ABSTRACT
The free microvascular fibula and soft tissue transfer has become a widely used method for reconstruction of different regions. Donor site morbidity for free fibula microvascular flaps has generally been reported to be low, or at least acceptable. We describe the case of a patient who underwent vascularized free fibula graft harvest for mandibular reconstruction. After 21 months, he had sustained an open dislocation of the left high ankle joint during recreational sports activity. We did not found such case in the published data.
Subject(s)
Ankle Joint , Bone Transplantation/adverse effects , Fibula/transplantation , Joint Dislocations/etiology , Mandibular Neoplasms/surgery , Surgical Flaps/adverse effects , Adult , Athletic Injuries/etiology , Fibula/blood supply , Fractures, Open/etiology , Humans , Male , Mandible/pathology , Mandible/surgery , Mandibular Neoplasms/secondary , Mandibular Reconstruction/methods , Surgical Flaps/blood supply , Tissue and Organ Harvesting/adverse effectsABSTRACT
Replantation is defined as reattachment of the part that has been completely amputated and there is no connection between the severed part and the patient. In Boston in 1962 Malt successfully replanted a completely amputated arm of a 12-year-old boy. Komatsu and Tamai reported the first successful replantation of an amputated digit by microvascular technique. There are no strict indications and contraindications for replantation. It's on surgeon to explain to the patient the chances of success of viability, expected function, length of operation, hospitalization and long rehabilitation protocol. Survival and useful function in replantation of upper extremity amputations is questionable. Success depends on microvascular anastomoses, but the final function is related with tendon, nerve, bone and joint repair.
Subject(s)
Amputation, Traumatic/surgery , Finger Injuries/surgery , Hand Injuries/surgery , Replantation , Upper Extremity/surgery , Humans , Microsurgery , Microvessels/surgery , Patient Selection , Replantation/adverse effects , Replantation/methods , Upper Extremity/injuriesABSTRACT
The scaphoid is vitally important for the proper mechanics of wrist function. Fracture of the scaphoid bone is the most common carpal fracture. Among all wrist injuries the incidence of scaphoid fracture is second only to fractures of the distal radius. Scaphoid fractures are significant because a delay in diagnosis can lead to a variety of adverse outcomes that include nonunion, delayed union, decreased grips strength, range of motion and osteoarthritis of the radiocarpal joint. To avoid missing this diagnosis, a high index of suspicion and a through history and physical examination are necessary, because initial radiographs are often negative. Regardless of the technique of bone grafting, there will almost always be some loss of motion even if the fracture unites.
