Total calcaneal reconstruction using a massive bone allograft and a distally pedicled osteocutaneous fibula flap: A novel technique to prevent amputation after calcaneal malignancy
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Total calcaneal reconstruction using a massive bone allograft and a distally pedicled osteocutaneous fibula flap : A novel technique to prevent amputation after calcaneal malignancy. / Hamrouni, Nizar; Højvig, Jens Hjermind; Petersen, Michael Mørk; Hettwer, Werner; Jensen, Lisa Toft; Bonde, Christian Torsten.
I: Journal of Plastic, Reconstructive and Aesthetic Surgery, Bind 76, 2023, s. 44-48.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Total calcaneal reconstruction using a massive bone allograft and a distally pedicled osteocutaneous fibula flap
T2 - A novel technique to prevent amputation after calcaneal malignancy
AU - Hamrouni, Nizar
AU - Højvig, Jens Hjermind
AU - Petersen, Michael Mørk
AU - Hettwer, Werner
AU - Jensen, Lisa Toft
AU - Bonde, Christian Torsten
N1 - Publisher Copyright: © 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons
PY - 2023
Y1 - 2023
N2 - In patients with primary calcaneal malignancies, such as Ewing's sarcoma, radical treatment with amputation of the foot can result in serious functional impairment and chronic pain. Total calcanectomy followed by the reconstruction of the calcaneal defect offers an alternative treatment to amputation. Capanna et al. described a technique for successfully reconstructing long limb segmental bone defects using a free fibula flap placed within the intramedullary canal of an allograft. We present both a review of the literature on calcaneal reconstruction and describe how the principles of Capanna can be adapted to reconstruct the calcaneus. Total calcanectomy due to Ewing's sarcoma and the subsequent application of this novel reconstructive technique was performed in two young patients aged 5 and 16 years. The reconstruction was achieved by inserting a distally pedicled osteocutaneous fibula flap within the reamed canal of an allograft and placing the composite in the calcaneal defect. Reconstruction was successful with complete bone union between the allograft and the adjacent bone. There were no fractures or infections and both flaps survived. Functional outcome was assessed with a physiotherapist at a follow-up period of 2 years postoperatively, showing near-normal ambulance. This novel technique proved excellent as a limb salvage procedure, avoiding amputation, and offering a satisfactory oncological and functional outcome.
AB - In patients with primary calcaneal malignancies, such as Ewing's sarcoma, radical treatment with amputation of the foot can result in serious functional impairment and chronic pain. Total calcanectomy followed by the reconstruction of the calcaneal defect offers an alternative treatment to amputation. Capanna et al. described a technique for successfully reconstructing long limb segmental bone defects using a free fibula flap placed within the intramedullary canal of an allograft. We present both a review of the literature on calcaneal reconstruction and describe how the principles of Capanna can be adapted to reconstruct the calcaneus. Total calcanectomy due to Ewing's sarcoma and the subsequent application of this novel reconstructive technique was performed in two young patients aged 5 and 16 years. The reconstruction was achieved by inserting a distally pedicled osteocutaneous fibula flap within the reamed canal of an allograft and placing the composite in the calcaneal defect. Reconstruction was successful with complete bone union between the allograft and the adjacent bone. There were no fractures or infections and both flaps survived. Functional outcome was assessed with a physiotherapist at a follow-up period of 2 years postoperatively, showing near-normal ambulance. This novel technique proved excellent as a limb salvage procedure, avoiding amputation, and offering a satisfactory oncological and functional outcome.
KW - Calcaneal reconstruction
KW - Fibula flap
KW - Heel
KW - Lower limb
KW - Microsurgery
KW - Oncology
KW - Orthoplastic approach
KW - Pediatric
KW - Pedicled flap
KW - Reconstruction
KW - Sarcoma
U2 - 10.1016/j.bjps.2022.10.039
DO - 10.1016/j.bjps.2022.10.039
M3 - Journal article
C2 - 36516510
AN - SCOPUS:85143666687
VL - 76
SP - 44
EP - 48
JO - Journal of plastic, reconstructive & aesthetic surgery : JPRAS
JF - Journal of plastic, reconstructive & aesthetic surgery : JPRAS
SN - 1748-6815
ER -
ID: 363268734