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Reintroducing the latissimus-rib free flap as a long bone substitute in the reconstruction of lower extremity injuries

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Author(s): Shahram Nazerani | Amir R. Motabar

Journal: Medical Journal of the Islamic Republic of Iran
ISSN 1016-1430

Volume: 22;
Issue: 2;
Start page: 104;
Date: 2008;
Original page

Keywords: free rib flap | tibial injury | reconstruction

ABSTRACT
  Abstract   The leg is a complex district with functions of weightbearing support, stability,   and motility. The management of extensive and complex defects is more challenging   and often results in leg amputation or shortening. Leg amputation is a severe   mutilation that alters the patient’s work and social life by limiting ambulation and   self-sufficiency. During a 3 years period we treated four patients with leg injury   consisting of tibial defect who underwent one-stage surgery for soft tissue and bone   reconstruction. The follow-up period was from 31 to 36 months. Time to bony union   ranged from 4 to 7 months. Time to full weight bearing was from 5 to 9 months after   operation. All of the transferred tissue showed hypertrophy after weight bearing.   Nonunion & abscess occurred in one case. Arterial thrombosis & valgus deformity   were other postoperation complications. The limb was shorter by an average of 0.5   cm in three cases, longer by 1.1 cm in one case, and in the last case, it was not measurable. Other disabling complications were not seen. We believe that this forgotten   method can be a valuable alternative to other techniques such as free fibula flap in   certain cases that the surgeon can reconstruct bone & soft tissue defects in one stage.  
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