FIBULA OSTEOSEPTOCUTANEOUS FREE FLAP GRAFTING IN PATIENT WITH GUNSHOT DIAPHYSEAL DEFECTS OF FOREARM

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Abstract

The authors report a case of a gunshot complex combined skeletal and soft tissue defect of the upper extremity complicated by chronical wound infection successfully treated with fibula osteoseptocutaneous free flap. A military man had sustained a gunshot-comminuted fracture and diaphyseal defect of both bones in the middle third of the right forearm fixed by Ilizarov external fixator. There also was a soft tissue defect on the radial aspect of the right forearm and persisting chronic wound process. A free vascularized osteoseptocutaneous fibula graft was harvested from the right lower extremity, prepared and inserted between radius fragments. Fixation of the graft was made by locking intramedullary nail. All wounds and the donor site healed primarily. Postoperative x-rays at 5 months demonstrated healing at both ends of the fibular graft.

About the authors

M. V. Tkachenko

Kirov Military Medical Academy

Author for correspondence.
Email: tkachenko_med@mail.ru

Cand. Sci. (Med.), Senior Lecture, department of military traumatology and orthopedic

6, ul. Akad. lebedeva, 194044, St. Petersburg

Russian Federation

V. V. Khominets

Kirov Military Medical Academy

Email: fake@neicon.ru

Dr. Sci. (Med.), head of department of Military Traumatology and orthopedic

6, ul. Akad. lebedeva, 194044, St. Petersburg

Russian Federation

V. S. Ivanov

Kirov Military Medical Academy

Email: fake@neicon.ru

Assistant Chief, department of military traumatology and orthopedic

6, ul. Akad. lebedeva, 194044, St. Petersburg

Russian Federation

References

  1. Grubor P., Milicevic S., Grubor M., Meccariello L. Treatment of bone defects in war wounds: retrospective study. Med Arch. 2015;69(4):260-264. doi: 10.5455/medarh.2015.69.260-264.
  2. Камека А.Л., Леонова С.Н., Данилов Д.Г., Рехов А.В. Использование костной пластики для замещения костных дефектов при хронической гнойной инфекции. Сибирский медицинский журнал (Иркутск). 2014; 125(2):99-101. Kameka A.L., Leonova S.N., Danilov D.G., Rekhov A.V. [Use of the bone grafts to replace bone loss in chronic purulent infection]. Sibirskii meditsinskii zhurnal (Irkutsk) [Siberian Medical Journal (Irkutsk)]. 2014;125(2):99-101. (in Russian).
  3. Родоманова Л.А., Полькин А.Г. Реконструктивная микрохирургия верхней конечности. Травматология и ортопедия России. 2006;(4):15-19. Rodomanova L.A., Pol’kin A.G. [Reconstructive microsurgery of the upper extremity]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of Russia]. 2006;(4):15-19. (in Russian).
  4. Mattar J., Azze R.J., Ferreira M.C., Starck R., Canedo A.C. Vascularised fibular graft for management of severe osteomyelitis of the upper extremity. Microsurgery. 1994;15(1):22-27.
  5. Cavadas P.C., Landin L., Thione A., Ibañez J., Nthumba P., Roger I. Reconstruction of massive bone losses of the elbow with vascularized bone transfers. Plast Reconstr Surg. 2010;126(3):964-972. doi: 10.1097/PRS.0b013e3181e6b0b9.
  6. Барабаш А.П., Кесов Л.А., Барабаш Ю.А., Шпиняк С.П. Замещение обширных диафизарных дефектов длинных костей конечностей. Травматология и ортопедия России. 2014;(2):93-99. Barabash A.P., Kesov L.A., Barabash Yu.A., Shpinyak S.P. [The replacement of extensive diaphyseal defects of long bones of limbs]. Travmatologiya i ortopediya Rossii [Traumatology and orthopedics of Russia]. 2014;(2): 93-99. (in Russian).
  7. Chmell M.J., McAndrew M.P., Thomas R., Schwartz H.S. Structural autoografts for reconstruction of lower extremity open fractures with 10 centimeters or more of acute segmental defects. J Orthop Trauma. 1995;9(3):222-226.
  8. Lowenberg D.W., Buntic R.F., Buncke G.M., Parrett B.M. Long-term results and costs of muscle flap coverage with Ilizarov bone transport in lower limb salvage. J Orthop Trauma. 2013;27(10):576-581. doi: 10.1097/BOT.0b013e31828afde4.
  9. Taylor G.I., Niller C.D., Ham F.J. The free vascularized bone graft: A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975;55(5):533-544.
  10. Noaman H.H. Management of upper limb bone defects using free vascularised osteoseptocutaneous fibular bone graft. Ann Plast Surg. 2013;71(5):503-509. doi: 10.1097/SAP.0b013e3182a1aff0.
  11. Taylor G.I., Corlett R.J., Ashton M.W. The Evolution of free vascularized bone transfer: A 40-Year Experience. Plast Reconstr Surg. 2016;137(4):1292-1305. doi: 10.1097/PRS.0000000000002040.
  12. Дажин А.Ю., Минасов Б.Ш., Валеев М.М., Чистиченко С.А., Бикташева Э.М. Свободная костная пластика васкуляризированным фрагментом малоберцовой кости при лечении больных с обширными сегментарными дефектами костей предплечья. Гений ортопедии. 2013;(2):58-61. Dazhin A.Yu., Minasov B.Sh., Valeev M.M., Chistichenko S.A., Biktasheva E.M. [Free bone graft with a vascularized fragment of the fibula in the treatment of patients with extensive segmental defects in the bones of the forearm]. Genij Ortopedii [Orthopeadic Genius]. 2013;(2): 58-61. (in Russian).
  13. Oliveira M., Ferreira P.C., Barbosa R.F., Horta R.J., Bartosch I.M., Reis J.C., Amarante J.M. Gunshot upper extremity injury reconstructed with a fibula osteoseptocutaneous free flap (case report). Tech Hand Up Extrem Surg. 2009;13(2):60-64. doi: 10.1097/BTH.0b013e31818d1e1a.
  14. Белоусов А.Е., Кочиш А.Ю. Классификация типов кровоснабжения покровных тканей с позиций пластической хирургии. Вестник хирургии им. И.И. Грекова. 1990;144(3):90-93. Belousov A.E., Kochish A.Yu. [Classification of the types of blood supply of integumentary tissues from the position of plastic surgery] Vestnik khirurgii im. I.I. Grekova [I.I. Grekov Journal of surgery]. 1990;144(3): 90-93. (in Russian).
  15. Ефименко Н.А., Рыбаков С.М., Грицюк А.А., Нелин н.и., васютык б.м. Пластика дефектов длинных трубчатых костей свободными кровоснабжаемыми костными аутотрансплантатами. Военно- медицинский журнал. 2001;322(12):22-26. Efimenko N.A, Rybakov S.M., Gritsyuk A.A., Nelin n.i., vasyutyk b.m. [Replacement of the defects of the long tubular bones with free vascularized bone autografts]. Voenno-meditsinskii zhurnal [Military Medical Journal]. 2001;322(12):22-26. (in Russian).

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