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Lower limb reconstruction with bone free flaps: experience of 25 cases

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Abstract

Bone structure is fundamental for the function of the lower limbs—orthostatism and locomotion. Before the technical evolution observed in the last two decades, many extremities that are saved now were amputated in the past. Lower limb bone defects are generally associated with complex traumatic lesions and constitute a permanent reconstructive challenge. The management of this kind of defect requires a multidisciplinary approach involving plastic and orthopedic surgeons. The bone free flaps are a very important and technically exacting tool for lower limb bone reconstruction. We present and analyze our experience in 25 traumatic cases where we used 17 fibula free flaps and 2 iliac crest free flaps for tibia and talus reconstruction; 5 fibula free flaps for femur reconstruction; and 1 antebrachial radial osteocutaneous free flap for first metatarsal reconstruction. We registered 88% of success (three flap necroses—12%) with good bone integration and good functional recovery. Lower limb bone reconstruction is a long and tortuous stair whose success depends not only on the multidisciplinary surgical team but also on the patient's cooperation and determination

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Authors and Affiliations

  1. Plastic, Reconstructive and Maxillofacial Surgery Unit, Centro Hospitalar de Vila Nova de Gaia/Espinho EPE, Rua Conceição Fernandes, 4434-502, Vila Nova de Gaia, Portugal

    Luís Azevedo, Horácio Zenha, Leonor Rios, Hugo Sequeira, Gustavo Coelho, Augusta Cardoso, Maria da Luz Barroso, Cristina Cunha & Horácio Costa

  2. I.C.B.A.S., Oporto University, Oporto, Portugal

    Horácio Costa

Authors
  1. Luís Azevedo
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  2. Horácio Zenha
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  3. Leonor Rios
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  4. Hugo Sequeira
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  5. Gustavo Coelho
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  6. Augusta Cardoso
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  7. Maria da Luz Barroso
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  8. Cristina Cunha
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  9. Horácio Costa
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Correspondence to Horácio Costa.

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Azevedo, L., Zenha, H., Rios, L. et al. Lower limb reconstruction with bone free flaps: experience of 25 cases. Eur J Plast Surg 35, 359–364 (2012). https://doi.org/10.1007/s00238-011-0654-2

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  • DOI: https://doi.org/10.1007/s00238-011-0654-2

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