부산대학교 도서관

Background: The free vascularized fibula flap (FVFF) has proven a versatile means of reconstruction since its first description. Its broad spectrum of applications includes limb and craniofacial reconstruction following oncological resection and trauma. Methods: A retrospective chart review was carried out on patients undergoing FVFF reconstruction in our centre between 1993 and 2021. The surgical indication, intraoperative technique and post-operative outcomes were recorded. A systematic review was conducted using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) guidelines specifically regarding long bone reconstruction with FVFF in adult patients. This enabled a comparison to parameters assessed in our case series as well as a recently published systematic review on FVFF reconstruction in the paediatric population. Results: In our centre, 15 patients underwent FVFF reconstruction for indications including osteomyelitis and following tumour resection. Mean time to bony union of the FVFF was 7 months and we report a low incidence of post-operative complications. In the systematic review we identified 369 adult patients across 47 studies. The most common indications for FVFF were tumour resection or traumatic bone loss. A quarter of patients had reconstructions incorporating a bony allograft in addition to the FVFF. The mean time to union was 6 months. Functional evaluation using patient reported scoring systems demonstrated excellent results with low rates of donor site morbidity. Conclusions: This systematic review highlights the versatility of the FVFF in long bone reconstruction of the limbs. This review provides clarification on the low morbidity associated with this procedure and the high functional outcomes as reported by the patients themselves. Level of evidence: Level IV, Risk/Prognostic; Therapeutic. [ABSTRACT FROM AUTHOR]