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Wheeless' Textbook of Orthopaedics

Wheeless' Textbook of Orthopaedics

C.R. Wheeless MD

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Wheeless' Textbook of Orthopaedics

Limb Reconstruction by Free-Tissue Transfer Combined With the Ilizarov Method.

Jupiter-Jesse-B. Kour-Anam-K. Palumbo-Mark-D. Yaremchuk-Michael-J.

From the Department of Orthopaedic Surgery and the Division of

Plastic and Reconstructive Surgery, Department of General Surgery, at

Massachusetts General Hospital. Received for publication December

11, 1990. Revised April 4, 1991.

Plastic and Reconstructive Surgery. 1991 Dec. 88(6). pp 943-951.

In four complex cases of extremity reconstruction, we have been able

to overcome the problems of combined bone and soft-tissue loss and

length discrepancy by a combination of free-tissue transfer and the

Ilizarov method of slow distraction. It is our observation that

gradual distraction of a free tissue is a safe and viable procedure;

the free tissue tolerates the pins of the circular external fixator

well, and there is an equal degree of distraction and regeneration of

the transferred free tissue and the native recipient tissue without

evidence of wound dehiscence. Corticotomy through free tissue and in

close proximity to vascularized bone is safe, with the subsequent

bone regeneration not unlike that of normal bone. Manipulation by

slow distraction does not appear to compromise the vasculature of the

recipient bed for later microsurgical procedures or endanger the

axial flow pattern of the transferred free tissue.


Limb Reconstruction by Free-Tissue Transfer Combined With the Ilizarov Method.

Jupiter-Jesse-B. Kour-Anam-K. Palumbo-Mark-D. Yaremchuk-Michael-J.

From the Department of Orthopaedic Surgery and the Division of

Plastic and Reconstructive Surgery, Department of General Surgery, at

Massachusetts General Hospital. Received for publication December

11, 1990. Revised April 4, 1991.

Plastic and Reconstructive Surgery. 1991 Dec. 88(6). pp 943-951.

In four complex cases of extremity reconstruction, we have been able

to overcome the problems of combined bone and soft-tissue loss and

length discrepancy by a combination of free-tissue transfer and the

Ilizarov method of slow distraction. It is our observation that

gradual distraction of a free tissue is a safe and viable procedure;

the free tissue tolerates the pins of the circular external fixator

well, and there is an equal degree of distraction and regeneration of

the transferred free tissue and the native recipient tissue without

evidence of wound dehiscence. Corticotomy through free tissue and in

close proximity to vascularized bone is safe, with the subsequent

bone regeneration not unlike that of normal bone. Manipulation by

slow distraction does not appear to compromise the vasculature of the

recipient bed for later microsurgical procedures or endanger the

axial flow pattern of the transferred free tissue.

 
 
 
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