• Title/Summary/Keyword: Fibula

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Sequential treatment from mandibulectomy to reconstruction on mandibular oral cancer - Case review II: mandibular anterior and the floor of the mouth lesion of basaloid squamous cell carcinoma and clear cell odontogenic carcinoma

  • Yang, Jae-Young;Hwang, Dae-Seok;Kim, Uk-Kyu
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.216-223
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    • 2021
  • Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I-III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I-III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.

Condyle dislocation following mandibular reconstruction using a fibula free flap: complication cases

  • Kang, Sang-Hoon;Lee, Sanghoon;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.14.1-14.10
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    • 2019
  • Background: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. Cases presentation: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. Conclusion: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.

Treatment of Bone Tumor with Free Vascularized Fibular Graft (유리혈관부착 비골 이식술을 이용한 골종양의 치료)

  • Hahn, Soo-Bong;Choei, Joung-Hyuk;Koh, Young-Gon
    • Archives of Reconstructive Microsurgery
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    • v.4 no.1
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    • pp.43-51
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    • 1995
  • In certain low-grade malignant bone tumors such as chondrosarcoma or frequent recurrent benign bone tumors as ossifying fibroma, radical treatment may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free vascularized bone graft a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defect with excellent clinical results. We tried wide excision and free vascularized fibula graft in 5 patients with ossifying fibroma and one patient with chondrosarcoma from January 1984 to December 1994 and followed for more one year. The shortest bony defect was 7cm and the longest bony defect was 20cm and mean bony defect was 13cm. All patients were evaluated clinically and roentgenographycally on basis of functional recovery and bony union. All patients showed satisfactory functional recovery with sound bony union and showed bony hypertrophy. And, local recurrence was not seen.

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Reconstruction of Wrist Joint Using Vascularized Free Fibular Head Graft After the Wide Tumor Excision of Distal Radius (원위 요골 악성 종양의 광범위 절제술 후 혈행성 유리 비골 두 이식을 이용한 수근관절 재건술)

  • Song, Seok-Whan;Lee, Yoon-Min
    • Archives of Reconstructive Microsurgery
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    • v.20 no.1
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    • pp.82-88
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    • 2011
  • Vascularized free fibula head transfer is an established method for reconstruction of long bone defects of the upper limb involving the distal radius or the proximal humerus. For the wrist following tumor resection, in cases of resection of the radial articular surface, three reconstructive options are possible: 1. fibular head transfer to replace the radial joint surface, 2. fixation of the fibula to the scaphoid and lunate, 3. complete wrist fusion. The decision on the type of the operation depends on the amount of the resection and the remained normal anatomical structures, and also the necessity of function of the wrist in the future. The authors believe that the vascularized free fibula head graft is a safe and reliable method for reconstructing the upper limb, especially for patients with a defect of the distal radius, and report the operative methods, donor vascular consideration, complications, and functional result after this operation.

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The Effect of Complex Korean Medical Treatment for Tibia, Fibula and Patellar Fractures in Patient with Sequelae of Poliomyelitis: A Case Report (경비골, 슬개골 동시 골절된 소아마비 후유증 환자에 대한 한방복합치료 1례)

  • Chae-Young Kim;Ji-Su Choi;Hee-Duk An
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.2
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    • pp.173-180
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    • 2024
  • Objectives The purpose of this study is to report the effects of Korean medicine treatment on tibia, fibula, and patellar fractures with sequelae of poliomyelitis. Methods A 64-year-old male patient was treated with acupuncture, herbal medicine, cupping, moxibustion, and exercise treatment for 59 days after open reduction and internal fixation and tension band wiring surgery. The effects were evaluated using a visual analog scale (VAS), manual muscle testing (MMT), range of motion (ROM), Western Ontario and McMaster Universities (WOMAC), and EuroQol-5 dimension (EQ-5D) index. Results After treatment, VAS decreased from 7 to 2. MMT, ROM, WOMAC, EQ-5D and walking ability were improved. Conclusions This case study suggests that Korean medicine treatment could be effective for tibia, fibula, patellar fractures in patients with sequelae of poliomyelitis.

