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Assessment of donor site morbidity for free radial forearm osteocutaneous flaps

Identifieur interne : 003D39 ( Main/Exploration ); précédent : 003D38; suivant : 003D40

Assessment of donor site morbidity for free radial forearm osteocutaneous flaps

Auteurs : Catherine F. Sinclair [États-Unis] ; John P. Gleysteen [États-Unis] ; Terence M. Zimmermann [États-Unis] ; Mark K. Wax [États-Unis] ; Babak Givi [États-Unis] ; Daniel Schneider [États-Unis] ; Eben L. Rosenthal [États-Unis]

Source :

Microsurgery [ 0738-1085 ] ; 2012-05.

RBID : ISTEX:767081B6F7EB008C58E61FB541F2FFABEFC28BE3

English descriptors

Abstract

Purpose: Assessment of donor site morbidity and recipient site complications following free radial forearm osteocutaneous flap (FRFOCF) harvest and evaluation of patient perceived upper limb disability for free radial forearm osteocutaneous versus fasciocutaneous flaps (FRFF). Methods: First a case series was undertaken of 218 patients who underwent an FRFOCF at two tertiary referral centers between February 1998 and November 2010. Outcomes included forearm donor site morbidity and recipient site complications. Second, the disability of the arm, shoulder, and hand (DASH) questionnaire assessing patient perceived arm disability was administered by phone to 60 consecutive patients who underwent an FRFOCF or FRFF. Results: Mean patient age was 63 years with male predominance (62.8%). Median bone length harvested was 8 cm (range, 3–12 cm) with prophylactic plating of the radius following harvest. Donor site morbidity included fracture (1 patient, 0.5%) and sensory neuropathy (5 patients, 2.3%). Mean DASH scores were comparative between groups and to established normative values. Mandibular malunion rate was 3.2% and hardware extrusion at the recipient site occurred in 15.6%. Conclusion: Reluctance to perform FRFOCF by surgeons usually centers on concerns regarding potential donor site morbidity and adequacy of available bone stock; however, we identified minimal objective or patient perceived donor site morbidity or recipient site complications following harvest of FRFOCFs. Mild wrist weakness and stiffness are common but do not impede ability to perform activities of daily living. Data from this and other reports suggest this flap is particularly useful for midfacial and short segment mandibular reconstruction. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.

Url:

DOI: 10.1002/micr.21950

Affiliations:

