The two-staged prefabricated vascularized fibula free flap is used in maxillofacial reconstruction. We describe the possible cause and management of two cases of fibula fracture after implant placemen...
The patients were treated with two-stage reconstruction with a prefabricated vascularized fibula free flap. Six dental implants were placed in both fibulas. Fibula fractures occurred during the osseoi...
Both fibulas fractured in the distal segment, possibly due to a thinner cortex more distally. Harvesting of a fractured fibula flap is more difficult than normally due to callus formation and fibrosis...
The fracture apparently did not compromise the vascularisation of the fibula and proved still sufficient for successful harvest and transfer of the flap. The patient should be made aware that addition...
We report a case of a rare "floating fibula" ankle injury characterized by dislocation of the proximal tibiofibular joint (PTFJ), syndesmosis disruption, complete deltoid disruption, and tibiotalar di...
This case highlights the unique features of the "floating fibula" injury and shows that reduction and intraoperative assessment may be more challenging than a typical Maisonneuve injury....
The anterior cervical discectomy and fusion (ACDF) is the gold standard in the treatment of cervical compression pathology and the titanium cage for fusion represents the most used procedure at an ins...
To compare the rate of fusion, subsidence and functional clinical results after discectomy with titanium cage and fibular autograft....
A clinical trial with follow-up at 3 and 6 months was carried out in patients diagnosed with cervical spondylosis, candidates for ACDF. 2 groups were formed: fibular autograft and titanium cage. Pre a...
A sample of 20 patients with an average age of 56 years was obtained, finding a fusion rate of 90% for fibular autograft and 30% for titanium (p = 0.02) at 3 months. 10% of patients with fibular autog...
The use of autologous fibular graft offers a better rate of fusion and subsidence compared to the titanium cage, as well as similar functional results at 3 months of follow-up. It represents an excell...
Few articles discuss the management of a free fibula flap (FFF) necrosis in maxillofacial reconstruction....
Between 2005 and 2020, 170 FFF were used for maxillofacial reconstruction at the University Hospital of Caen, among which 16 cases suffered total necrosis and flap removal. The authors categorized the...
In Group A, two patients underwent immediate reconstruction with a new free flap. There were no postoperative complications, and the average hospitalization duration after removal of the first flap wa...
Based on our experience and the literature review, the use of an immediate new free flap appears to be the best approach after the removal of a FFF. This generates shorter healing times and shorter ho...
The fibula flap has been the workhorse flap for mandibular reconstruction. However, relationships among the bone, skin, and vessels raise concerns about donor-side selection. This study aimed to clari...
Between September 2013 and June 2021, 61 cases of fibula osteoseptocutaneous flaps for mandibular and intraoral reconstruction were categorized into the landing-down (N = 25) and swing-up (N = 36) gro...
Overall, seven (11%) flaps developed skin necrosis, including four partial and three total necrosis. The skin necrosis rate was higher in the swing-up than in the landing-down group (19% vs. 0%, p = 0...
When using the fibula osteoseptocutaneous flap for mandibular and intraoral reconstructions, ensuring that the skin is properly located within the oral cavity could reduce the risk of skin necrosis....
In unstable ankle fractures, the role of the deltoid and syndesmosis ligaments has been widely studied. However, it is uncertain what the importance of the lateral ankle ligament complex (LALC) is in ...
Eleven below-knee cadaveric specimens were used in this study. Proximal traction of the fibula was performed by applying 50 N in the intact state and after sequential transection of the syndesmotic li...
The vertical displacement of the fibula in the intact state, and after sequential transection of syndesmotic ligaments, ATFL, and CFL was 1.96 ± 1.19 mm, 3.96 ± 1.33 mm, 5.9 ± 1.73 mm, and 10.22 ± 2.7...
The complete disruption of syndesmotic ligaments did not significantly increase the proximal displacement of the fibula. However, when the ATFL ± CFL were additionally disrupted, there was a significa...
To our knowledge, this is the first study describing that LALC plays a paramount role in the vertical stability of the fibula. Concomitant syndesmosis and LALC should be suspected in an axially unstab...
Mechanical and morphological factors have both been described to influence the rate of pseudarthrosis in mandibular reconstruction. By minimizing mechanical confounders, the present study aims to eval...
Patients were screened retrospectively for undergoing multi-segment fibula free flap reconstruction of the mandible including the anterior part of the mandible and osteosynthesis using patient-specifi...
The bone interface (p = 0.223) did not significantly impact the change in bone volume at the intersegmental gap. Radiotherapy (p < 0.001), time between CBCT scans (p = 0.006) and wound healing disorde...
The bone interface at the intersegmental gap in mandibular reconstruction did not influence long-term bone healing significantly. Mechanical and clinical properties seem to be more relevant for surgic...
Iatrogenic injury of the fibula free flap pedicle is rare. Postoperative flap survival and reconstructive outcomes following intraoperative pedicle severance are unknown. This study assesses free flap...
Multi-institutional retrospective chart review from 2000 to 2020....
Of 2975 harvested fibula free flaps, 26 had a history of pedicle severance during surgical reconstruction. Reasons for intraoperative pedicle severance included transection during muscular dissection ...
Accidental severance of fibula free flap pedicle vessels can be corrected with intraoperative repair, without affecting long-term flap survival or reconstructive outcomes. Protecting the flap vessels ...
Lateral malleolus fractures are very common, and the distal fibular geometry is complex. This study aimed to classify the lateral malleolus fossa (MF) into different types by characterizing the latera...
Anteroposterior CT reconstruction was performed on 248 subjects. After reconstruction, the deepest point of the lateral MF was located, and then, the cross-sectional shape of the lateral MF was observ...
According to the morphology of the CT cross section, the lateral MF was divided into three types: type C (43.1%), type V (32.2%), and type Flat (24.7%). Type V (3.98 ± 0.82) was significantly longer t...
According to the morphology of the CT cross section, the lateral MF was divided into three types: type C, type V and type Flat. Type V is most likely to be invaded when fixing the distal fibula. Screw...
Tibial malrotation can occur with medullary nailing of diaphyseal tibial fractures. Fibular alignment has been proposed as a surrogate for axial plane reduction intraoperatively. The purpose of this s...
Deidentified CT scans of 50 patients with normal tibial anatomy were selected. Using ImageJ software, we simulated osteotomies at three sites (proximal third, mid-diaphysis, and distal third). We over...
A total of 50 patients were included. The mean age was 62 years, average BMI was 25.8, and 28 of 50 patients (56%) were male. Earliest loss of fibular contact occurred at 24° ER and 22° IR at the prox...
Surgeons should be aware that 20° or more of malrotation is likely present when fibular contact is lost during medullary nailing of the tibia. Greater than 50% loss of contact should raise suspicion f...
