Reintroducing the latissimus-rib free flap as a long bone substitute in the reconstruction of lower extremity injuries

Authors

  • Amir R. Motabar Department of Surgery, Iran University of Medical Sciences. Hazrat-e-Rasool-e-Akram Hospital, Niyayesh Street,Te hran, Iran.
  • Shahram Nazerani Department of Surgery, Iran University of Medical Sciences, Firozgar Hospital, Tehran, Iran.
Abstract:

  Abstract   The leg is a complex district with functions of weightbearing support, stability,   and motility. The management of extensive and complex defects is more challenging   and often results in leg amputation or shortening. Leg amputation is a severe   mutilation that alters the patient’s work and social life by limiting ambulation and   self-sufficiency. During a 3 years period we treated four patients with leg injury   consisting of tibial defect who underwent one-stage surgery for soft tissue and bone   reconstruction. The follow-up period was from 31 to 36 months. Time to bony :::union:::   ranged from 4 to 7 months. Time to full weight bearing was from 5 to 9 months after   operation. All of the transferred tissue showed hypertrophy after weight bearing.   Non:::union::: & abscess occurred in one case. Arterial thrombosis & valgus deformity   were other postoperation complications. The limb was shorter by an average of 0.5   cm in three cases, longer by 1.1 cm in one case, and in the last case, it was not measurable. Other disabling complications were not seen. We believe that this forgotten   method can be a valuable alternative to other techniques such as free fibula flap in   certain cases that the surgeon can reconstruct bone & soft tissue defects in one stage.  

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Journal title

volume 22  issue 2

pages  104- 110

publication date 2008-08

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