Background: Extensive loss of soft tissue and bone due to neoplasia, trauma, or infection in extremities often leads to amputation.
Case Presentation: We present the case of a 72-year-old female patient presenting with an extended cutaneous squamous cell carcinoma of the lower leg, developed on top of necrobiosis lipoidica. After achieving the R0 resection, a 26 × 20-cm soft tissue and 15-cm tibial bone defect resulted. The contralateral leg had been lost due to the same disease 18 years before. We achieved a successful reconstruction of the leg using a pedicled fibula transplantation, an extended anterolateral thigh perforator flap, and an internal fixation with plate and screws. Two years after the original surgery, the patient is relapse-free and mobile, with adequate function of the reconstructed foot.
Conclusions: Our case presented a unique combination of pedicled fibula transplantation and free extended ALT perforator flap to reconstruct an extensive defect after resection of a rare cSCC on top of NL. In selected cases, the boundaries of limb salvage can be pushed far beyond the current standards of treatment.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9901077 | PMC |
| http://dx.doi.org/10.1186/s12957-023-02923-z | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The vascular supply to the lateral compartment of the leg with emphasis on fibular flap harvesting.
Surg Radiol Anat
January 2025
Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.
Purpose: The aim of this study is to determine the exact locations of vascular pedicles that supply the fibularis longus and brevis, to identify the morphometric features of those vessels in the lateral compartment of the leg, and to indicate the branching points of the pedicles from the main arteries.
Methods: The popliteal arteries of 40 lower limbs from 20 adult cadavers (12 males, 8 females) were bilaterally injected with colored latex. After dissection, the branches of the arteries were identified and counted.
Evaluation of the results of reconstruction of large bony defects of humerus using vascularized bone grafts.
J Hand Microsurg
March 2025
Department of Orthopedics Surgery and Traumatology, Faculty of Medicine, Assiut University, Assiut, Egypt.
Background: Vascularized bone grafts (VBGs) are currently the main surgical option for the restoration of humeral bone defects particularly when defects are larger than 6 cm. Because it offers a strong, rapid blood supply, VBGs easily integrate into the recipient sites and undergo active resorption and remodeling into healthy bone through primary bone healing. Additionally, they support the recipient site's immune system in preventing and reducing infection.
View Article and Find Full Text PDFCombination of Vascularized and Non-vascularized Fibula Free Flap With Dermofat Graft for Maxilla and Mandibula Reconstruction After Malignant Spindle Cell Tumor Resection.
J Craniofac Surg
January 2025
Department of Plastic Reconstructive and Aesthetic Surgery, Airlangga University-Dr. Soetomo General Hospital Surabaya, Surabaya, East Java.
The spindle cell tumor is a variant of sarcomatoid carcinoma that mostly affects the oral cavity. Bone involvement in this tumor leads to a wide excision, which sometimes requires resection of both the maxilla and mandible. The maxilla and mandible are important bones that function to form the 3-dimensional dimensions of the facial bones.
View Article and Find Full Text PDFSingle-Double-Single Barrel (1-2-1) Fibula Free Flap Design for Functional and Esthetic Brown Class III Mandibular Reconstruction.
Plast Reconstr Surg
January 2025
Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong.
This novel hybrid single-double-single barrel (1-2-1) design for fibula free flap reconstruction addresses the unique challenges presented by Brown Class III mandibular defects, which involve long-span defects at both bodies of the mandible and the chin. The importance of this design lies in its ability to overcome the limitations of traditional approaches in terms of mandible height and pedicle length, while optimizing both functional and esthetic outcomes.The technique utilizes a combination of single-double-single barrel fibula segments to achieve ideal esthetics and support for dental prosthesis across different areas of the mandible.
View Article and Find Full Text PDFPedicle ossification following mandibular reconstruction using fibular free flap in a patient with osteoradionecrosis of the jaw: a case report.
J Korean Assoc Oral Maxillofac Surg
December 2024
Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
Article Synopsis
- Pedicle ossification is a rare complication that can occur after using a fibular free flap (FFF) for mandibular reconstruction, potentially simulating tumor recurrence and leading to diagnostic challenges.
- A case study of a 38-year-old male with squamous cell carcinoma highlighted how postoperative complications led to the need for FFF reconstruction, and over 4 years, CT scans showed ossification in the flap's vascular pedicle, yet the patient remained asymptomatic.
- Regular imaging and clinical assessments are key to distinguishing ossification from tumor recurrence, with surgery usually only considered if symptoms arise.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!