Does Fibula Free Flap Harvesting Affect Donor Site of Patients in Facial Reconstructions: A Gait Analysis Study.

Details

Serval ID
serval:BIB_CCB8D40A1035
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Does Fibula Free Flap Harvesting Affect Donor Site of Patients in Facial Reconstructions: A Gait Analysis Study.
Journal
Journal of oral and maxillofacial surgery
Author(s)
Denys E., Pincet L., Lambercy K., Broome M., May L.
ISSN
1531-5053 (Electronic)
ISSN-L
0278-2391
Publication state
Published
Issued date
06/2024
Peer-reviewed
Oui
Volume
82
Number
6
Pages
728-733
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Vascularized fibula free flap (VFFF) remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity.
The aim of this study was to analyze walking ability of patients following VFFF operation and to determine if there are long term walking disabilities.
The retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study.
Primary predictor is the reconstruction status, VFFF versus healthy patients (controls).
Main outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait Up system (Gait Up SA, EPFL Innov'Park-C, Lausanne, Switzerland), which are wearable motion sensors that provides 3D analytics of the gait.
Covariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires.
This study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a P value of .001), the stride length [m] (1.4 vs 1.2 for a P value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a P value of .006) and the pushing phase [%] (34.1 vs 25.1 for a P value of .008).
Reconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including preoperative and postoperative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.
Keywords
Humans, Free Tissue Flaps, Fibula/transplantation, Male, Female, Retrospective Studies, Middle Aged, Gait Analysis, Transplant Donor Site/surgery, Adult, Plastic Surgery Procedures/methods, Aged, Tissue and Organ Harvesting/methods, Gait/physiology
Pubmed
Web of science
Create date
02/04/2024 9:33
Last modification date
26/07/2024 7:01
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