Thoracic limb salvage by fibular free flap
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Date
2020-01
Journal Title
Journal ISSN
Volume Title
Publisher
Medip Academy
Abstract
The treatment of most fractures of the ulna and radius is usually performed by anatomical reduction and internal fixation, when damage is extensive and local soft tissue cannot provide a complete wound coverage, locoregional flaps present a suitable reconstructive benefit. A 35-year-old male patient suffered an exposed diaphysio-metaphyseal fracture with multi-fragmented distal radius. The patient was evaluated during a 10-day period at the National Institute of Rehabilitation, where the osteosynthesis material and a severe infectious process with necrosis were identified. Necrosectomy of the posterior compartment and removal of the osteosynthesis material was performed, a skin defect of approximately 22x16 cm was observed with a bone gap of 6 cm of radius and ulna. a fibula-free flap is placed to correct the skin defect and an external fixative used for bone alignment. The fibular free flap presents an excellent therapeutic alternative in the resolution of bone gaps with extensive skin defect. Whenever a trained microsurgery team is available, current scales of limb injury should be considered but not utilized for therapeutic approach, always trying to shift amputation as the first option, to the very last one of them.
Description
Keywords
Amputation, Complex trauma, Fibular free flap, Fracture, Microsurgery, Microvascular flap
Citation
Ruiz Rodrigo Banegas, Treviño Alan I. Valderrama, Mendoza Francisco Fabián Gómez, Aceves Rodrigo A. Mendoza, Hernández Rigoberto Román, Alba Ismael Vejar, Verdejo Fernando Gómez, Montero José Antonio Rivas, López Karolina Ortega, Caprielova Yuri Jiménez, Arteaga Leonel Dalain Hernández, Ortega Emilio Pérez, Mera Baltazar Barrera. Thoracic limb salvage by fibular free flap. International Journal of Research in Medical Sciences. 2020 Jan; 8(1): 351-354