Is minimal reconstruction (meshplasty) adequate to restore ankle function after excision of distal fibula tumors?
Ankle function
Distal fibula
Meshplasty
Prolene mesh
Reconstruction
Journal
Journal of clinical orthopaedics and trauma
ISSN: 0976-5662
Titre abrégé: J Clin Orthop Trauma
Pays: India
ID NLM: 101559469
Informations de publication
Date de publication:
Historique:
received:
19
03
2020
revised:
26
03
2020
accepted:
27
03
2020
entrez:
15
5
2020
pubmed:
15
5
2020
medline:
15
5
2020
Statut:
ppublish
Résumé
Reconstruction modalities described after distal fibula resection varies from no reconstruction to size matched allograft or reconstruction with ipsilateral proximal fibula. Every procedure has their own limitation. We used Prolene mesh to reconstruct lateral restraint (Meshplasty) after distal fibulectomy. Is a minimal reconstruction using prolene mesh (meshplasty) adequate to restore ankle stability and function post distal fibula resection? This retrospective analysis was performed in patients who underwent distal fibulectomy at the tertiary cancer hospital in India, between 01/01/2006 and 31/12/2016. Distal fibulectomy was performed through standard lateral approach. A prolene mesh was anchored to distal tibia and talus using screws or Ethibond sutures. Rehabilitation protocol included below knee cast for 6 weeks followed by gradual full weight bearing mobilization and ankle range of motion. Total 9 patients with mean age of 25 years (range: 13-43) got operated for distal fibulectomy during this period. Mean resection length was 13.3 cm (range: 9-20). Seven patients were available for final assessment at a median follow-up duration of 78 months (range: 34-161 months). Two patients developed local recurrence. Two patients developed distant recurrence both died of disease. One patient of GCT developed local recurrence in soft tissue at 30months, which was excised. Another patient of OGS developed local recurrence after 8 months along with distant recurrence. One patient of PNET developed distant recurrence at 3 months. One patient had a valgus deformity at 55 months follow up without any restriction of activity while the others had a stable ankle without any deformity. The mean MSTS score was 28 (24-29). "Meshplasty" after distal fibulectomy is an easy, reproducible, time and cost effective reconstruction modality with minimal complications. It adequately restores ankle function while providing results comparable to other procedures. IV.
Sections du résumé
BACKGROUND
BACKGROUND
Reconstruction modalities described after distal fibula resection varies from no reconstruction to size matched allograft or reconstruction with ipsilateral proximal fibula. Every procedure has their own limitation. We used Prolene mesh to reconstruct lateral restraint (Meshplasty) after distal fibulectomy.
QUESTION
OBJECTIVE
Is a minimal reconstruction using prolene mesh (meshplasty) adequate to restore ankle stability and function post distal fibula resection?
METHOD
METHODS
This retrospective analysis was performed in patients who underwent distal fibulectomy at the tertiary cancer hospital in India, between 01/01/2006 and 31/12/2016. Distal fibulectomy was performed through standard lateral approach. A prolene mesh was anchored to distal tibia and talus using screws or Ethibond sutures. Rehabilitation protocol included below knee cast for 6 weeks followed by gradual full weight bearing mobilization and ankle range of motion. Total 9 patients with mean age of 25 years (range: 13-43) got operated for distal fibulectomy during this period. Mean resection length was 13.3 cm (range: 9-20).
RESULTS
RESULTS
Seven patients were available for final assessment at a median follow-up duration of 78 months (range: 34-161 months). Two patients developed local recurrence. Two patients developed distant recurrence both died of disease. One patient of GCT developed local recurrence in soft tissue at 30months, which was excised. Another patient of OGS developed local recurrence after 8 months along with distant recurrence. One patient of PNET developed distant recurrence at 3 months. One patient had a valgus deformity at 55 months follow up without any restriction of activity while the others had a stable ankle without any deformity. The mean MSTS score was 28 (24-29).
CONCLUSION
CONCLUSIONS
"Meshplasty" after distal fibulectomy is an easy, reproducible, time and cost effective reconstruction modality with minimal complications. It adequately restores ankle function while providing results comparable to other procedures.
LEVEL OF EVIDENCE
METHODS
IV.
Identifiants
pubmed: 32405211
doi: 10.1016/j.jcot.2020.03.023
pii: S0976-5662(20)30106-5
pmc: PMC7211805
doi:
Types de publication
Journal Article
Langues
eng
Pagination
467-470Informations de copyright
© 2020 Delhi Orthopedic Association. All rights reserved.
Déclaration de conflit d'intérêts
We don’t have any conflict of interest.
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