ABSTRACT
A case is presented of an 18-year-old athlete with fibrous dysplasia of the femoral neck and head. The approach was by joint plastic and orthopaedic teams, which minimized operating time and allowed the option of vascular bone grafting. The lesion was curetted through a greater trochanteric window and the defect reconstructed with a free vascularized fibula graft with excellent result. Weight bearing was achieved in six months and there was minimal donor site morbidity. We believe the free vascularized fibula graft to be a reconstructive option, in difficult orthopaedic problems, facilitated by microsurgery and there is immense benefit of a joint effort between the orthopaedic and plastic surgical teams
Subject(s)
Humans , Adolescent , Femur Head/pathology , Bone Cysts/surgery , Fibula/transplantation , Femur Head Necrosis/surgery , Bone Transplantation/methods , Femur Head , Bone Cysts/pathology , Bone Cysts , Microsurgery , Femur Head Necrosis/pathology , Femur Head Necrosis , Plastic Surgery Procedures , Transplantation, AutologousABSTRACT
We present a case of a failed bipedicled (unilateral rectus flap with superior epigastric pedicle preserved and inferior epigastric vessels anastomosed to the thoracodorsal trunk as the second pedicle) transverse rectus abdominis muscle flap that had compromised the dominant pedicle of the latissimus dorsi muscle. A salvage procedure was possible using this muscle as a pedicle flap based on the back-flow from the serratus anterior arterial branch with success. The use of the reconstructive ladder is highlighted
Subject(s)
Humans , Female , Middle Aged , Surgical Flaps , Rectus Abdominis/blood supply , Rectus Abdominis/surgery , Arteries/surgery , Reoperation , Salvage TherapyABSTRACT
The radial forearm free flap is one of the most commonly used free flaps in reconstructive surgery. It is a recognized option for facial reconstruction internationally, but, to our knowledge, it has not been widely used in the Caribbean. We present a patient who posed a difficult reconstructive problem, for which the radial forearm free flap was the ideal solution, utilizing the flap's features of a long length of pedicle, large area of coverage, minimal tissue bulk, and options for further cosmetic revision
Subject(s)
Humans , Female , Adolescent , Plastic Surgery Procedures , Facial Injuries/surgery , Surgical Flaps , West IndiesABSTRACT
An audit was conducted of pedicled flaps used in reconstructive surgery in Trinidad from 1983 to 2000. This consisted of 65 flaps. There were four cases of partial flap necrosis: three involving tram flaps and the other involving the metacarpal artery flap. There were no cases of total flap loss. Pedicled flap coverage provides immediate closure of potentially difficult wounds. This early cover reduces the risk of infection as a result of increasing the blood supply and providing a physical barrier. This contributes to a shorter hospital stay and earlier rehabilitation. Our present team approach with the inclusion of a reconstructive surgeon now allows for uncompromised dÚbridement in trauma and oncological resection.