eMedicine Specialties > Plastic Surgery > Lower Extremity Reconstruction

Lower Extremity Reconstruction, Tibia: Follow-up

Author: Fabio Santanelli, MD, PhD, Associate Professor of Plastic Surgery, University of Rome; Chief of Unita Operativa Dipartimentale di Chirurgia Plastica, Azienda Ospedaliera, Sant'Andrea, Rome
Coauthor(s): Francesca Romana Grippaudo, MD, Assistant Professor, Unit of Plastic Surgery, 2nd Medical Faculty, Sapienza University of Rome, Italy; Guido Paolini, MD, Plastic Surgery Unit, Assistant Professor of Plastic Surgery, Sant'Andrea Hospital- University of Rome La Sapienza -Italy; Luca Francesco Renzi, MD, PhD, Staff Physician, Department of Plastic Surgery, University of Rome Policlinico Umberto I, Italy
Contributor Information and Disclosures

Updated: Jun 27, 2008

Outcome and Prognosis

Lee and Park reported a 93% success rate in the reconstruction of extensive tibial fractures with free vascularized fibula flaps.12 Of 46 patients, 43 achieved bone union after an average of 3.75 months (range of 3-7 mo) from surgery. Partial weightbearing was started after bone union with the aid of crutches or splints.

Free fibular transplantation following cancer resection often achieves lower success rates than the same procedure used for traumas.

In 1992, Han and coworkers reported the results of 69 patients affected by bone cancer who underwent tibial resection and reconstruction with the free fibula; 46 patients (67%) obtained bone union, while another 10 needed a further procedure for bone union, bringing the success rate to 81%.13

Han and coworkers also reported the results of 60 patients affected by chronic osteomyelitis who were treated with free contralateral fibula flaps and achieved a primary union success rate of 48%.13 After a second procedure, the final success rate was 77%.

In 1983, Weiland et al reported a bone union rate of 60% in 13 patients.14 Free fibula transplantation remained the technique of choice for congenital pseudoarthrosis. Gilbert and Wood reported 43 cases of congenital pseudoarthrosis treated with free fibula protibia from 1976-1992, some of whom were operated on several times and observed for up to 5 years, with a final success rate of 91%.15 Morrissy and colleagues reported lower success rates in 40 patients, with a union rate of 55%.16

 


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References
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References

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Further Reading

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Keywords

tibial reconstruction, tibia reconstruction, lower leg reconstruction, leg reconstruction, cancellous bone grafting, external fixation, leg amputation, tibial injury, tibia injury, vascularized fibular transfer, complex tibia fracture, complex tibial fracture, tibia fracture, tibial fracture, traumatic fracture, bone tumor, osteomyelitis, pseudoarthrosis, pseudo-arthrosis, cosmetic surgery, leg reconstruction, flap graft, muscle flap, muscle-skin flap, musculocutaneous flap, cutaneous flap

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Contributor Information and Disclosures

Author

Fabio Santanelli, MD, PhD, Associate Professor of Plastic Surgery, University of Rome; Chief of Unita Operativa Dipartimentale di Chirurgia Plastica, Azienda Ospedaliera, Sant'Andrea, Rome
Fabio Santanelli, MD, PhD is a member of the following medical societies: American Society of Plastic and Reconstructive Surgery, European Association of Plastic Surgeons, and International Confederation for Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Francesca Romana Grippaudo, MD, Assistant Professor, Unit of Plastic Surgery, 2nd Medical Faculty, Sapienza University of Rome, Italy
Francesca Romana Grippaudo, MD is a member of the following medical societies: International Confederation for Plastic and Reconstructive Surgery
Disclosure: Nothing to disclose.

Guido Paolini, MD, Plastic Surgery Unit, Assistant Professor of Plastic Surgery, Sant'Andrea Hospital- University of Rome La Sapienza -Italy
Disclosure: Nothing to disclose.

Luca Francesco Renzi, MD, PhD, Staff Physician, Department of Plastic Surgery, University of Rome Policlinico Umberto I, Italy
Disclosure: Nothing to disclose.

Medical Editor

Christian Paletta, MD, FACS, Professor, Division Chief and Program Director, Department of Plastic and Reconstructive Surgery, St Louis University School of Medicine
Christian Paletta, MD, FACS is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Burn Association, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

B Sekhar Chandrasekhar, MD, Associate Professor, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Southern California
B Sekhar Chandrasekhar, MD is a member of the following medical societies: American Association of Plastic Surgeons, American College of Surgeons, American Society for Reconstructive Microsurgery, and California Medical Association
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

 
 
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