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Recipient Vessels: Tibia Reconstruction

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Recipient Vessels in Reconstructive Microsurgery

Abstract

The free fibula is an effective option for reconstructing large and segmental defects of the tibia. This chapter describes the use of the vascularized free fibula flap and potential recipient vessels. Applied anatomy and surgical exposure are discussed.

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References

  1. Banic A, Hertel R. Double vascularized fibulas for reconstruction of large tibial defects. J Reconstr Microsurg. 1993;9(6):421–8. https://doi.org/10.1055/s-2007-1006751.

    Article  CAS  PubMed  Google Scholar 

  2. Bibbo C, Bauder AR, Nelson J, et al. Reconstruction of traumatic defects of the tibia with free fibula flap and external fixation. Ann Plast Surg. 2020;85(5):516–21. https://doi.org/10.1097/SAP.0000000000002240.

    Article  CAS  PubMed  Google Scholar 

  3. Li J, Wang Z, Guo Z, Chen G, Li S, Pei G-X. The use of massive allograft with intramedullary fibular graft for intercalary reconstruction after resection of tibial malignancy. J Reconstr Microsurg. 2011;27(1):37–46. https://doi.org/10.1055/s-0030-1267381.

    Article  PubMed  Google Scholar 

  4. Schwarz GS, Disa JJ, Mehrara BJ, Healey JH, Cordeiro PG. Reconstruction of oncologic tibial defects in children using vascularized fibula flaps. Plast Reconstr Surg Published online. 2012; https://doi.org/10.1097/PRS.0b013e318230e463.

  5. Cavadas PC, Landín L, Ibáñez J, Nthumba P. Reconstruction of major traumatic segmental bone defects of the tibia with vascularized bone transfers. Plast Reconstr Surg. 2010;125(1):215–23. https://doi.org/10.1097/PRS.0b013e3181c495b3.

    Article  CAS  PubMed  Google Scholar 

  6. Chang DW, Weber KL. Use of a vascularized fibula bone flap and intercalary allograft for diaphyseal reconstruction after resection of primary extremity bone sarcomas. Plast Reconstr Surg. 2005;116(7):1918–25. https://doi.org/10.1097/01.prs.0000189203.38204.d5.

    Article  CAS  PubMed  Google Scholar 

  7. Zhen P, Liu X-Y, Lu H, Li X-S. Fixation and reconstruction of severe tibial shaft fractures with vascularized fibular grafting. Arch Orthop Trauma Surg. 2011;131(1):93–9. https://doi.org/10.1007/s00402-010-1121-4.

    Article  PubMed  Google Scholar 

  8. Zhen P, Hu YY, Luo ZJ, Liu XY, Lu H, Li XS. One-stage treatment and reconstruction of gustilo type III open tibial shaft fractures with a vascularized fibular osteoseptocutaneous flap graft. J Orthop Trauma. Published online. 2010; https://doi.org/10.1097/BOT.0b013e3181d88a07.

  9. Zaretski A, Amir A, Meller I, et al. Free fibula long bone reconstruction in orthopedic oncology: a surgical algorithm for reconstructive options. Plast Reconstr Surg. 2004;113(7):1989–2000. https://doi.org/10.1097/01.prs.0000122213.82011.c5.

    Article  PubMed  Google Scholar 

  10. Wang X, Li Y, Guo J. Repairing chronic osteomyelitis complicated by long bone defect in tibia with free segmented-fibula transplantation. Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese J reparative Reconstr Surg. 2007;21(3):278–81.

    Google Scholar 

  11. Shankhdhar VK, Yadav PS, Puri A, et al. Free fibula flap for lower limb salvage after tumour resection. Indian J Plast Surg. 2018;51(3):274–82. https://doi.org/10.4103/ijps.IJPS_113_17.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Mateev M, Huang C, Imanaliev A, Ono S, Hyakusoku H, Ogawa R. Combining the external fixation and microsurgical osteoseptocutaneous flap transplantation methods for limb salvage. Eplasty. 2012;12:e16.

