Does fibula free flap harvesting affect donor site of patients in facial reconstructions: a gait analysis study.
Journal of Oral and Maxillofacial Surgery(2024)
摘要
Backround
Vascularized fibula free flap remains gold standard for reconstruction of bony defects of the maxilla or mandible. Research and publications in recent years essentially focused on the evolution and improvement of the recipient reconstructed area but very few concerning the donor site morbidity.
Purpose
The aim of this study was to analyze walking ability of patients following vascularized fibula free flap (VFFF) operation and to determine if there are long term walking disabilities.
Study design
The retrospective cohort study involved healthy controls and patients who had undergone VFFF between 2012 and 2019 at the oral and maxillo-facial department of the University Hospital in Lausanne, Switzerland. Patients with cardiovascular, pulmonary, neuromuscular or musculoskeletal pathologies that could impair walking were excluded from the study.
Predictor/exposure/independent variables
Primary predictor is the reconstruction status, vascularized fibula free flap (VFFF) vs healthy patients (controls)
Main outcome variables
Main outcomes were gait parameters. Objective evaluation of walking abilities was assessed using the Gait up ® system (Gait Up SA, EPFL Innov’Park-C, Lausanne Switzerland), which are wearable motion sensors that provides 3D analytics of the gait.
Covariates
Covariates implied patient characteristics such as age, sex, time after surgery and subjective evaluation of the gait obtained with two orthopedic validated questionnaires.
Results
This study implied 10 healthy controls and 11 patients who had undergone VFFF. Results showed statistically significant differences in the speed [m/s] (1.3 vs 1.1 for a p-value of 0.001) , the stride length [m] (1.4 vs 1.2 for a p-value of 0.003), the flat foot phase [%] (55.0 vs 63.3 for a p-value of 0.006) and the pushing phase [%] (34.1 vs 25.1 for a p-value of 0.008).
Conclusion and Relevance
Reconstruction using vascularized autograft in maxillofacial surgery is substantial and well described. Our attention focusing on donor site morbidity has demonstrated subjective and objective long-term alterations. These results will have to be confirmed with gait analysis in a prospective project including pre-operative and post-operative analysis of the gait of the patient acting himself as his own control, with a larger scale of patients.
更多查看译文
关键词
Vascularized fibula free flap,walking,Gait up®,Maxillo-facial
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要