Le document en format XML

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<term>Bone length</term>
<term>Bone stock</term>
<term>Bular</term>
<term>Categorical variables</term>
<term>Consecutive patients</term>
<term>Current series</term>
<term>Dash questionnaire</term>
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<term>Dental implantation</term>
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<term>Donor site</term>
<term>Donor site morbidity</term>
<term>Early reports</term>
<term>Extrusion</term>
<term>Fasciocutaneous</term>
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<term>Forearm</term>
<term>Forearm donor site morbidity</term>
<term>Forearm fasciocutaneous</term>
<term>Forearm osteocutaneous</term>
<term>Fracture</term>
<term>Frff</term>
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<term>Frff patients</term>
<term>Frfocf</term>
<term>Frfocf group</term>
<term>Frfocf harvest</term>
<term>Frfocf patients</term>
<term>Graft</term>
<term>Hardware extrude</term>
<term>Hardware extrusion</term>
<term>Household chores</term>
<term>Implantation</term>
<term>Light bulb</term>
<term>Male predominance</term>
<term>Malunion</term>
<term>Mandibular</term>
<term>Mild wrist weakness</term>
<term>Minimal objective</term>
<term>Morbidity</term>
<term>Nancial barriers</term>
<term>Neck defects</term>
<term>Neck surgery</term>
<term>Nondominant hand</term>
<term>Normative</term>
<term>Normative values</term>
<term>Operative characteristics</term>
<term>Oral maxillofac surg microsurgery</term>
<term>Oregon health</term>
<term>Oromandibular reconstruction</term>
<term>Osteocutaneous</term>
<term>Other reports</term>
<term>Patient selfreport</term>
<term>Plast</term>
<term>Plast reconstr surg</term>
<term>Plating</term>
<term>Plating system</term>
<term>Potential donor site morbidity</term>
<term>Prophylactic</term>
<term>Prophylactic plating</term>
<term>Radial defect</term>
<term>Radial diameter</term>
<term>Radial forearm</term>
<term>Radial fracture</term>
<term>Recipient site</term>
<term>Recipient site complications</term>
<term>Recipient site function</term>
<term>Reconstruction plate</term>
<term>Science university</term>
<term>Segmental mandibular defects</term>
<term>Sensory neuropathy</term>
<term>Skin graft failure</term>
<term>Standard deviation</term>
<term>Surg</term>
<term>Upper limb disability</term>
<term>Wiley periodicals</term>
</keywords>
<keywords scheme="Teeft" xml:lang="en"><term>Available bone stock</term>
<term>Bone length</term>
<term>Bone stock</term>
<term>Bular</term>
<term>Categorical variables</term>
<term>Consecutive patients</term>
<term>Current series</term>
<term>Dash questionnaire</term>
<term>Dash scores</term>
<term>Defect</term>
<term>Dental implantation</term>
<term>Dental restoration</term>
<term>Donor</term>
<term>Donor site</term>
<term>Donor site morbidity</term>
<term>Early reports</term>
<term>Extrusion</term>
<term>Fasciocutaneous</term>
<term>Fasciocutaneous frff</term>
<term>Forearm</term>
<term>Forearm donor site morbidity</term>
<term>Forearm fasciocutaneous</term>
<term>Forearm osteocutaneous</term>
<term>Fracture</term>
<term>Frff</term>
<term>Frff group</term>
<term>Frff patients</term>
<term>Frfocf</term>
<term>Frfocf group</term>
<term>Frfocf harvest</term>
<term>Frfocf patients</term>
<term>Graft</term>
<term>Hardware extrude</term>
<term>Hardware extrusion</term>
<term>Household chores</term>
<term>Implantation</term>
<term>Light bulb</term>
<term>Male predominance</term>
<term>Malunion</term>
<term>Mandibular</term>
<term>Mild wrist weakness</term>
<term>Minimal objective</term>
<term>Morbidity</term>
<term>Nancial barriers</term>
<term>Neck defects</term>
<term>Neck surgery</term>
<term>Nondominant hand</term>
<term>Normative</term>
<term>Normative values</term>
<term>Operative characteristics</term>
<term>Oral maxillofac surg microsurgery</term>
<term>Oregon health</term>
<term>Oromandibular reconstruction</term>
<term>Osteocutaneous</term>
<term>Other reports</term>
<term>Patient selfreport</term>
<term>Plast</term>
<term>Plast reconstr surg</term>
<term>Plating</term>
<term>Plating system</term>
<term>Potential donor site morbidity</term>
<term>Prophylactic</term>
<term>Prophylactic plating</term>
<term>Radial defect</term>
<term>Radial diameter</term>
<term>Radial forearm</term>
<term>Radial fracture</term>
<term>Recipient site</term>
<term>Recipient site complications</term>
<term>Recipient site function</term>
<term>Reconstruction plate</term>
<term>Science university</term>
<term>Segmental mandibular defects</term>
<term>Sensory neuropathy</term>
<term>Skin graft failure</term>
<term>Standard deviation</term>
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<term>Upper limb disability</term>
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<front><div type="abstract" xml:lang="en">Purpose: Assessment of donor site morbidity and recipient site complications following free radial forearm osteocutaneous flap (FRFOCF) harvest and evaluation of patient perceived upper limb disability for free radial forearm osteocutaneous versus fasciocutaneous flaps (FRFF). Methods: First a case series was undertaken of 218 patients who underwent an FRFOCF at two tertiary referral centers between February 1998 and November 2010. Outcomes included forearm donor site morbidity and recipient site complications. Second, the disability of the arm, shoulder, and hand (DASH) questionnaire assessing patient perceived arm disability was administered by phone to 60 consecutive patients who underwent an FRFOCF or FRFF. Results: Mean patient age was 63 years with male predominance (62.8%). Median bone length harvested was 8 cm (range, 3–12 cm) with prophylactic plating of the radius following harvest. Donor site morbidity included fracture (1 patient, 0.5%) and sensory neuropathy (5 patients, 2.3%). Mean DASH scores were comparative between groups and to established normative values. Mandibular malunion rate was 3.2% and hardware extrusion at the recipient site occurred in 15.6%. Conclusion: Reluctance to perform FRFOCF by surgeons usually centers on concerns regarding potential donor site morbidity and adequacy of available bone stock; however, we identified minimal objective or patient perceived donor site morbidity or recipient site complications following harvest of FRFOCFs. Mild wrist weakness and stiffness are common but do not impede ability to perform activities of daily living. Data from this and other reports suggest this flap is particularly useful for midfacial and short segment mandibular reconstruction. © 2012 Wiley Periodicals, Inc. Microsurgery, 2012.</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Alabama</li>
<li>Oregon</li>
</region>
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<tree><country name="États-Unis"><region name="Alabama"><name sortKey="Sinclair, Catherine F" sort="Sinclair, Catherine F" uniqKey="Sinclair C" first="Catherine F." last="Sinclair">Catherine F. Sinclair</name>
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<name sortKey="Givi, Babak" sort="Givi, Babak" uniqKey="Givi B" first="Babak" last="Givi">Babak Givi</name>
<name sortKey="Gleysteen, John P" sort="Gleysteen, John P" uniqKey="Gleysteen J" first="John P." last="Gleysteen">John P. Gleysteen</name>
<name sortKey="Rosenthal, Eben L" sort="Rosenthal, Eben L" uniqKey="Rosenthal E" first="Eben L." last="Rosenthal">Eben L. Rosenthal</name>
<name sortKey="Rosenthal, Eben L" sort="Rosenthal, Eben L" uniqKey="Rosenthal E" first="Eben L." last="Rosenthal">Eben L. Rosenthal</name>
<name sortKey="Rosenthal, Eben L" sort="Rosenthal, Eben L" uniqKey="Rosenthal E" first="Eben L." last="Rosenthal">Eben L. Rosenthal</name>
<name sortKey="Schneider, Daniel" sort="Schneider, Daniel" uniqKey="Schneider D" first="Daniel" last="Schneider">Daniel Schneider</name>
<name sortKey="Wax, Mark K" sort="Wax, Mark K" uniqKey="Wax M" first="Mark K." last="Wax">Mark K. Wax</name>
<name sortKey="Zimmermann, Terence M" sort="Zimmermann, Terence M" uniqKey="Zimmermann T" first="Terence M." last="Zimmermann">Terence M. Zimmermann</name>
</country>
</tree>
</affiliations>
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Assessment of donor site morbidity for free radial forearm osteocutaneous flaps

Assessment of donor site morbidity for free radial forearm osteocutaneous flaps

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