Fibula flap surgical technique book

The aim of this study was to describe and evaluate surgical navigationassisted mandibular reconstruction with the fibula flap. In this article, we will discuss the details of free flap surgery microvascular and how free flap. Fibula flap harvest the patient is placed in the supine position with a bump under the ipsilateral hip to lessen the need for excessive internal rotation of the lower leg. Free fibula flow through osteocutaneous flap in the upper. Health, general cancer chemotherapy histochemistry sarcoma. The illuminoss implant can be used for either the left or the right fibula. The skin paddle has proven to be dependable if care is taken to preserve the fasciocutaneous perforators. Fibula osteocutaneous free flap dissection surgical video. Drawing on 25 years of experience, this book atlas on the standard technique used for reconstructing the mandible and the maxilla.

This is a result of various factors, such as improved preoperative examination methods, appropriate patient and donorsite selection, advancement in surgical techniques and instruments, and surgeons increasing experiences with microsurgery. The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap fff. Mandibular reconstruction with a fibular free flap fff is currently considered the best choice for functional and aesthetic rehabilitation after oncological surgery. Application of digital technology in virtual surgical planning. Below knee amputation bka statpearls ncbi bookshelf. Experimental flap surgery aims to increase our understanding of flap physiology and to test new surgical techniques to increase flap viability. In general, a bka is preferred over an aboveknee amputation aka, as the former has better rehabilitation and functional outcomes. However, the fibula and the upper leg are the most common donor sites for free flap tissues. With the advent of lower profile fracturespecific implants and minimally invasive surgical techniques mis, wound complications may be mitigated. It can be harvested as a purely osseus flap or can include a large fasciocutaneous component if needed. The study reports five consecutive patients with benign or malignant disease requiring mandibular reconstruction using a microvascular fibular free flap, preoperative virtual planning, construction of cutting guides and customized laser prebent titanium plates.

Preplating, plate removal, resection, replating, template modelling, contouring and fixation of the fibula represent the key points of the procedure. Phalloplasty is the construction or reconstruction of a penis, or the artificial modification of the penis by surgery. In order to reduce overall operation time, surgery was performed using two teams. In spiral or oblique fracture patterns, a clamp can be applied for reduction. Vascularized fibula graft for humeral reconstruction. Watch surgeons perform procedures in real time with an unparalleled twohour video collection that demonstrates harvest of the fibula flap for use in mandible reconstruction, the jejunum for esophagus reconstruction, and the siea, diep and igap flaps for breast reconstruction functioning muscle transfers for a variety of defects, including the gracilis muscle for facial reanimation and the gracilis musculocutaneous flap for finger flexion reconstruction with innervation using the. Here, we aimed to establish the preplating technique for oromandibular reconstruction in a stepbystep fashion, based on 41 patients. Full text of stepbystep mandibular reconstruction with. Vascularized fibula graft is a good option for large humeral defects resulting from trauma, tumor resection, or infection and for smaller defects where enhanced blood supply is necessary for healing. Osteocutaneous flap an overview sciencedirect topics. However, little is published about its role in reconstructing the mandibular condyle. Novel surgical techniques in female to male gender.

This atlas deals with the standard technique used for reconstructing the mandible and the maxilla the fibula flap. Atlas of microsurgical composite tissue transplantation 1st edition. Several authors have previously reported minimally invasive techniques to address distal fibula fractures, although most achieved fixation without anatomic reduction of the fracture site 611. In this video, the technique is demonstrated on a 3d model of the fibula flap. This book includes complimentary access to a digital copy. Repositioning template for mandibular reconstruction with. Many experimental flap models have been described with the advancement of flap surgery and research. Free fibula flow through osteocutaneous flap in the upper extremity sarcoma reconstruction. Alternatively, the lateral decubitus position can be used, with the harvest leg placed up and the patient held in position with a beanbag. Donor leg morbidity and function after fibula free flap mandible. Its indicational spectrum, therefore, reaches from bony reconstruction at the extremities to replacement of the whole mandible, including closure of large perforating defects of the oral cavity. Primary disease, type of reconstruction, defect area, fibula segment length and number of.

When harvesting an osteocutaneous flap, the posterolateral skin incision is now made down to the fascia and a subfascial elevation of the skin from the soleus muscle is made. The fibula osteocutaneous free flap is arguably the workhorse bone flap for both maxillary and mandibular reconstruction. The reader will find useful information on all issues that are important in the. Fibula osteocutaneous free flap dissection video youtube. Watch surgeons perform procedures in real time with an unparalleled twohour video collection that demonstrates harvest of the fibula flap for use in mandible reconstruction, the jejunum for esophagus reconstruction, and the siea, diep and igap flaps for breast reconstruction functioning muscle transfers for a variety of defects, including the gracilis muscle for facial reanimation and the gracilis musculocutaneous flap. The technique for implantation in fibula flap is very similar to the technique in native mandible but access to the bone is the most difficult step of the surgery. Metoidioplasty is one of the most popular surgical techniques for creating neophallus in female transsexuals. European archives of otorhinolaryngology, 272 6, 14911501.

