Minimal neuropathic pain was reported after the acute postoperative period. All seven (100%) of the subjects reported functional phantom limb sensation over the same time. Complications included significant soft tissue necrosis in two (29%) patients and minor wound healing issues in one (14%) patient.</p></div><div><h3>Conclusions</h3><p>TFA incorporating AMI construction appears to offer promising benefits similar to those previously reported in patients undergoing similar interventions at the transtibial level.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"14 ","pages":"Pages 46-53"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000180/pdfft?md5=9b53b656ece8066ad54e1acfe9043200&pid=1-s2.0-S2666769X23000180-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135389457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spino-plastic surgery: A literature review of vascularized bone grafts and their uses in spine reconstruction","authors":"Jonathan L. Jeger ,&nbsp;Alec Simoni ,&nbsp;Maria Shvedova ,&nbsp;Alanna Rebecca ,&nbsp;Sebastian Winocour ,&nbsp;Maziyar A. Kalani ,&nbsp;Michael Bohl ,&nbsp;Alexander E. Ropper ,&nbsp;Edward M. Reece","doi":"10.1016/j.orthop.2023.09.003","DOIUrl":"10.1016/j.orthop.2023.09.003","url":null,"abstract":"<div><p>The role of plastic surgeons in the world of spine surgery is quickly evolving. The plastic surgeon now serves both a therapeutic and prophylactic role in addressing complications of complex and revision spine surgery. The field of Spino-plastic Surgery is characterized by the use of vascularized bone grafts (VBGs). VBGs are bone segments transferred on their corresponding muscular attachments without the inclusion of a named vessel. The bone graft is adequately vascularized through the connection of the tendon by Sharpey's fibers and their associated microvasculature. VBGs provide an autologous, pedicled tissue rearrangement option with osteoinductive properties and adequate structural support for complex spine reconstruction. VBGs are associated with a lower risk of adverse events and shorter times to fusion than allografts, and bypass the need for lengthy microsurgical anastomosis. Five types of VBGs for spine reconstruction are described in this article, including iliac crest, rib, occiput, scapula, and spinous process VBG. Virtually any vertebral level can be reached for arthrodesis using one or more of these VBGs.</p></div>","PeriodicalId":100994,"journal":{"name":"Orthoplastic Surgery","volume":"14 ","pages":"Pages 15-22"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666769X23000210/pdfft?md5=9a4c5c4c0bb239de684229629e3d5cd8&pid=1-s2.0-S2666769X23000210-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135248193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}