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Soleus-fibula free transfer in lower limb reconstruction
P Pelissier1, V Casoli, E Demiri
1Service de Chirurgie Plastique, Hôpital Pellegrin, Bordeaux, France. philippe.pelissier@chu-aquitaine.fr
Plastic and Reconstructive Surgery
|March 4, 2000
Summary
Free-fibula transfer, with soleus muscle, offers a reliable solution for extensive lower limb bone and soft tissue defects. This composite flap ensures constant vascularization and minimal donor site sequelae.
Area of Science:
- Orthopedic Surgery
- Microsurgery
- Reconstructive Surgery
Background:
- Free-fibula transfer is a well-established technique for limb reconstruction.
- Existing methods have undergone modifications to improve outcomes.
- Composite flaps offer potential for addressing complex defects.
Purpose of the Study:
- To evaluate the efficacy of a modified free-fibula flap incorporating the soleus muscle.
- To assess the reliability and outcomes of this composite flap for extensive lower limb defects.
Main Methods:
- A series of 14 patients undergoing free-fibula transfer with associated soleus muscle (lateral or whole) were reviewed.
- Minimum 2-year follow-up was conducted.
- Data on defect size, fibula length, healing time, and functional recovery were collected.
Main Results:
- Average bone defect: 12 cm; average fibula harvested: 18.6 cm.
- Successful reconstruction in 13 out of 14 patients.
- Mean bone healing time: 11 months; average return to ambulation: 17 months.
- Minimal donor site morbidity was observed.
Conclusions:
- The composite free-fibula flap with soleus muscle is a reliable and effective option for extensive lower limb reconstruction.
- This technique provides consistent vascularization and good functional recovery.
- The soleus muscle component enhances vascular security and preserves bone supply.