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Osteocutaneous Flap (osteocutaneou + flap)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

One-stage reconstruction of the complex midfoot defect with a multiple osteotomized free fibular osteocutaneous flap: Case report and literature review

MICROSURGERY, Issue 1 2010
Efstathios G. Lykoudis M.D., Ph.D.
Complex midfoot defects represent a reconstructive challenge since midfoot plays a key role in standing and gait. We report the case of a 27-year-old patient with a complex midfoot defect due to a high-energy gun shot injury. The defect included the tarsometatarsal complex, all three arches of the foot, and the overlying dorsal skin of the foot. Reconstruction was achieved in a single stage with a free fibular osteocutaneous flap. The fibula was osteotomized into three segments, which were used to reconstruct the bone defects, while the skin paddle of the flap was used for stable soft tissue coverage of the reconstructed bony skeleton. Early and late postoperative periods were uneventful. Bone incorporation was radiographically evident at 12 weeks, and full weight bearing was possible at 6 months postop. Final follow up, at 2 years postop, showed a very good functional and esthetic outcome. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. [source]

Synchronous reconstruction of the floor of mouth and chin with a single skin island fibular free flap

MICROSURGERY, Issue 4 2008
F.A.C.S., Richard O. Wein M.D.
Objectives: The goal this presentation is to: 1) Review the reconstructive options for anterior mandible through-and-through composite defects and 2) Instruct the audience in the application of the double-skin paddle fibular flap in selected patients. Methods: Case presentation with review of the literature. Results: A 70-year old male with an anterior floor of mouth squamous cell carcinoma underwent composite resection that included resection of a 5-cm ovoid component of overlying chin skin. The defect was reconstructed with a fibular osteocutaneous flap with a double skin paddle technique. Conclusions: Several reconstructive options have been described in the literature for extended oral cavity defects including the use of multiple free flaps, combinations of regional and distant flaps, and sequential reconstruction. This case report reviews the use of a single flap reconstruction of these defects for selected patients. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]

Increasing Use of the Scapula Osteocutaneous Free Flap ,

THE LARYNGOSCOPE, Issue 9 2000
Sean C. Coleman MD
Abstract Objectives To determine the appropriate use of the scapula osteocutaneous free flap (SOFF) and to document donor site morbidity. Study Design Retrospective review and prospective physical therapy evaluation. Methods A computer database of all free flap procedures performed at a single institution was created. Specific clinical and operative details from cases involving a bone flap were extracted from the database. Rates of usage of the various osteocutaneous flaps were compared over four successive 2-year intervals (1992,1999). A single physical therapist performed a structured evaluation of the donor site. Results Overall, 64 bone flap procedures were performed, of which 24 (37.5%) were SOFF procedures. The SOFF utilization has increased from 6.6% to 63.6%, while fibula and iliac crest utilization has fallen significantly. This is in part because of the greater versatility of the SOFF, with the possibility of separate skin paddles and adequate bone length. The mean cutaneous area harvested with the SOFF was 110 cm2 (range, 48,200 cm2) compared with 55.4 cm2 (range, 25,102 cm2) and 77.6 cm2 (range, 50,120 cm2) for the fibula and iliac crest, respectively. Mean bone flap lengths were 8.37, 7.65, and 10.1 cm, respectively, for the SOFF, fibula, and iliac crest. Dual skin paddles were used in 50% of the SOFF procedures versus 2.8% for the fibula flap procedures. There were no significant complications of the donor site in any patient, and there was only one flap failure (4.1%). Related to the SOFF, donor site morbidity was subjectively judged as "mild," for pain, mobility, and strength. There were no complaints of poor appearance of the donor site. Activities of daily living were judged as "not limited" or "limited a little" in the majority of patients. Objective measurements of range of motion revealed an average reduction of 1° to 12° in five different shoulder functions. Elbow and arm ranges of motion were not limited. Strength was minimally reduced in the shoulder, while the arm and forearm showed no reduction in strength. Conclusions The SOFF is a versatile osteocutaneous free flap that can be used for a multitude of reconstructive problems. This and its relative lack of significant donor site morbidity have caused its use to increase significantly. [source]