ABSTRACT
To summarize the application of enhanced recovery after surgery (ERAS) principles in treating long bone defect with free fibula graft (FVFG). Methods From January, 2012 to January, 2017, ERAS principles were applied in 26 cases of long bone defect treating with vascularized fibula flap graft, via a series of com-prehensive measures, including strengthening psychological nursing, nutrition support and pain management, optimiz-ing operation plan, and early scientific functional exercise. Surgical duration, hospital stay time, satisfaction of pa-tients, postoperative visual analogue scale (VAS) score, bone defect healing time, and Enneking score were recorded through regular outpatient follow-up after discharge. Results The average length of surgical duration and hospital stay time was(3.2±0.5) h and (10.2±1.2) d, respectively. Discharged satisfaction was greater than 95%. Postoperative VAS score was less than 3. During the follow-up period of 1.6-6.0 years, 26 fibular flap survived, and all the bone defect were healed, with an average healing time of (5.5±0.6) months.Followed-up at 1.5 years after the operation, the upper limb function of 7 patients increased by 80.1%, and the lower limb function of 19 patients increased by 82.5%. Conclusion The application of ERAS in treating long bone defect with FVFG can obtain satisfactory limb function, alleviate patients’pain, shorten the duration of hospitalization, promote the rehabilitation and satisfaction of patients.
ABSTRACT
Objective To summarize the clinical experience of treating long bone defect with vascularized fibular graft.Methods From January,2008 to January,2015,31 cases of long bone defect were treated with vascularized fibula composite or not composite tissue flap graft.The length of transplanted fibula was 9-20 cm,and the flap area was 5 cm×3 cm to 21 cm×14 cm.All patients were followed up regularly.Limb function was assessed 12 months after surgery.Results Thirty-one cases of vascularized fibular flap survived after surgery.Thirty patients were followed up for 1.5 to 6 years (average,2.5 years).One patient was lost to follow-up.The bone defects of patients followed up were healed.There was one case fracture occurred for trauma,was treated with plaster cast for 6 months and healed.The transplanted fibular thickened for 1.3 to 2.5 years(average,1.6 years).Conclusion Vascularized fibular graft can reconstruct long bone defect for single use and shorten the duration of treatment with a good limb function.For cases combined soft tissue defect,vascularized fibula composite tissue flap can be applied to repair at the meantime.