Utility of the Free Vascularized Fibula Flap to Reconstruct Segmental Bone Defects in the Upper Extremity Following Tumor Resection

OrthoMedia ◽  
2021 ◽  
Keyword(s):  
Upper Extremity ◽  
Tumor Resection ◽  
Bone Defects ◽  
Fibula Flap ◽  
Vascularized Fibula ◽  
Segmental Bone ◽  
Segmental Bone Defects

scholarly journals Vascularized fibula flap in the management of segmental bone loss following osteomyelitis in children at a Ugandan hospital

2021 ◽  
Vol 6 (6) ◽  
pp. 179-187
Author(s):  
Antonio Loro ◽  
Andrew Hodges ◽  
George William Galiwango ◽  
Francesca Loro
Keyword(s):  
Soft Tissue ◽  
Bone Defects ◽  
Sub Saharan Africa ◽  
Soft Tissue Envelope ◽  
Low Resource ◽  
Fibula Flap ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Vascularized Fibula ◽  
Segmental Bone

Abstract. Background: Hematogenous osteomyelitis is commonly observed in the pediatric population across sub-Saharan Africa. This retrospective case series was designed to evaluate the complications and outcomes of treatment using a vascularized fibula flap (VFF) to fill segmental bone defects secondary to osteomyelitis in children in a low-resource setting in CoRSU Rehabilitation Hospital, Uganda. Methods: Clinical notes and radiographs of children with a diagnosis of osteomyelitis that subsequently underwent a VFF procedure between October 2013 and December 2017 were reviewed. All patients were clinically and radiographically evaluated in 2019. Results: Forty-four children, with an average bone defect of 10.5 cm, were included. Eighty-four percent of children had successful VFF limb reconstruction. Integration of the graft was radiologically sound in 20.8 weeks on average. The postoperative phase was uneventful in 29 % of patients. Complications were observed in the remaining patients, including flap failure (6), donor leg neurapraxia (3), cutaneous paddle necrosis (11), graft fracture (2), skin graft loss (6), fixator failure (1) and non-union (2). Functional outcomes were rated as excellent in 13 patients, good in 14, fair in 9 and poor in 8. There was no recurrence of the bone infection in any of the enrolled children. Conclusion: Despite being a complex and demanding procedure, VFF is a good option for reconstructing post-osteomyelitis bone defects, particularly when associated with loss of soft tissue envelope. Considering the more than satisfactory functional and clinical outcomes, this procedure should be kept in mind for these complex pediatric cases of bone and soft tissue loss, even in a low-resource setting.

scholarly journals Robotic in situ 3D bio-printing technology for repairing large segmental bone defects

2020 ◽  
Author(s):  
Lan Li ◽  
Jianping Shi ◽  
Kaiwei Ma ◽  
Jing Jin ◽  
Peng Wang ◽  
...  
Keyword(s):  
Bone Defects ◽  
Printing Technology ◽  
Segmental Bone ◽  
Segmental Bone Defects

Experimental study on repair of large segmental bone defects of goat femur by nano calcium-deficient hydroxyapatite-multi (amino acid) copolymer membrane tubes

2021 ◽  
pp. 088532822110002
Author(s):  
Yan Xiong ◽  
Hong Duan ◽  
Bin Zhang ◽  
Cheng Ren ◽  
Zeping Yu ◽  
...  
Keyword(s):  
Amino Acid ◽  
Bone Defects ◽  
Torsional Stiffness ◽  
Control Group ◽  
Allogenic Bone ◽  
Acid Copolymer ◽  
Membrane Tube ◽  
Segmental Bone ◽  
Experimental Group ◽  
Segmental Bone Defects

Objective The purpose of this study was to observe feasibility of nano calcium-deficient hydroxyapatite-multi (amino acid) copolymer (n-CDHA-MAC) membrane tubes in repairing goat femurs’ large defects. Methods Twelve goats were divided into two groups, whose femurs were created 30 mm segmental bone defects and then implants were performed. In experimental group, the bone defect of right femur was reconstructed by n-CDHA-MAC membrane tube, while left side was reconstructed by allogenic bone tube in control group. Every three goats were sacrificed at 4, 8, 16, 24 weeks after operation respectively. General observation, X-ray analysis, histology, Scanning electron microscope (SEM) examination and protein level comparison of BMP-2 were conducted to evaluate the effects of repairing segmental bone defects. Results All goats recovered well from anesthesia and surgical interventions. The radiographic evaluations showed that periosteal reaction outside of the membrane tubes and allogenic bone tubes were observed 4 weeks after surgery. At 16 weeks, callus was continuously increased in experimental group, which was more obvious than control group. At 24 weeks, callus outside of the membrane tubes connected together. Histologic evaluation showed fibro-cartilage callus was evolved into bony callus in experimental group, which was more obvious than control group at 8 and 16 weeks. The protein expression level of BMP-2 increased at 4, 8 weeks and peaked at 16 weeks in experimental groups. There were statistical differences at 8 and 16 weeks ( P < 0.05). At each time point in 8, 16, 24 weeks after surgery, the bending stiffness, torsional stiffness and compressive strength of the two groups were similar, and there was no significant difference ( P > 0.05). Conclusions This novel surface degradation n-CDHA-MAC membrane tube has good ability to maintain enough membrane space, which can provide long-term and stable biomechanical support for large bone defects and integrate well with the surrounding bone.

scholarly journals Regenerating Critical Size Rat Segmental Bone Defects with a Self‐Healing Hybrid Nanocomposite Hydrogel: Effect of Bone Condition and BMP‐2 Incorporation

2021 ◽  
pp. 2100088
Author(s):  
Claire I. A. Houdt ◽  
Marianne K. E. Koolen ◽  
Paula M. Lopez‐Perez ◽  
Dietmar J. O. Ulrich ◽  
John A. Jansen ◽  
...  
Keyword(s):  
Critical Size ◽  
Bone Defects ◽  
Self Healing ◽  
Nanocomposite Hydrogel ◽  
Hybrid Nanocomposite ◽  
Segmental Bone ◽  
Bone Condition ◽  
Segmental Bone Defects
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