A Efficacy of Ginseng radix on the Preservation of Spinal Bone Mineral Density and Bone Inorganic Substance of Oophorectomized Rats

  • Byun, Boo-hyeong;Seo, Bu-il
    • Preventive Nutrition and Food Science
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    • v.8 no.3
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    • pp.245-248
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    • 2003
  • This study was undertaken to investigate the effects of the Ginseng radix in osteoporosis of the oophorectomized rats. In this experiment, the rats were oophorectomized and administered the water extracts of the Ginseng radix. The spinal bone mineral density, calcium, phosphorus and ash weight of the bones were measured. The spinal bone mineral density was significantly increased in the ovariectomized (OVX)-Ginseng radix group at 8 weeks as compared to the OVX-saline group. Furthermore, the calcium and phosphorus contents of the femoral and fibula-tibia were significantly increased in the OVX-Ginseng radix group as compared to the OVX-saline group. The ash weights of the femoral and fibula-tibial bones were increases in the OVX-Ginseng Radix group, although it was not statistically significant. On reviewing these experiments, it appears that the Ginseng radix possess efficacy for the prevention of osteoporosis. Further study would be of value to confirm the efficacy of the Ginseng radix for the treatment and/or prevention of osteoporosis in humans.

Mandibular Reconstruction using Simulation Surgery with 3D RP Model in Osteoradionecrosis Patient: A Case Report

  • Park, Tae-Jun;Kim, Hong-Joon;Ahn, Kang-Min
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.76-79
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    • 2015
  • One of the most serious complications after head and neck radiation is osteoradionecrosis (ORN) of the jaw. The etiology of ORN is extraction, minor dental procedure or dental implant surgery. When ORN of the jaw progressed to stage III, free fibular flap is the most useful methods for reconstruction. In this case report, a 67-year-old ORN patient who underwent fibular free flap reconstruction using simulation surgery with 3-dimensional rapid prototype (3D RP) model was reviewed. After partial mandibulectomy, a osteocutaneous fibula flap was used for reconstruction. Oro-cutaneous fistula was resolved after operation. Patients reported improved food intake after operation without pus discharge. Functional and esthetic results showed successful reconstruction.

Ankle Arthrodesis Using Auto Fibula Bone Graft: Two Cases Report (자가 비골이식술을 이용한 족관절 유합술: 2예 보고)

  • Yi, Chang-Ho;Yoon, Won-Sik;Oh, Jin-Rok
    • Journal of Korean Foot and Ankle Society
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    • v.15 no.2
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    • pp.102-106
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    • 2011
  • Recently, development and improvement in joint replacement therapy, the need for arthrodesis has been decreasing. However, result of joint replacement is not always satisfactory, and most cases are rather indicative to ankle arthrodesis than ankle replacement. Often, ankle arthrodesis can be more beneficial salvage method to treat cases with failure in joint replacement therapy, talar avascular necrosis with massive bone defect, talus fracture with severe comminution and bone defect and ankle dislocation. In cases with large bone defect that need to be treated with ankle arthrodesis using internal fixation, it is difficult to fill the defect with conventional auto-iliac bone or all-bone graft. Thus, we make a report on our experience in treating 2 cases with ankle arthrodesis using auto-fibular bone graft and plate fixation.

Intramedullary fibula strut bone allograft in a periprosthetic humeral shaft fracture with implant loosening after total elbow arthroplasty

  • Jo, Young-Hoon;Lee, Seung Gun;Kook, Incheol;Lee, Bong Gun
    • Clinics in Shoulder and Elbow
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    • v.23 no.3
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    • pp.152-155
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    • 2020
  • Periprosthetic fracture after total elbow replacement surgery is a difficult complication to manage, especially when it comes together with implant loosening. If stem revision and internal fixation of the periprosthetic fracture are performed simultaneously, this would be a very challenging procedure. Most of total elbow replacement implants are cemented type. Cement usage at periprosthetic fracture site may interfere healing of fractured site. Authors underwent internal fixation with use of locking plate and cerclage wire for periprosthetic fracture, allogenous fibular strut bone inserted into the humerus intramedullary canal allowing the fractured site to be more stable without cement usage. At 10-month follow-up, the complete union and good clinical outcome was achieved. We present a novel technique for treating periprosthetic fracture with implant loosening after total elbow replacement surgery, using intramedullary allogenous fibula strut bone graft.