A long segment of bone up to approximately 22 cm is available for harvest. Atlas of microsurgical composite tissue transplantation. It includes chapters and expert commentaries from more than 100 authors and worldrenowned leaders in the field, while. Long posterior flap burgess technique zdesigned by kendrick 1956 and made popular by burgess 1969. Free vascularized fibula flap alpha hand surgery centre. Preplating, plate removal, resection, replating, template modelling, contouring and fixation of the fibula. Atlas of mandibular and maxillary reconstruction with the. Patients recruited into the study had a custom dental splint fabricated to maintain the mandible in a fixed position. Original article by journal of evolution of medical and dental sciences. Conveys information on all important issues in the surgical procedure, including the use of cadcam technology, bone synthesis and flap modelling. A senior surgeon did the planning, flap harvesting. Stepbystep surgical technique for mandibular reconstruction with fibular free flap. Osteocutaneous fibula free flap iowa head and neck protocols. Stepbystep mandibular reconstruction with free fibula.

The fvff technique was first developed by taylor et al. Later, the computed tomography ct scan, preoperative design. A belowknee amputation bka is a transtibial amputation that involves removing the foot, ankle joint, and distal tibia and fibula with related soft tissue structures. Whenever surgery is required to remove a tumor from ones body, free flap surgery fills the space that was the tumor once occupied. This paper describes a simplified technique for primary reconstruction of mandibular defects, including. The main goal of metoidioplasty is to give the patient malelooking genitalia and the possibility to void in standing position. The fibula free flap has become a standard treatment option for primary restoration of segmental mandibular deformities. In paediatric patients, the fvff is used chiefly for bone defects due to a tumour, infection, or trauma, although other indications include congenital pseudarthrosis of the tibia and. The term phalloplasty is also occasionally used to refer to penis enlargement the first phalloplasty done for the purposes of sexual reassignment was performed on michael dillon, a trans man, in 1946 by dr.

The fibula s anatomy lends itself to this procedure, where the bone is long and straight, and its vascular supply is radially directed. Ten distally based peroneus brevis muscle flaps were elevated in 10 patients 8 males and 2 females with major lower third leg and ankle defects that were 612 cm in length and 610 cm in width, with open book splitting of the proximal portion of the muscle. Surgical technique zmost common surgical techniques are. The reader will find useful information on all issues that are important in the surgical procedure, including the use of cadcam technology computer assisted technology, bone synthesis and flap modelling. With coverage of nearly twice the number of flaps as the previous edition, flaps and reconstructive surgery, 2 nd edition provides trainees and practicing surgeons alike with the detailed, expert knowledge required to ensure optimal outcomes. Surgical navigationassisted mandibular reconstruction. The fibula flap has been used extensively for oromandibular reconstruction. Free vascularised fibular flap harvesting in children. It is critical that fibular length, alignment and rotation are accurately restored. Microvascular surgical methods attach the small blood vessels and capillaries from the donor tissue to the host site to ensure normal blood circulation. The fibula free flap provides a long, strong segment of bone for use in reconstructive surgery.

The fibula is the longest bone flap available and can be transferred as a bone flap or in combination with one or two skin paddles. Transfer of a free vascularised fibular flap fvff is an option for treating bone defects of 5 cm or more in children. The pedicle runs the length of the fibula, with perforators extending to supply the skin paddle. Openbook splitting of a distally based peroneus brevis. A novel technique to increase bone density for dental implantation in osseous reconstruction. The peroneus brevis muscle flap is a wellknown distally based safe flap that is used to cover a small defect. The surgical technique is discussed in a stepbystep fashion. The latter team harvested the flap according to the principles described by hidalgo.

If you are a seller for this product, would you like to suggest updates through seller support. Long posterior flap a burgess technique b bruckner technique 2. Most commonly used experimental flaps used in rats, including dorsal skin, flank, epigastric, oblique groin, pectoral, latissimus. Adequate assessment of the mandible for invasion by primary tumours of the oral cavity is crucial to accurate surgical treatment planning. The fibula free flap approach allows the possibility of using bone withwithout skin for restoring the defect. About book this atlas deals with the standard technique used for reconstructing the mandible and the maxilla the fibula flap. First video of a two part presentation on the technique of fibula flap osteotomy. This document is intended as an outline for the surgical technique of the repair of the fibula. Conveys information on all important issues in the surgical procedure, including the use of cadcam technology, bone synthesis and flap. Innervation of the flap is possible, and the flap has ample bone stock for the placement. The aim of this study was to evaluate the accuracy of computerassisted surgery in primary mandibular reconstruction with an iliac crest bone flap compared with an osteomyocutaneous fibula flap. Harold gillies, which is documented in pagan kennedys book. Documenting in unprecedented detail the surgical procedures, techniques, and approaches used by the experts, this new atlastext is the definitive fullcolor pictorial reference on major flap.