TY - JOUR
T1 - Reconstruction of the pelvic ring with vascularized double-strut fibular flap following internal hemipelvectomy
AU - Chang, David W.
AU - Fortin, Amanda J.
AU - Oates, Scott D.
AU - Lewis, Valerae O.
PY - 2008/6
Y1 - 2008/6
N2 - BACKGROUND: After internal hemipelvectomy, successful pelvic reconstruction can provide a durable and pain-free reconstruction for the young, active patient. Such reconstruction is extremely challenging, and often patients have less than optimal ambulation with a limp, leg length discrepancy, or leg instability. The authors present an innovative method for pelvic ring reconstruction using a vascularized double-strut fibular bone flap that provides a stable pelvis and recovery of normal or near-normal gait. METHODS: From December of 2003 to November of 2005, six sarcoma patients underwent internal hemipelvectomy and pelvic ring reconstruction with a vascularized double-strut fibular bone flap. The length of each strut was 7 to 12 cm. RESULTS: All bone flaps survived. The mean follow-up was 18 months (range, 8 to 32 months). Radiographic evidence of bone bridging was seen at a mean of 2.5 months (range, 2 to 4 months). The mean time to ambulation without assistance was 8 months (range, 5 to 18 months). One patient died as a result of metastatic disease. The remaining five patients are ambulatory with a mild limp or no limp. CONCLUSION: Use of a vascularized double-strut fibular bone flap for pelvic ring reconstruction is effective in facilitating early ambulation and restoring normal to near-normal gait in patients undergoing internal hemipelvectomy.
AB - BACKGROUND: After internal hemipelvectomy, successful pelvic reconstruction can provide a durable and pain-free reconstruction for the young, active patient. Such reconstruction is extremely challenging, and often patients have less than optimal ambulation with a limp, leg length discrepancy, or leg instability. The authors present an innovative method for pelvic ring reconstruction using a vascularized double-strut fibular bone flap that provides a stable pelvis and recovery of normal or near-normal gait. METHODS: From December of 2003 to November of 2005, six sarcoma patients underwent internal hemipelvectomy and pelvic ring reconstruction with a vascularized double-strut fibular bone flap. The length of each strut was 7 to 12 cm. RESULTS: All bone flaps survived. The mean follow-up was 18 months (range, 8 to 32 months). Radiographic evidence of bone bridging was seen at a mean of 2.5 months (range, 2 to 4 months). The mean time to ambulation without assistance was 8 months (range, 5 to 18 months). One patient died as a result of metastatic disease. The remaining five patients are ambulatory with a mild limp or no limp. CONCLUSION: Use of a vascularized double-strut fibular bone flap for pelvic ring reconstruction is effective in facilitating early ambulation and restoring normal to near-normal gait in patients undergoing internal hemipelvectomy.
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U2 - 10.1097/PRS.0b013e3181706ff2
DO - 10.1097/PRS.0b013e3181706ff2
M3 - Article
C2 - 18520887
AN - SCOPUS:48049112440
SN - 0032-1052
VL - 121
SP - 1993
EP - 2000
JO - Plastic and reconstructive surgery
JF - Plastic and reconstructive surgery
IS - 6
ER -