Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique : A cross-sectional study of long-term outcomes

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Repo , J P , Barner-Rasmussen , I , Roine , R P , Sintonen , H & Tukiainen , E J 2016 , ' Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique : A cross-sectional study of long-term outcomes ' , Journal of Plastic, Reconstructive & Aesthetic Surgery , vol. 69 , no. 4 , pp. 524-532 . https://doi.org/10.1016/j.bjps.2015.12.011

Title: Treatment of compound tibia fracture with microvascular latissimus dorsi flap and the Ilizarov technique : A cross-sectional study of long-term outcomes
Author: Repo, J.P.; Barner-Rasmussen, I.; Roine, R. P.; Sintonen, H.; Tukiainen, E. J.
Contributor: University of Helsinki, Plastiikkakirurgian yksikkö
University of Helsinki, Plastiikkakirurgian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Harri Sintonen Research Group
University of Helsinki, Clinicum
Date: 2016-04
Language: eng
Number of pages: 9
Belongs to series: Journal of Plastic, Reconstructive & Aesthetic Surgery
ISSN: 1748-6815
URI: http://hdl.handle.net/10138/223908
Abstract: Background: Extensive compound tibial fractures present reconstructive challenges. The present study aimed to assess the outcomes of microvascular latissimus dorsi (LD) flap combined with the Ilizarov technique for extensive compound tibial fractures with bone loss and bone healing complications. Methods: Patient records were reviewed retrospectively. The Lower Extremity Functional Scale (LEFS), the Disabilities of the Arm, Hand and Shoulder (DASH), and the 15D health-related quality of life (HRQoL) instrument were applied. Results: Between 1989 and 2014, 16 patients underwent reconstruction with a microvascular LD flap and bone transport (11/16) or late bone lengthening (5/16). The mean clinical follow-up time was 6.6 (standard deviation (SD): 6.5) years. Three patients had minor complications requiring reoperation. Partial necrosis of one flap required late flap reconstruction in one case. Late bone grafting was used to enhance union in eight of 16 cases. The mean new bone gain was 3.8 cm (SD: 2.5). Overall, 11 patients completed the questionnaires in a mean of 22.3 years (SD: 2.4) after surgery. The main findings revealed a relatively good function of the reconstructed limb and good shoulder function. The mean HRQoL was comparable to that of an age-standardized sample of the general population. Conclusion: Segmental tibia transport and lengthening to correct limb length discrepancy do not compromise the microvascular muscle flap. Combined microvascular LD flap reconstruction and the Ilizarov technique can be used in treating acute compound tibial defects, pseudoarthrosis, and osteitis, all associated with significant amputation risk. Fair long-term functional outcomes and HRQoL are achieved when these combined techniques are used. (C) 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Subject: Tibia fracture
Latissimus dorsi
Muscle flap
Lower extremity reconstruction
Ilizarov
Distraction osteogenesis
QUALITY-OF-LIFE
POSTTRAUMATIC BONE DEFECTS
LOWER-EXTREMITIES
LIMB SALVAGE
RECONSTRUCTION
DISTRACTION
SHOULDER
CLASSIFICATION
TRANSPORT
GENESIS
3126 Surgery, anesthesiology, intensive care, radiology
3142 Public health care science, environmental and occupational health
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