    PubMed  PubMed Central  Google Scholar 

  13. Özaksar K, Sügün TS, Toros T, Gürbüz Y, Kayalar M, Özerkan F. Free vascularized fibular grafts in type 3 open tibia fractures. Acta Orthop Traumatol Turc. 2012;46(6):430–7. https://doi.org/10.3944/aott.2012.2876.

    Article  PubMed  Google Scholar 

  14. Chung DW, Han CS, Lee JH. Reconstruction of composite tibial defect with free flaps and ipsilateral vascularized fibular transposition. Microsurgery. 2011;31(5):340–6. https://doi.org/10.1002/micr.20884.

    Article  PubMed  Google Scholar 

  15. Lee KS, Park JW. Free vascularized osteocutaneous fibular graft to the tibia. Microsurgery. 1999;19(3):141–7. https://doi.org/10.1002/(sici)1098-2752(1999)19:3<141::aid-micr4>3.0.co;2-w.

    Article  CAS  PubMed  Google Scholar 

  16. Beppu M, Hanel DP, Johnston GH, Carmo JM, Tsai TM. The osteocutaneous fibula flap: an anatomic study. J Reconstr Microsurg. 1992;8(3):215–23. https://doi.org/10.1055/s-2007-1006703.

    Article  CAS  PubMed  Google Scholar 

  17. Wei FC, Chen HC, Chuang CC, Noordhoff MS. Fibular osteoseptocutaneous flap: anatomic study and clinical application. Plast Reconstr Surg. 1986;78(2):191–200. https://doi.org/10.1097/00006534-198608000-00008.

    Article  CAS  PubMed  Google Scholar 

  18. Abou-Foul AK, Fasanmade A, Prabhu S, Borumandi F. Anatomy of the vasculature of the lower leg and harvest of a fibular flap: a systematic review. Br J Oral Maxillofac Surg. 2017;55(9):904–10. https://doi.org/10.1016/j.bjoms.2017.08.363.

    Article  CAS  PubMed  Google Scholar 

  19. Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular techniques. Plast Reconstr Surg. 1975;55(5):533–44. https://doi.org/10.1097/00006534-197505000-00002.

    Article  CAS  PubMed  Google Scholar 

  20. Yoshimura M, Shimamura K, Iwai Y, Yamauchi S, Ueno T. Free vascularized fibular transplant. A new method for monitoring circulation of the grafted fibula. J Bone Joint Surg Am. 1983;65(9):1295–301.

    Article  CAS  Google Scholar 

  21. Yazar S, Lin C-H, Wei F-C. One-stage reconstruction of composite bone and soft-tissue defects in traumatic lower extremities. Plast Reconstr Surg. 2004;114(6):1457–66. https://doi.org/10.1097/01.prs.0000138811.88807.65.

    Article  PubMed  Google Scholar 

  22. Guo Q-F, Xu Z-H, Wen S-F, et al. Value of a skin island flap as a postoperative predictor of vascularized fibula graft viability in extensive diaphyseal bone defect reconstruction. Orthop Traumatol Surg Res. 2012;98(5):576–82. https://doi.org/10.1016/j.otsr.2012.03.009.

    Article  PubMed  Google Scholar 

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Correspondence to Meenakshi Rajan .

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Electronic Supplementary Material

Anatomic dissection of the recipient anterior tibial vessels is provided in the accompanying video (MP4 185899 kb)

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Rajan, M., Joy, M., Levin, L.S., Kovacs, S.J. (2021). Recipient Vessels: Tibia Reconstruction. In: Gurunian, R., Djohan, R. (eds) Recipient Vessels in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-030-75389-4_38

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  • DOI: https://doi.org/10.1007/978-3-030-75389-4_38

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-75388-7

  • Online ISBN: 978-3-030-75389-4

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