Autologous double barrel vascularized fibular bone graft for reconstruction after hemi resection of mandible due to ameloblastoma: Surgical case report.

INTRODUCTION: Mandibular abnormalities caused by ameloblastoma present significant surgical and reconstructive difficulties. This study investigates double barrel fibular bone graft to correct these abnormalities and improve mandibular function and appearance. CASE PRESENTATION: A 28-year-old male presented with a mandibular lump and facial asymmetry. The radiographic and histologic examination detected was subsequently diagnosed as ameloblastoma. After undergoing a hemi mandibulectomy procedure, a free vascularized fibular bone graft was harvested from the patient's left leg and transplanted to reconstruct the mandibular angle. The evaluation of the patient's functional outcomes was assessed utilising the University of Washington Quality of Life (UW-QOL) questionnaire. The patient UW - QOL Score has increased 62.5 pre-treatment to 93.75 post-treatment. DISCUSSION: The suggested strategy to treating aggressive ameloblastomas is radical surgery, involving the use of wide resection and following bone reconstruction. Vascularized grafts, including the double-barrel fibular bone graft, are usually preferred in relation to mandibular defect reconstruction for their ability to offer improved stability, height, and thickness, which enhances functional results. In contrast to conventional approaches, our case did not show any signs of facial deformities or bone resorption. The utilization of the vascularized fibular bone graft proved to be a valuable option for early rehabilitation in patients with mandibular continuity defects, offering promising outcomes in terms of patient well-being and quality of life. This final result provides proof supporting the potential of this technique for managing mandibular defects. CONCLUSION: Double-barrel fibular bone grafts and dental rehabilitation can restore mandibular continuity defect from ameloblastoma.

Longstanding Volkmann ischemic contracture of the forearm following traditional bonesetter practice successfully treated with combined flexor origin slide and tendon transfer: A case report.

INTRODUCTION AND IMPORTANCE: The Volkman ischemic contracture (VIC) of the forearm is a sequel of the compartment syndrome of the forearm. There were no studies reported the outcome of surgical treatment for VIC, particularly the muscle origin slide procedure, in treating the VIC that had been developed more than 20 years. CASE PRESENTATION: We reported a 34 years old right-hand dominant painter with fingers flexion contracture, decreased hand mobility and sensation on her right hand. She had history of closed right forearm fracture when she was 10 years old that was treated by a traditional bonesetter. A week afterward, she experienced clinical presentation of compartment syndrome. Not long thereafter, the pain subsided but she started to have stiffness and discomfort in her forearm and hand condition. Twenty-four years later, she wants to get treatment for her hand. We diagnosed her with VIC, moderate degree based on Tsuge Classification. We then performed flexor origin slide procedure and tendon transfer. In 1.5 year of follow-up, a satisfactory functional outcome was noted. CLINICAL DISCUSSION: Flexor origin slide was the preferred treatment if the flexors still retain adequate strength. During the surgery, severe degeneration of FPL and FDP was found. Therefore, we performed tendon transfer to increase the grip strength. CONCLUSION: VIC is not uncommon following fracture treated in the traditional bonesetter. For moderate VIC, the flexor origin slide procedure and tendon transfer could still give benefit, even in the case of treatment delay of more than 20 years from onset.