Reconstruction of the pelvic ring with vascularized double-strut fibular flap following internal hemipelvectomy.
| Autor: | Chang DW; Houston, Texas From the Departments of Plastic Surgery and Surgical Oncology, University of Texas M. D. Anderson Cancer Center., Fortin AJ, Oates SD, Lewis VO |
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| Jazyk: | angličtina |
| Zdroj: | Plastic and reconstructive surgery [Plast Reconstr Surg] 2008 Jun; Vol. 121 (6), pp. 1993-2000. |
| DOI: | 10.1097/PRS.0b013e3181706ff2 |
| Abstrakt: | Background: After internal hemipelvectomy, successful pelvic reconstruction can provide a durable and pain-free reconstruction for the young, active patient. Such reconstruction is extremely challenging, and often patients have less than optimal ambulation with a limp, leg length discrepancy, or leg instability. The authors present an innovative method for pelvic ring reconstruction using a vascularized double-strut fibular bone flap that provides a stable pelvis and recovery of normal or near-normal gait. Methods: From December of 2003 to November of 2005, six sarcoma patients underwent internal hemipelvectomy and pelvic ring reconstruction with a vascularized double-strut fibular bone flap. The length of each strut was 7 to 12 cm. Results: All bone flaps survived. The mean follow-up was 18 months (range, 8 to 32 months). Radiographic evidence of bone bridging was seen at a mean of 2.5 months (range, 2 to 4 months). The mean time to ambulation without assistance was 8 months (range, 5 to 18 months). One patient died as a result of metastatic disease. The remaining five patients are ambulatory with a mild limp or no limp. Conclusion: Use of a vascularized double-strut fibular bone flap for pelvic ring reconstruction is effective in facilitating early ambulation and restoring normal to near-normal gait in patients undergoing internal hemipelvectomy. |
| Databáze: | MEDLINE |
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